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Early detection of melanoma showed an impact on the thickness of the lesions at the time of diagnosis. One challenge is to improve the modalities.
Decrease the rate of non-compliant patients among patients referred to the dermatologist for a suspicious lesion (patients who will never go to the consultation), and reduce the time interval between the first identification of the lesion and the excision allowing the diagnosis are major issues.
Direct contact between the general practitioner (GP) and the dermatologist would probably make it possible to shorten the care pathway of patients with lesions justifying excision.
The objective is to evaluate whether contacting the dermatologist directly by telephone and e-mailing the photograph of a suspicious melanoma lesion can significantly reduce the time required for access to the consultation for the following patients: (a) referred for a suspicious lesion of melanoma by the GP (b) and having a sufficiently suspicious lesion of melanoma so that the dermatologist conclude at the need for excision (true positives).
Expected results: The procedure should shorten the care pathway for patients with melanoma and decrease the proportion of patients who do not consult the dermatologist when they were referred ("non-observing patients").
This should facilitate the identification of thinner lesions. The benefit for the patient is then direct with a survival at 5 years higher.
In public health terms, it is expected a benefit as better optimization of resources. In a situation of shortage of professionals, access to the dermatologist should be optimized by optimizing emergency access for patients who require it.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention group | Experimental | General practitioners will be invited to screen for melanoma as part of their regular consultations.
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| Control group | No Intervention | General practitioners will be invited to screen for melanoma as part of their regular consultations. General practitioners and dermatologists continue their practice in the usual way. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Taking photographs of suspicious lesions with his smartphone and sending them to the dermatologist | Other | Taking photographs of suspicious lesions with his smartphone and sending them to the dermatologist |
| Measure | Description | Time Frame |
|---|---|---|
| Time limit for consultation general practitioner / dermatologist, patients having a sufficiently suspicious lesion of melanoma | Time limit for consultation between consultation of the general practitioner and consultation with the dermatologist, for patients:
| 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Time limit for consultation general practitioner / dermatologist, patients NOT having a sufficiently suspicious lesion of melanoma | Time limit for consultation between consultation of the general practitioner and consultation with the dermatologist, for patients:
|
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Inclusion Criteria:
Patients:
Exclusion Criteria:
Patients:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital | Nantes | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38783296 | Derived | Bouton C, Schmeltz H, Leveque C, Gaultier A, Quereux G, Dreno B, Nguyen JM, Rat C. Early diagnosis of melanoma: a randomized trial assessing the impact of the transmission of photographs taken with a smartphone from the general practitioner to the dermatologist on the time to dermatological consultation. BMC Health Serv Res. 2024 May 24;24(1):660. doi: 10.1186/s12913-024-11106-9. |
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Cluster randomization of MGs corresponding to their exercise sites
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| 12 months |
| "Non-observing" patients between the 2 randomization groups | Proportion of "non-observing" patients between the 2 randomization groups. A non-observing patient is a patient who has not consulted a dermatologist within 12 months following the prescription of his or her GP. | 12 months |