Method of Assessing Skin Cancerization and KeratosesTM (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

被引：7

作者：

Baker, Christopher ^{[1
,2
]}

James, Amelia ^{[1
]}

Supranowicz, Madeleine ^{[3
]}

Spelman, Lynda ^{[3
]}

Shumack, Stephen ^{[4
,5
]}

Cole, Judith ^{[6
]}

Weightman, Warren ^{[7
]}

Sinclair, Robert ^{[3
]}

Foley, Peter ^{[1
,2
,8
]}

机构：

[1] St Vincents Hosp Melbourne, Dept Dermatol, 41 Victoria Parade, Fitzroy, Vic 3065, Australia

[2] Univ Melbourne, Dept Med, Melbourne, Vic, Australia

[3] Specialist Connect Serv, Brisbane, Qld, Australia

[4] Univ Sydney, Sydney Med Sch, Sydney, NSW, Australia

[5] Royal North Shore Hosp, Dept Dermatol, Sydney, NSW, Australia

[6] St John God Hosp, Dept Dermatol, Subiaco, WA, Australia

[7] Queen Elizabeth Hosp, Dept Dermatol, Woodville, SA, Australia

[8] Skin Hlth Inst, Prob Med Res, Melbourne, Vic, Australia

来源：

CLINICAL AND EXPERIMENTAL DERMATOLOGY | 2022年 / 47卷 / 06期

关键词：

ACTINIC KERATOSIS; SOLAR KERATOSES; RELIABILITY; CANCER; AGREEMENT; CONSENSUS; AREA;

D O I：

10.1111/ced.15136

中图分类号：

R75 [皮肤病学与性病学];

学科分类号：

100206 ;

摘要：

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 (TM) (MASCK (TM)), 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.

引用

页码：1144 / 1153

页数：10