Same-day Versus Separate-day Preoperative Consultation for Mohs Surgery

Study Overview
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Brief Summary
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The purpose of this study is to determine whether separate- versus same-day preoperative consultation affects time to treatment (start to finish), utilization rate of Mohs, rate of case cancellations, cost, and patient satisfaction. The investigators hypothesize that patients with same-day preoperative consultation will have a shorter time between cancer diagnosis and removal but, only when coordination of care is needed, longer time between removal and consultation with other specialists, as compared to patients with separate-day consultation. The investigators anticipate that patients with same-day preoperative consultation will have a decrease in travel cost as compared to patients with separate-day consultation. The investigators expect that there will be no difference in various satisfaction matters between groups, with the exception of potentially greater convenience reported by patients in the same-day preoperative consultation group. Finally, the investigators hypothesize that there will be no difference between groups in regards to rates of surgery cancellation.

Detailed Description
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Procedure: Prospective trial which randomly assigns patients to either separate- or same-day preoperative consultation for Mohs surgery. A phone consultation will take place, which will assist in determining whether the patient is appropriate for enrollment into the study. If so, the patient will be randomized to either separate-day or same-day preoperative consultation. Materials: Patient survey Methods of data collection: The patient-specific data obtained from the medical record will include: Patient age, number of previous skin cancers, preoperative size, history of cutaneous surgery, employment status, and distance between home address and dermatology facility. Outcome measures that will be obtained from the medical record will include: Time between cancer diagnosis, removal and defect repair, rate of proceeding with Mohs as opposed to other treatment options, and rate of cancelling surgery (due to site discrepancy, anticoagulation issues). A survey will be used to assess patient satisfaction.

Official Title
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Same-day Versus Separate-day Preoperative Consultation for Mohs Surgery

Conditions
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Non-melanoma Skin Cancer, Squamous Cell Carcinoma of Skin, Basal Cell Carcinoma

Intervention / Treatment
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* Other: Same-day preoperative consultation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients will be considered for enrollment if they have been referred to a Mohs surgeon for consideration of Mohs surgery for non-melanoma skin cancer Exclusion Criteria: Patients would be excluded if there is a lack of indication for Mohs Significant comorbidities, or In the case of a high-risk location or tumor size, for which in advance it is known that they will need consultation with other specialties

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Separate-day preoperative consultation<br>Patients referred for Mohs surgery for non-melanoma skin cancer will have a preoperative consultation in advance of the day of the procedure. | |
| Experimental: Same-day preoperative consultation<br>Patients referred for Mohs surgery for non-melanoma skin cancer will have a preoperative consultation on the day same day as the procedure. | Other: Same-day preoperative consultation<br>* Preoperative consultation occurs on the same day as Mohs surgery<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to treatment | Assess the total amount of time elapsed between skin cancer diagnosis and defect repair | Eight weeks | 
| Time to consultation with other specialties | Assess the amount of time between cancer diagnosis and consultation with non-dermatologic specialties | Eight weeks | 
| Time to repair | Assess the amount of time elapsed between cancer removal and defect repair | Eight weeks | 
| Patient satisfaction | Administer a survey to assess patient's perception of convenience, level of comfort with the procedure, and self-evaluation of knowledge regarding the diagnosis and treatment | Eight weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Utilization rate of Mohs surgery | Assess the percentage of patients who actually proceed with undergoing Mohs surgery in each arm | Eight weeks | 
| Rate of case cancellation | Assess the number of cases that are cancelled due to site discrepancy, anticoagulation or other medical issues in each arm | Eight weeks | 
| Travel cost | Assess the total distance traveled by each patient coming and going to Mohs appointment(s) | Eight weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Mohs surgery, Preoperative consultation