Henvisninger for malignt melanom: Muligheder for kvalitetssikring og udvikling

Introduction: This paper describes the quality of referrals and prehospitals biopsies in patients with malignant melanoma (MM). Materials and methods: Our study is based on the case records of patients with MM referred to the Department of Plastic Surgery, Roskilde Hospital, during 2001 (n=171). Information about the quality of the referrals was collected, and the referrals were assigned 0-4 points, with 4 points the maximum achievable. The number of prehospital biopsies was determined, and their quality was assessed based on the proportion of histologically complete biopsies. Results: Of 171 case records examined, 145 fulfilled the inclusion criteria. The information contained in the referrals was often insufficient, as 29% of the referrals achieved less than 2 points in the proposed evaluation scale. Referrals from dermatologists were generally more complete. Prehospital excisional biopsies had been done in 102 of the 145 cases, but only 55% of these were complete, i.e., included the entire lesion. Dermatologists in private practice accomplished this goal more frequently. Discussion: There seems to be considerable scope for improvement in communication among different medical specialists, as well as further activities to ensure quality for the benefit of the treatment of patients. A greater focus on the content of the referral letters and biopsies, so that a larger part of these are complete, would permit treatment to be more individualised.