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Diagnostic agreement and interobserver concordance with teledermoscopy referrals.

https://arctichealth.org/en/permalink/ahliterature290096
Source
J Eur Acad Dermatol Venereol. 2017 May; 31(5):898-903
Publication Type
Journal Article
Date
May-2017
Author
J Dahlén Gyllencreutz
J Paoli
M Bjellerup
Z Bucharbajeva
H Gonzalez
K Nielsen
C Sandberg
I Synnerstad
K Terstappen
A-M Wennberg Larkö
Author Affiliation
Department of Dermatology and Venereology, Skaraborg Hospital, Skövde, Sweden.
Source
J Eur Acad Dermatol Venereol. 2017 May; 31(5):898-903
Date
May-2017
Language
English
Publication Type
Journal Article
Keywords
Carcinoma, Squamous Cell - diagnosis
Dermoscopy - methods
Humans
Melanoma - diagnosis
Observer Variation
Referral and Consultation
Skin Neoplasms - diagnosis
Sweden
Telemedicine
Abstract
Malignant melanoma and non-melanoma skin cancers are among the fastest increasing malignancies in many countries. With the help of new tools, such as teledermoscopy referrals between primary health care and dermatology clinics, the management of these patients could be made more efficient.
To evaluate the diagnostic agreement and interobserver concordance achieved when assessing referrals sent through a mobile teledermoscopic referral system as compared to referrals sent via the current paper-based system without images.
The referral information from 80 teledermoscopy referrals and 77 paper referrals were evaluated by six Swedish dermatologists. They were asked to answer questions about the probable diagnosis, the priority, and a management decision.
Teledermoscopy generally resulted in higher diagnostic agreement, better triaging and more malignant tumours being booked directly to surgery. The largest difference between the referral methods was seen for invasive melanomas. Referrals for benign lesions were significantly more often correctly resent to primary health care with teledermoscopy. However, referrals for cases of melanoma in situ were also incorrectly resent five times. The interobserver concordance was moderate with both methods.
By adding clinical and dermoscopic images to referrals, the triage process for both benign and dangerous skin tumours can be improved. With teledermoscopy, patients with melanoma especially can receive treatment more swiftly.
PubMed ID
28150389 View in PubMed
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Incidence of cutaneous squamous cell carcinoma in coastal and inland areas of Western Sweden.

https://arctichealth.org/en/permalink/ahliterature101231
Source
Cancer Epidemiol. 2011 Aug 11;
Publication Type
Article
Date
Aug-11-2011
Author
E M Andersson
J. Paoli
G. Wastensson
Author Affiliation
Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, Sweden.
Source
Cancer Epidemiol. 2011 Aug 11;
Date
Aug-11-2011
Language
English
Publication Type
Article
Abstract
BACKGROUND: The incidence of squamous cell carcinoma (SCC) has increased in recent decades, both in Sweden and worldwide. The aim of this study was to investigate the development of SCC over time (1970-2007) in the western part of Sweden (WS), with emphasis on the incidence trends on the coast and in the inland areas. METHODS: Cancer data on SCC for different subareas in WS were obtained from the Swedish Cancer Registry. The incidence standardized for the Swedish population in 2000 was analyzed. The incidence trends were estimated and compared using regression analysis. RESULTS: The incidence was significantly higher in the coastal areas. The incidence rate in 2007 was higher for men than for women, whereas the average growth of the incidence was higher among women. CONCLUSION: This study shows that another important aspect regarding sun exposure, apart from latitude, is whether an area lies in the inland or on the coast. The higher sun exposure on the coast is associated with higher incidence of SCC. Preventive actions are needed; and perhaps extra information should be given to people living on the coast, who have a higher sun exposure.
PubMed ID
21840282 View in PubMed
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Merkel cell carcinoma incidence is increasing in Sweden.

https://arctichealth.org/en/permalink/ahliterature282080
Source
J Eur Acad Dermatol Venereol. 2016 Oct;30(10):1708-1713
Publication Type
Article
Date
Oct-2016
Author
O. Zaar
M. Gillstedt
B. Lindelöf
A-M Wennberg-Larkö
J. Paoli
Source
J Eur Acad Dermatol Venereol. 2016 Oct;30(10):1708-1713
Date
Oct-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Carcinoma, Merkel Cell - epidemiology
Female
Humans
Incidence
Male
Middle Aged
Retrospective Studies
Sweden - epidemiology
Young Adult
Abstract
Merkel cell carcinoma (MCC) is a rare aggressive neuroectodermal skin cancer with a high recurrence rate and a high mortality rate. Risk factors for MCC are reported to include high age, UV exposure, Caucasian skin type and immunosuppression. The incidence is reported to be increasing.
The purpose of this study was to describe a Swedish cohort and calculate incidence.
The study design is a retrospective cohort study of population-based data for MCC collected by the Swedish Cancer Registry to determine the incidence of MCC in Sweden and the clinical characteristics of these tumours including demographics, TNM classification, body part distribution and overall survival after diagnosis. De-identified data were collected from 1993 to 2012.
A total of 606 cases of MCC were identified during the study period. The median age was 81 years (range 21-99) and a majority, 54.4% were women but age-adjusted incidence is higher in men. The incidence (per 100,000) of MCC in Sweden in 1993-2012 increased from 0.09 to 0.20 for men and 0.12-0.17 for women, adjusted for age to the world standard population. For the both sexes, the increase was from 0.11 to 0.19 per 100 000, an increase of 73%. The most common site of the primary tumour was the head and neck, with 51.8% of the cases. The size of the tumour was
PubMed ID
27136306 View in PubMed
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Work productivity loss and indirect costs associated with new cardiovascular events in high-risk patients with hyperlipidemia: estimates from population-based register data in Sweden.

https://arctichealth.org/en/permalink/ahliterature282613
Source
Eur J Health Econ. 2016 Dec;17(9):1117-1124
Publication Type
Article
Date
Dec-2016
Author
J. Banefelt
S. Hallberg
K M Fox
J. Mesterton
C J Paoli
G. Johansson
L-Ã? Levin
P. Sobocki
S R Gandra
Source
Eur J Health Econ. 2016 Dec;17(9):1117-1124
Date
Dec-2016
Language
English
Publication Type
Article
Keywords
Adult
Anticholesteremic Agents - therapeutic use
Cardiovascular Diseases - complications - economics
Cost of Illness
Efficiency
Female
Health Care Costs - statistics & numerical data
Humans
Hyperlipidemias - complications - drug therapy
Logistic Models
Male
Middle Aged
Pensions
Registries
Retrospective Studies
Risk factors
Sick Leave
Sweden
Young Adult
Abstract
To estimate productivity loss and associated indirect costs in high-risk patients treated for hyperlipidemia who experience cardiovascular (CV) events.
Retrospective population-based cohort study conducted using Swedish medical records linked to national registers. Patients were included based on prescriptions of lipid-lowering therapy between 1 January 2006 and 31 December 2011 and followed until 31 December 2012 for identification of CV events and estimation of work productivity loss (sick leave and disability pension) and indirect costs. Patients were stratified into two cohorts based on CV risk level: history of major cardiovascular disease (CVD) and coronary heart disease (CHD) risk equivalent. Propensity score matching was applied to compare patients with new events (cases) to patients without new events (controls). The incremental effect of CV events was estimated using a difference-in-differences design, comparing productivity loss among cases and controls during the year before and the year after the cases' event.
The incremental effect on indirect costs was largest in the CHD risk equivalent cohort (n = 2946) at �3119 (P value
Notes
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PubMed ID
26607457 View in PubMed
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