TY - JOUR
T1 - Geographic disparities in diagnostic screening for metastatic uveal melanoma
AU - Gombos, Dan S.
AU - Van Quill, Kurtis R.
AU - Uusitalo, Marita
AU - O'Brien, Joan M.
N1 - Funding Information:
Supported by the Heed Ophthalmic Foundation Fellowship, Cleveland, Ohio (DSG); Hearst Foundation, Inc., San Francisco, California (MU); Knight's Templar Eye Foundation, Inc., Chicago, Illinois (MU); Research to Prevent Blindness Physician Scientist Award, New York, New York (KRVQ, JMO); That Man May See Foundation, Inc., San Francisco, California (KRVQ, JMO); Sand Hill Foundation, Menlo Park, California (KRVQ, JMO); and National Eye Institute, Bethesda, Maryland (grant nos.: R01 EY 013812-01 A1 [KRVQ, JMO], EY02162 [University of California San Francisco Department of Ophthalmology Core Grant (DSG, KRVQ, MU, JMO)]).
PY - 2004/12
Y1 - 2004/12
N2 - To evaluate current practice patterns in diagnostic screening for asymptomatic metastatic uveal melanoma. Survey. Ocular oncologists practicing in North America (United States, Canada) and Europe. Questionnaire sent to specialists participating in the Collaborative Ocular Melanoma Study (COMS) or listed in the Ophthalmic Oncology Task Force of the European Organization for Research and Treatment of Cancer. Methods used to screen patients with uveal melanoma for asymptomatic metastasis at initial presentation and follow-up. Thirty-six of 43 (84%) North American (COMS) specialists and 57 of 103 (55%) European specialists responded to the survey. At presentation, 6 of 36 (17%) North American specialists, versus 54 of 57 (95%) European specialists, performed at least one type of liver imaging study (computed tomography, magnetic resonance imaging, ultrasonography, or nuclear medicine) (P<0.0001). On follow-up, only 1 of 36 (3%) North American specialists, versus 45 of 57 (79%) European specialists, obtained a liver imaging study (P<0.0001). Thirty-six of 36 (100%) North American specialists, versus 49 of 57 (86%) European specialists, ordered chest x-rays at presentation (P<0.02). This disparity was greater at the time of follow-up, when 28 of 36 (78%) North American specialists, versus 28 of 57 (49%) European specialists, ordered chest x-rays (P<0.01). Similar proportions of specialists in North America and Europe obtained a physical examination and liver function tests at the time of presentation and on subsequent follow-up examination. Significant differences exist between ocular oncologists in North America and Europe in the use of techniques to screen for metastatic uveal melanoma. North American COMS centers rely primarily upon liver function tests and chest x-rays. The majority of European centers use liver ultrasonography at initial diagnosis and continue to do so every 6 months. Cost-effective screening protocols for patients with uveal melanoma should be designed and implemented uniformly among ocular oncologists.
AB - To evaluate current practice patterns in diagnostic screening for asymptomatic metastatic uveal melanoma. Survey. Ocular oncologists practicing in North America (United States, Canada) and Europe. Questionnaire sent to specialists participating in the Collaborative Ocular Melanoma Study (COMS) or listed in the Ophthalmic Oncology Task Force of the European Organization for Research and Treatment of Cancer. Methods used to screen patients with uveal melanoma for asymptomatic metastasis at initial presentation and follow-up. Thirty-six of 43 (84%) North American (COMS) specialists and 57 of 103 (55%) European specialists responded to the survey. At presentation, 6 of 36 (17%) North American specialists, versus 54 of 57 (95%) European specialists, performed at least one type of liver imaging study (computed tomography, magnetic resonance imaging, ultrasonography, or nuclear medicine) (P<0.0001). On follow-up, only 1 of 36 (3%) North American specialists, versus 45 of 57 (79%) European specialists, obtained a liver imaging study (P<0.0001). Thirty-six of 36 (100%) North American specialists, versus 49 of 57 (86%) European specialists, ordered chest x-rays at presentation (P<0.02). This disparity was greater at the time of follow-up, when 28 of 36 (78%) North American specialists, versus 28 of 57 (49%) European specialists, ordered chest x-rays (P<0.01). Similar proportions of specialists in North America and Europe obtained a physical examination and liver function tests at the time of presentation and on subsequent follow-up examination. Significant differences exist between ocular oncologists in North America and Europe in the use of techniques to screen for metastatic uveal melanoma. North American COMS centers rely primarily upon liver function tests and chest x-rays. The majority of European centers use liver ultrasonography at initial diagnosis and continue to do so every 6 months. Cost-effective screening protocols for patients with uveal melanoma should be designed and implemented uniformly among ocular oncologists.
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U2 - 10.1016/j.ophtha.2004.06.022
DO - 10.1016/j.ophtha.2004.06.022
M3 - Article
C2 - 15582082
AN - SCOPUS:9644268932
SN - 0161-6420
VL - 111
SP - 2254
EP - 2258
JO - Ophthalmology
JF - Ophthalmology
IS - 12
ER -