Felicity Reilly is the main author, and participant of the Academic Primary Care Research Group; the scholar has six publications at the University of Aberdeen connected to neuroscience, clinical trials methodology, diabetes, and cognitive behavioral therapy. Reilly and Walter (2021) participated in research and evaluation related to various spheres of medicine. They analyzed the data and provided the manuscript for other credited authors to manage the feedback on the final manuscript.
The Purpose of the Study
The purpose of the study is to evaluate the digital intervention’s effectiveness in supporting skin self-examination for cutaneous melanoma.
Purpose of the Article
The target audience of this article is doctors and potential patients with melanoma. As stated by the study, melanoma survivors still require immunotherapies and long-term surveillance of their health condition. Because of the possible remission of cancer, adequate examinations and tests are highly needed to prevent significant social and psychological consequences for the patients. Two tests are analyzed in this research paper: Total Skin Examination (TSSE) and Achieving Self-Directed Integrated Cancer Aftercare (ASICA) (Reilly et al., 2021). The first test implies that it can help to detect cancer earlier, but it is ineffective. The second intervention helps to prompt and improve the TSSE.
Research Questions
- Is the ASICA teledermatology method effective in facilitating prompt referral to GPs and secondary care clinics for concerning melanoma cases submitted by melanoma survivors?
- To what extent are people prone to use digital diagnosis rather than common TSSE?
Review of the Literature
Research provides a wide range of existing literature analyses on melanoma. To present the case study and demographics, scholars use melanoma statistics, Information Services Division NHS on melanoma statistics until 2020. The study provides various perspectives on cancer treatment; the literature review by Reilly et al. (2021) shows melanoma has a high risk of relapse. To prove this point, the authors apply the results study on increased risks of second cancers after the melanoma diagnosis. Reilly et al. (2021) present a clinical review of follow-up practices and surveillance after surviving cutaneous melanoma. Scholars provide results on systemic therapy of cancer.
Moreover, the diagnosis rate for melanoma survivors is the same as that of adults without a cancer history. There is a need for a more progressive method of diagnosis. Mainly authors are concerned with the rurality of the patients and the possibility of them staying in the villages or small cities without the opportunity to visit oncologists or related specialists every day.
Population, Sample Size, and Sample Selection Process
Melanoma is rising in cases across the US: it is the second most common disease for people under 50. The sample size for intervention was 121 recruited melanoma patients who had received ASICA for 12 months. Patients were selected on the criteria of being older than 18, who had melanoma, and completed treatment within the previous 60 months. The stage of cutaneous melanoma had to be 0-2C.
Research Methods Used in the Study
Dependent Variables were the number of reporting occasions and concerns included per the report, the number of resolutions of concern, and the identification rate of melanoma. Independent Variables included participant demographics like gender, age, rurality, and data recorded like concerned areas of the body. In addition, the quality of the skin picture submitted, additional documents submitted, and DNP assessment of concern. The researchers used an existing data pool collected out of reported melanoma concerns.
The concerns were tabulated and displayed using Microsoft Excel and SPSS. The reports were divided on the methodology that patients use to report any skin concerns for melanoma. The primary tool was the ASICA; researchers were looking for the number of successful report cases within the existing demographic range. The criteria for evaluation included the quality of skin photographs submitted, reports’ frequency, and the DNP’s clinical assessments. The study also used the subsequent judgments and doctors’ decisions on melanoma. The control variable was the significant events that had occurred during the study.
Research Findings
The results covered the number of digital diagnosis users, the number of photographs, and doctors’ conclusions. Out of 121 recruited melanoma survivors that had received ASICA for 12 months, only 69 participants submitted 123 reports detailing 189 separate skin-related concerns and including 188 skin photographs (Reilly et al., 2021). Most cases were resolved remotely, while 19 required secondary care clinic (Reilly et al., 2021). Over half of the participants were rural-dwellers, which addresses the lack of healthcare in rural areas. However, the digital identification of melanoma was complicated due to the bad quality of the photographs. Additional photographs had to be requested for further examination.
Article Critique
The limitations of the article are the shortage of provided results and the regulation of demographics. The article mentions that many participants did not submit their photographs for further examination. The article does not discuss the possible requirements for the format and quality of the pictures, while those are the main drawbacks of the digital examination.
Discussion of How the Information in the Article Might be Useful in Future Nursing Practice
The study aimed to evaluate the ASICA digital tool’s performance and test the population’s readiness for novel digital intervention. It was a sizeable two-centered feasibility trial of DNP examining the previously treated melanoma remotely. The implication of ASICA in future nursing would connect underserved communities and those in rural settings. Rural citizens would require a teledermatology because they cannot get a professional face-to-face evaluation with a dermatologic specialist. It is an opportunity to enhance digital healthcare delivery and ease the burden on hospitals. This further supports the digitalization and optimization of the tested tool for diagnosing melanoma.
Reference
Reilly, F., Contstable, L., Brant, W., Rahman, K., Durrani, A., Burrows, N., Proby C., Allan J., Johnston M., Walter F. & Murchie, P. (2021). Achieving integrated self-directed Cancer aftercare (ASICA) for melanoma: how a digital intervention to support total skin self-examination was used by people treated for cutaneous melanoma. BMC Cancer, 21(1), 1-15.