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Article ; Online: Improving the effectiveness of multidisciplinary team meetings on skin cancer: Analysis of the National Cancer Research UK survey responses.

Ali, Stephen R / Dobbs, Thomas D / Jovic, Matthew / Hutchings, Hayley A / Whitaker, Iain S

Journal of plastic, reconstructive & aesthetic surgery : JPRAS

2023 Volume 82, Page(s) 141–151

Abstract: Introduction: Skin cancer is the most common form of cancer in the UK, comprising at least 25% of all new cancer diagnoses. Many patients require referral to the local or specialist skin cancer multidisciplinary team (MDT) for ongoing management. ... ...

Abstract	Introduction: Skin cancer is the most common form of cancer in the UK, comprising at least 25% of all new cancer diagnoses. Many patients require referral to the local or specialist skin cancer multidisciplinary team (MDT) for ongoing management. However, national data have shown that Specialist Skin Cancer MDTs are costly and do not currently meet NICE standards for composition and quoracy. Innovative solutions to these problems are therefore warranted. Methods: We performed a secondary comparative analysis of 3563 quantitative responses to two Cancer Research UK commissioned surveys along with subanalysis of 282 skin cancer MDT respondents. Results: Good uniformity was observed amongst skin respondents in the belief that risk stratification and prioritization of complex cases were the most important factors compared to other cancer MDT members. The most important priorities for areas requiring change to MDT working deemed by the skin MDT were 1) imaging and pathology results ready for the meeting, 2) time to discuss patients in detail, 3) clear meeting owner in charge, and 4) clear agenda, in advance of the meeting. There was agreement (median Likert score 4) amongst skin MDT respondents that patients should be placed on protocolized treatment pathways. Conclusion: The responses of skin MDT respondents analyzed in the current study support changes to meeting attendance, preparation, and protocolized streaming. In line with other studies, we support tumor-specific guidance for streamlining MDT discussions. We also encourage stakeholders to adopt an evidence-based approach to test, develop, and reassess changes in this herculean task.
MeSH term(s)	Humans ; Patient Care Team ; Skin Neoplasms/therapy ; Surveys and Questionnaires ; United Kingdom
Language	English
Publishing date	2023-03-28
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2217750-4
ISSN	1878-0539 ; 1748-6815 ; 0007-1226
ISSN (online)	1878-0539
ISSN	1748-6815 ; 0007-1226
DOI	10.1016/j.bjps.2023.01.002
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Article: The psychosocial impact of microtia and ear reconstruction: A national data-linkage study.

Jovic, Thomas H / Gibson, John A G / Jovic, Matthew / Dobbs, Thomas D / Griffiths, Rowena / Akbari, Ashley / Whitaker, Iain S

Frontiers in pediatrics

2023 Volume 11, Page(s) 1148975

Abstract: Introduction: Children with visible facial differences are believed to be at increased risk of negative psychosocial behaviours which may manifest as affective disorders. The aim of this study was to determine whether a diagnosis of microtia, and the ... ...

Abstract	Introduction: Children with visible facial differences are believed to be at increased risk of negative psychosocial behaviours which may manifest as affective disorders. The aim of this study was to determine whether a diagnosis of microtia, and the associated surgical intervention, is associated with psychosocial implications including impaired educational attainment and a diagnosis of an affective disorder. Methods: A retrospective case-control study was conducted using data linkage to identify patients in Wales with a diagnosis of microtia. Matched controls were sought on the basis of age, gender and socioeconomic deprivation status to yield a total sample size of 709. incidence was calculated using annual and geographic birth rates. Surgical operation codes were used to classify patients into those that had no surgery, autologous reconstruction or prosthetic reconstruction. Educational attainment at 11 years of age, plus a diagnosis of depression or anxiety were used as markers of adverse psychosocial outcomes and the relative risk was attained using logistic regression analyses. Results: There were no significant associations between a diagnosis of microtia and an increased risk of adverse educational attainment or a risk of an affective disorder diagnosis. Male gender and higher deprivation scores were significantly associated with poorer educational attainment, irrespective of a diagnosis of microtia. Surgical intervention of any nature was also not associated with any increased risk of adverse educational or psychosocial outcomes in microtia patients. Discussion: Microtia patients in Wales do not appear to be at greater risk of developing affective disorders or impaired academic performance as a result of their diagnosis or associated surgical intervention. Whilst reassuring, the need for appropriate support mechanisms to maintain positive psychosocial wellbeing and academic achievement in this patient cohort is reinforced.
Language	English
Publishing date	2023-04-18
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711999-3
ISSN	2296-2360
ISSN	2296-2360
DOI	10.3389/fped.2023.1148975
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Article ; Online: Personal Recovery Among People at Risk for Developing Serious Mental Health Problems: A Qualitative Systematic Review.

Jordan, Gerald / Bassetto, Stella / DeLuca, Joseph / Dobbs, Matthew F / Florence, Ana / Allemang, Brooke / O'Keeffe, Donal / Basile, Mikaela / Funaro, Melissa C / Davidson, Larry / Ben-David, Shelly / Shah, Jai

Psychiatric services (Washington, D.C.)

2024 , Page(s) appips20230133

Abstract: Objective: Personal recovery refers to a person's pursuit of a full, meaningful life despite the potentially debilitating impact of a mental illness. An evidence base describing personal recovery among people at risk for developing a mental illness is ... ...

Abstract	Objective: Personal recovery refers to a person's pursuit of a full, meaningful life despite the potentially debilitating impact of a mental illness. An evidence base describing personal recovery among people at risk for developing a mental illness is lacking, limiting the potential for mental health services to support personal recovery. To address this gap, the authors synthesized the extant research describing personal recovery among people at risk for developing a mental illness. Methods: A systematic search of several literature databases (MEDLINE, Embase, APA PsycInfo, Web of Science Core Collection, and Cochrane Library) was conducted to retrieve qualitative and case studies and first-person accounts. The Joanna Briggs Institute guidelines for systematic reviews were followed. Included studies reported on participants at variable risk for developing a schizophrenia spectrum, bipolar, major depressive, or borderline personality disorder. Articles were retrieved through a librarian-assisted search and through use of additional strategies (e.g., expert consultation). Abstracts were screened by the research team, and themes were developed by using thematic synthesis. Results: The 36 included articles were synthesized, and six themes were generated: difficulties and challenges; establishing an understanding of, and finding ways to cope with, one's mental health challenges; reestablishing a sense of agency and personhood; receiving support from people and services, as well as restoring relationships; reestablishing hope, meaning, and purpose; and overcoming stigma and destigmatizing mental illness in others. Conclusions: These findings provide a conceptual foundation that can guide future research on personal recovery and clinical interventions that foster it among people at risk for mental illness.
Language	English
Publishing date	2024-02-27
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1220173-x
ISSN	1557-9700 ; 1075-2730
ISSN (online)	1557-9700
ISSN	1075-2730
DOI	10.1176/appi.ps.20230133
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Article ; Online: Editorial: What CORR® Seeks From Papers About New Implants and Techniques.

Leopold, Seth S / Dobbs, Matthew B / Gebhardt, Mark C / Gioe, Terence J / Manner, Paul A / Porcher, Raphaël / Rimnac, Clare M / Wongworawat, Montri D

Clinical orthopaedics and related research

2022 Volume 480, Issue 10, Page(s) 1843–1845

MeSH term(s)	Biomedical Research ; Humans ; Orthopedics ; Prostheses and Implants ; Surveys and Questionnaires
Language	English
Publishing date	2022-08-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	80301-7
ISSN	1528-1132 ; 0009-921X
ISSN (online)	1528-1132
ISSN	0009-921X
DOI	10.1097/CORR.0000000000002376
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Article ; Online: Validating a novel natural language processing pathway for automated quality assurance in surgical oncology: incomplete excision rates of 34 955 basal cell carcinomas.

Ali, Stephen R / Dobbs, Thomas D / Jovic, Matthew / Strafford, Huw / Fonferko-Shadrach, Beata / Lacey, Arron S / Williams, Namor / Pickrell, William Owen / Hutchings, Hayley A / Whitaker, Iain S

The British journal of surgery

2023 Volume 110, Issue 9, Page(s) 1072–1075

MeSH term(s)	Humans ; Natural Language Processing ; Surgical Oncology ; Carcinoma, Basal Cell/pathology ; Skin Neoplasms/pathology ; Retrospective Studies
Language	English
Publishing date	2023-03-18
Publishing country	England
Document type	Journal Article
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1093/bjs/znad055
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Article ; Online: The psychosocial impact of microtia and ear reconstruction

Thomas H. Jovic / John A. G. Gibson / Matthew Jovic / Thomas D. Dobbs / Rowena Griffiths / Ashley Akbari / Iain S. Whitaker

Frontiers in Pediatrics, Vol

A national data-linkage study

2023 Volume 11

Abstract: IntroductionChildren with visible facial differences are believed to be at increased risk of negative psychosocial behaviours which may manifest as affective disorders. The aim of this study was to determine whether a diagnosis of microtia, and the ... ...

Abstract	IntroductionChildren with visible facial differences are believed to be at increased risk of negative psychosocial behaviours which may manifest as affective disorders. The aim of this study was to determine whether a diagnosis of microtia, and the associated surgical intervention, is associated with psychosocial implications including impaired educational attainment and a diagnosis of an affective disorder.MethodsA retrospective case-control study was conducted using data linkage to identify patients in Wales with a diagnosis of microtia. Matched controls were sought on the basis of age, gender and socioeconomic deprivation status to yield a total sample size of 709. incidence was calculated using annual and geographic birth rates. Surgical operation codes were used to classify patients into those that had no surgery, autologous reconstruction or prosthetic reconstruction. Educational attainment at 11 years of age, plus a diagnosis of depression or anxiety were used as markers of adverse psychosocial outcomes and the relative risk was attained using logistic regression analyses.ResultsThere were no significant associations between a diagnosis of microtia and an increased risk of adverse educational attainment or a risk of an affective disorder diagnosis. Male gender and higher deprivation scores were significantly associated with poorer educational attainment, irrespective of a diagnosis of microtia. Surgical intervention of any nature was also not associated with any increased risk of adverse educational or psychosocial outcomes in microtia patients.DiscussionMicrotia patients in Wales do not appear to be at greater risk of developing affective disorders or impaired academic performance as a result of their diagnosis or associated surgical intervention. Whilst reassuring, the need for appropriate support mechanisms to maintain positive psychosocial wellbeing and academic achievement in this patient cohort is reinforced.
Keywords	microtia ; depression ; anxiety ; education ; data science ; Pediatrics ; RJ1-570
Subject code	610
Language	English
Publishing date	2023-04-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
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Article ; Online: The epidemiology, healthcare and societal burden of basal cell carcinoma in Wales 2000-2018: a retrospective nationwide analysis.

Ibrahim, Nader / Jovic, Matthew / Ali, Stephen / Williams, Namor / Gibson, John A G / Griffiths, Rowena / Dobbs, Thomas D / Akbari, Ashley / Lyons, Ronan A / Hutchings, Hayley A / Whitaker, Iain S

The British journal of dermatology

2023 Volume 188, Issue 3, Page(s) 380–389

Abstract: Background: Basal cell carcinoma (BCC) represents the most commonly occurring cancer worldwide within the white population. Reports predict 298 308 cases of BCC in the UK by 2025, at a cost of £265-366 million to the National Health Service (NHS). ... ...

Abstract	Background: Basal cell carcinoma (BCC) represents the most commonly occurring cancer worldwide within the white population. Reports predict 298 308 cases of BCC in the UK by 2025, at a cost of £265-366 million to the National Health Service (NHS). Despite the morbidity, societal and healthcare pressures brought about by BCC, routinely collected healthcare data and global registration remain limited. Objectives: To calculate the incidence of BCC in Wales between 2000 and 2018 and to establish the related healthcare utilization and estimated cost of care. Methods: The Secure Anonymised Information Linkage (SAIL) databank is one of the largest and most robust health and social care data repositories in the UK. Cancer registry data were linked to routinely collected healthcare databases between 2000 and 2018. Pathological data from Swansea Bay University Health Board (SBUHB) were used for internal validation. Results: A total of 61 404 histologically proven BCCs were identified within the SAIL Databank during the study period. The European age-standardized incidence for BCC in 2018 was 224.6 per 100 000 person-years. Based on validated regional data, a 45% greater incidence was noted within SBUHB pathology vs. matched regions within SAIL between 2016 and 2018. A negative association between deprivation and incidence was noted with a higher incidence in the least socially deprived and rural dwellers. Approximately 2% travelled 25-50 miles for dermatological services compared with 37% for plastic surgery. Estimated NHS costs of surgically managed lesions for 2002-2019 equated to £119.2-164.4 million. Conclusions: Robust epidemiological data that are internationally comparable and representative are scarce for nonmelanoma skin cancer. The rising global incidence coupled with struggling healthcare systems in the post-COVID-19 recovery period serve to intensify the societal and healthcare impact. This study is the first to demonstrate the incidence of BCC in Wales and is one of a small number in the UK using internally validated large cohort datasets. Furthermore, our findings demonstrate one of the highest published incidences within the UK and Europe.
MeSH term(s)	Humans ; Wales ; Retrospective Studies ; State Medicine ; COVID-19 ; Carcinoma, Basal Cell/pathology ; Skin Neoplasms/pathology ; Delivery of Health Care
Language	English
Publishing date	2023-01-30
Publishing country	England
Document type	Journal Article
ZDB-ID	80076-4
ISSN	1365-2133 ; 0007-0963
ISSN (online)	1365-2133
ISSN	0007-0963
DOI	10.1093/bjd/ljac090
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Article ; Online: Revisiting basal cell carcinoma clinical margins: Leveraging natural language processing and multivariate analysis with updated Royal College of Pathologists histological reporting standards.

Ali, Stephen R / Dobbs, Thomas D / Jovic, Matthew / Strafford, Huw / Lacey, Arron S / Williams, Namor / Pickrell, William Owen / Hutchings, Hayley A / Whitaker, Iain S

Journal of plastic, reconstructive & aesthetic surgery : JPRAS

2023 Volume 88, Page(s) 443–451

Abstract: Introduction: Data supporting the current British Association of Dermatologists guidelines for the management of basal cell carcinoma (BCC) are based on historic studies and do not consider the updated Royal College of Pathologists (RCPath) histological ...

Abstract	Introduction: Data supporting the current British Association of Dermatologists guidelines for the management of basal cell carcinoma (BCC) are based on historic studies and do not consider the updated Royal College of Pathologists (RCPath) histological reporting standards. The aim of this study was to use natural language processing (NLP)-derived data and undertake a multivariate analysis with updated RCPath standards, providing a contemporary update on the excision margins required to achieve histological clearance in BCC. Methods: A validated NLP information extraction model was used to perform a rapid multi-centre, pan-specialty, consecutive retrospective analysis of BCCs, managed with surgical excision using a pre-determined clinical margin, over a 17-year period (2004-2021) at Swansea Bay University Health Board. Logistic regression assessed the relationship between the peripheral and deep margins and histological clearance. Results: We ran our NLP algorithm on 34,955 BCCs. Out of the 1447 BCCs that met the inclusion criteria, the peripheral margin clearance was not influenced by the BCC risk level (p = 0.670). A clinical peripheral margin of 6 mm achieved a 95% histological clearance rate (95% confidence interval [CI], 0.93-0.98). Tumour thickness inversely affected deep-margin histological clearance (OR 0.720, 95% CI, 0.525-0.991, p < 0.05). Depth level 2 had a 97% probability of achieving deep-margin histological clearance across all tumour thicknesses. Conclusion: Updated RCPath reporting standards minimally impact the peripheral margin histological clearance in BCC. Larger clinical peripheral margins than those indicated by current guidelines may be necessary to achieve excision rates of ≥95%. These findings emphasise the need for continuous reassessment of clinical standards to enhance patient care.
MeSH term(s)	Humans ; Skin Neoplasms/surgery ; Skin Neoplasms/pathology ; Retrospective Studies ; Pathologists ; Natural Language Processing ; Universities ; Carcinoma, Basal Cell/surgery ; Carcinoma, Basal Cell/pathology ; Margins of Excision ; Multivariate Analysis
Language	English
Publishing date	2023-10-20
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2217750-4
ISSN	1878-0539 ; 1748-6815 ; 0007-1226
ISSN (online)	1878-0539
ISSN	1748-6815 ; 0007-1226
DOI	10.1016/j.bjps.2023.10.106
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Article: Facial Reconstruction: A Systematic Review of Current Image Acquisition and Processing Techniques.

Tarassoli, Sam P / Shield, Matthew E / Allen, Rhian S / Jessop, Zita M / Dobbs, Thomas D / Whitaker, Iain S

Frontiers in surgery

2020 Volume 7, Page(s) 537616

Abstract: Introduction: ...

Abstract	Introduction:
Language	English
Publishing date	2020-12-07
Publishing country	Switzerland
Document type	Systematic Review
ZDB-ID	2773823-1
ISSN	2296-875X
ISSN	2296-875X
DOI	10.3389/fsurg.2020.537616
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Article ; Online: Prevalence and Impact of Underlying Diagnosis and Comorbidities on Chiari 1 Malformation.

Sadler, Brooke / Kuensting, Timothy / Strahle, Jennifer / Park, Tae Sung / Smyth, Matthew / Limbrick, David D / Dobbs, Matthew B / Haller, Gabe / Gurnett, Christina A

Pediatric neurology

2020 Volume 106, Page(s) 32–37

Abstract: Background: Chiari malformation type 1 affects approximately one in 1,000 people symptomatically, although one in 100 meet radiological criteria, making it a common neurological disorder. The diagnosis of underlying conditions has become more ... ...

Abstract	Background: Chiari malformation type 1 affects approximately one in 1,000 people symptomatically, although one in 100 meet radiological criteria, making it a common neurological disorder. The diagnosis of underlying conditions has become more sophisticated, and new radiological markers of disease have been described. We sought to determine the prevalence and impact of additional comorbidities and underlying diagnoses in patients with Chiari malformation type 1 on symptomatology and surgical treatment. Methods: A retrospective review of 612 pediatric patients with a Chiari malformation type 1 diagnosis and imaging data evaluated between 2008 and 2018 was performed. Because of extensive clinical heterogeneity, patients were separated into four categories based on their primary comorbidities (nonsyndromic, central nervous system, skeletal, and multiple congenital anomalies) to identify associations with age of onset, radiographic measurements, syringomyelia, and surgical treatment. Results: The largest group had nonsyndromic Chiari malformation type 1 (70%) and the latest age at diagnosis of any group. In the syndromic group, 6% were diagnosed with a known genetic abnormality, with overgrowth syndromes being the most common. Patients with multiple congenital anomalies had the earliest Chiari malformation type 1 onset, the most severe tonsillar ectopia and obex position, and were overrepresented among surgical cases. Although there were no statistically significant differences between groups and rates of syrinx, we observed differences in individual diagnoses. Conclusion: The underlying diagnoses and presence of comorbidities in patients with Chiari malformation type 1 impacts rates of syringomyelia and surgery. Although most Chiari malformation type 1 cases are nonsyndromic, clinical evaluation of growth parameters, scoliosis, and joint hypermobility should be routine for all patients as they are useful to determine syringomyelia risk and may impact treatment.
MeSH term(s)	Abnormalities, Multiple/epidemiology ; Adolescent ; Age of Onset ; Arnold-Chiari Malformation/diagnostic imaging ; Arnold-Chiari Malformation/epidemiology ; Arnold-Chiari Malformation/surgery ; Central Nervous System Diseases/epidemiology ; Child ; Comorbidity ; Connective Tissue Diseases/epidemiology ; Female ; Genetic Diseases, Inborn/epidemiology ; Humans ; Incidence ; Joint Diseases/epidemiology ; Joint Instability/epidemiology ; Magnetic Resonance Imaging ; Male ; Prevalence ; Retrospective Studies ; Scoliosis/diagnostic imaging ; Scoliosis/epidemiology ; Spinal Diseases/epidemiology ; Syndrome ; Syringomyelia/diagnostic imaging ; Syringomyelia/epidemiology ; Syringomyelia/surgery
Language	English
Publishing date	2020-01-21
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	639164-3
ISSN	1873-5150 ; 0887-8994
ISSN (online)	1873-5150
ISSN	0887-8994
DOI	10.1016/j.pediatrneurol.2019.12.005
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