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Method of Assessing Skin Cancerization and Keratoses(TM) (MASCK™): development and photographic validation in multiple anatomical sites of a novel assessment tool intended for clinical evaluation of patients with extensive skin field cancerization

BACKGROUND: A range of ‘field‐directed’ treatments is available for the management of extensive skin field cancerization (ESFC), but to date, the only validated objective quantitative tools are limited to assessment of actinic keratoses (AKs) affecting the head. AIMS: To develop a versatile quantita...

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Autores principales: Baker, Christopher, James, Amelia, Supranowicz, Madeleine, Spelman, Lynda, Shumack, Stephen, Cole, Judith, Weightman, Warren, Sinclair, Robert, Foley, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9313559/
https://www.ncbi.nlm.nih.gov/pubmed/35150158
http://dx.doi.org/10.1111/ced.15136
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author Baker, Christopher
James, Amelia
Supranowicz, Madeleine
Spelman, Lynda
Shumack, Stephen
Cole, Judith
Weightman, Warren
Sinclair, Robert
Foley, Peter
author_facet Baker, Christopher
James, Amelia
Supranowicz, Madeleine
Spelman, Lynda
Shumack, Stephen
Cole, Judith
Weightman, Warren
Sinclair, Robert
Foley, Peter
author_sort Baker, Christopher
collection PubMed
description BACKGROUND: A range of ‘field‐directed’ treatments is available for the management of extensive skin field cancerization (ESFC), but to date, the only validated objective quantitative tools are limited to assessment of actinic keratoses (AKs) affecting the head. AIMS: To develop a versatile quantitative instrument for objective clinical assessment of ESFC and perform initial internal validation across multiple anatomical zones. METHODS: The study comprised instrument development, pilot testing and instrument refinement and two rounds of reliability and inter‐rater validation testing. The study was noninterventional and used a convenience sample of de‐identified patient photographs selected based on preset criteria. An expert panel developed the instrument and scoring system via a modified Delphi voting process. A sample of 16 healthcare professionals from multiple specialties undertook the pilot testing, and a panel of seven dermatologists were involved in validation testing. Validation was determined by assessment of overall inter‐rater agreement using Gwet chance‐corrected agreement coefficients (ACs). RESULTS: The instrument produced, called the Method for Assessing Skin Cancer and Keratoses™ (MASCK™), comprises the Skin Field Cancerization Index (SFCIndex), derived from area of skin involvement and AKs (number and thickness), a global assessment score and a cancer‐in‐zone score, and uses Likert scales for quantitative scoring. The SFCIndex is a composite score comprising the number and thickness of AKs multiplied by area of skin involvement. ACs for the SFCIndex components, the overall SFCIndex score and the global assessment score were > 0.80 (rated ‘almost perfect’) while the AC for the cancer‐in‐zone metric was lower (0.33, rated ‘fair’). Internal consistency was demonstrated via positive correlation between the overall SFCIndex score and the global assessment score. CONCLUSIONS: Our study found near‐perfect agreement in inter‐rater reliability when using MASCK to assess the severity of ESFC in multiple anatomical sites. Further validation of this novel instrument is planned to specifically assess its reliability, utility and feasibility in clinical practice.
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spelling pubmed-93135592022-07-30 Method of Assessing Skin Cancerization and Keratoses(TM) (MASCK™): development and photographic validation in multiple anatomical sites of a novel assessment tool intended for clinical evaluation of patients with extensive skin field cancerization Baker, Christopher James, Amelia Supranowicz, Madeleine Spelman, Lynda Shumack, Stephen Cole, Judith Weightman, Warren Sinclair, Robert Foley, Peter Clin Exp Dermatol Original Articles BACKGROUND: A range of ‘field‐directed’ treatments is available for the management of extensive skin field cancerization (ESFC), but to date, the only validated objective quantitative tools are limited to assessment of actinic keratoses (AKs) affecting the head. AIMS: To develop a versatile quantitative instrument for objective clinical assessment of ESFC and perform initial internal validation across multiple anatomical zones. METHODS: The study comprised instrument development, pilot testing and instrument refinement and two rounds of reliability and inter‐rater validation testing. The study was noninterventional and used a convenience sample of de‐identified patient photographs selected based on preset criteria. An expert panel developed the instrument and scoring system via a modified Delphi voting process. A sample of 16 healthcare professionals from multiple specialties undertook the pilot testing, and a panel of seven dermatologists were involved in validation testing. Validation was determined by assessment of overall inter‐rater agreement using Gwet chance‐corrected agreement coefficients (ACs). RESULTS: The instrument produced, called the Method for Assessing Skin Cancer and Keratoses™ (MASCK™), comprises the Skin Field Cancerization Index (SFCIndex), derived from area of skin involvement and AKs (number and thickness), a global assessment score and a cancer‐in‐zone score, and uses Likert scales for quantitative scoring. The SFCIndex is a composite score comprising the number and thickness of AKs multiplied by area of skin involvement. ACs for the SFCIndex components, the overall SFCIndex score and the global assessment score were > 0.80 (rated ‘almost perfect’) while the AC for the cancer‐in‐zone metric was lower (0.33, rated ‘fair’). Internal consistency was demonstrated via positive correlation between the overall SFCIndex score and the global assessment score. CONCLUSIONS: Our study found near‐perfect agreement in inter‐rater reliability when using MASCK to assess the severity of ESFC in multiple anatomical sites. Further validation of this novel instrument is planned to specifically assess its reliability, utility and feasibility in clinical practice. John Wiley and Sons Inc. 2022-03-22 2022-06 /pmc/articles/PMC9313559/ /pubmed/35150158 http://dx.doi.org/10.1111/ced.15136 Text en © 2022 The Authors. Clinical and Experimental Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Baker, Christopher
James, Amelia
Supranowicz, Madeleine
Spelman, Lynda
Shumack, Stephen
Cole, Judith
Weightman, Warren
Sinclair, Robert
Foley, Peter
Method of Assessing Skin Cancerization and Keratoses(TM) (MASCK™): development and photographic validation in multiple anatomical sites of a novel assessment tool intended for clinical evaluation of patients with extensive skin field cancerization
title Method of Assessing Skin Cancerization and Keratoses(TM) (MASCK™): development and photographic validation in multiple anatomical sites of a novel assessment tool intended for clinical evaluation of patients with extensive skin field cancerization
title_full Method of Assessing Skin Cancerization and Keratoses(TM) (MASCK™): development and photographic validation in multiple anatomical sites of a novel assessment tool intended for clinical evaluation of patients with extensive skin field cancerization
title_fullStr Method of Assessing Skin Cancerization and Keratoses(TM) (MASCK™): development and photographic validation in multiple anatomical sites of a novel assessment tool intended for clinical evaluation of patients with extensive skin field cancerization
title_full_unstemmed Method of Assessing Skin Cancerization and Keratoses(TM) (MASCK™): development and photographic validation in multiple anatomical sites of a novel assessment tool intended for clinical evaluation of patients with extensive skin field cancerization
title_short Method of Assessing Skin Cancerization and Keratoses(TM) (MASCK™): development and photographic validation in multiple anatomical sites of a novel assessment tool intended for clinical evaluation of patients with extensive skin field cancerization
title_sort method of assessing skin cancerization and keratoses(tm) (masck™): development and photographic validation in multiple anatomical sites of a novel assessment tool intended for clinical evaluation of patients with extensive skin field cancerization
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9313559/
https://www.ncbi.nlm.nih.gov/pubmed/35150158
http://dx.doi.org/10.1111/ced.15136
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