Clark McKown, Maria Kharitonova, Nicole M Russo-Ponsaran, Beyza Aksu-Dunya
Development and Validation of a Shortened Form of SELweb EE, a Web-Based Assessment of Children's Social and Emotional Competence
Assessment
previous studies established geographic location strongly influences health literacy access care health outcomes across disease types many wellunderstood risk factors development melanoma likewise various markers disease severity however studies conducted determine role locality access dermatological care play incidence severity melanoma particularly south dakotans hypothesized living rural regions less access care increases risk advanced stage melanoma time diagnosis retrospective chart review electronic medical records patients diagnosis melanoma midwest dermatology practice south dakota performed authors examined patients rural vs urban status disease predictors markers disease severity multivariate descriptive statistical analysis utilized 148 unique cases identified average age 6232 sd1669 min25 max98 534 male n79 993 caucasian among 35 236 personal history nonmelanoma skin cancer nmsc 9 61 personal history melanoma 20 135 family history melanoma cases 757 least one documented visit primary care physician pcp within year melanoma diagnosis comparing geographic distance breslow depth time biopsy significant negative relationship p0009 resulted however eliminating 3 outliers breslow depths 222mm 190 mm 150mm relationship longer significant p0141 significant findings resulted comparing geographic distance provider site wide lesion excision wle postwle breslow depth p0778 pathological stage p0079 sentinel lymph node biopsy p0299 chemotherapyradiation p0191 comparing disease predictors severity markers disease significant finding personal history melanoma postwle breslow depth p0026 without personal history melanoma greater 308 vs 168 postwle breslow depth prior studies indicate increased distance dermatologist decreased density dermatologists represent significant associations breslow depth mortality contrast present data appear indicate significant difference melanoma detection outcomes based geographic parameters however support density dermatologists appropriate proxy melanoma outcomes pcp density lack impact based rural vs urban status may suggest current literature applicable states populations disparities access dermatologists melanoma treatment may overcome factors investigated presently eg ai teledermatology limitations include analyzing patients within single health system sample population consisting primarily persons located sioux falls metropolitan area rural south dakotans representing significant portion population state presents opportunity identify disparities access treatment based population community resources