ORCID Profile
0000-0001-5710-3914
Current Organisations
Institute for Maternal and Child Health, IRCCS Burlo Garofolo
,
Newcastle University
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Publisher: National Institute for Health and Care Research
Date: 11-2021
DOI: 10.3310/HTA25640
Abstract: Malignant melanoma is the fifth most common cancer in the UK, with rates continuing to rise, resulting in considerable burden to patients and the NHS. The objectives were to evaluate the effectiveness and cost-effectiveness of current and alternative follow-up strategies for stage IA and IB melanoma. Three systematic reviews were conducted. (1) The effectiveness of surveillance strategies. Outcomes were detection of new primaries, recurrences, metastases and survival. Risk of bias was assessed using the Cochrane Collaboration's Risk-of-Bias 2.0 tool. (2) Prediction models to stratify by risk of recurrence, metastases and survival. Model performance was assessed by study-reported measures of discrimination (e.g. D-statistic, Harrel's (1) The surveillance review included one randomised controlled trial. There was no evidence of a difference in new primary or recurrence detected (risk ratio 0.75, 95% confidence interval 0.43 to 1.31). Risk of bias was considered to be of some concern. Certainty of the evidence was low. (2) Eleven risk prediction models were identified. Discrimination measures were reported for six models, with the area under the operating curve ranging from 0.59 to 0.88. Three models reported calibration measures, with coefficients of ≥ 0.88. Overall performance was reported by two models. In one, the Brier score was slightly better than the American Joint Committee on Cancer scheme score. The other reported an Overall, few data of limited quality were available, and these related to earlier versions of the American Joint Committee on Cancer staging. Consequently, there was considerable uncertainty in the economic evaluation. Despite adoption of rigorous methods, too few data are available to justify changes to the National Institute for Health and Care Excellence recommendations on surveillance. However, alternative strategies warrant further research, specifically on improving estimates of incidence, progression of recurrent disease diagnostic accuracy and health-related quality of life developing and evaluating risk stratification tools and understanding patient preferences. This study is registered as PROSPERO CRD42018086784. This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in
Publisher: Elsevier BV
Date: 09-2014
Publisher: Elsevier BV
Date: 09-2014
Publisher: Public Library of Science (PLoS)
Date: 11-02-2019
Publisher: Elsevier BV
Date: 09-2014
Location: Italy
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Luca Ronfani.