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Sunburns according to gender
P1324
P1326
SUNBURNS ACCORDING TO GENDER Pascale Guitera, MD, Hopital St Louis, Paris, France; Charles Taieb, MD, Eric Myon, PhD, Public Health, Quality of Life and Health Economics, Boulogne Billancourt, France; Louis Dubertret, MD, Hopital St Louis, Paris, France
THE MISUSE OF STATISTICS IN THE DERMATOLOGY LITERATURE Julie Neville, MD, Wei Lang, PhD, Alan Fleischer Jr, MD, Wake Forest University, Winston-Salem, NC, United States Introduction: A large percentage of the articles published in the medical literature contain statistical errors. The objective of this study was to determine the incidence of errors in the dermatology literature. Methods: All original studies from January through December 2003 appearing in Archives of Dermatology and Journal of the American Academy of Dermatology were analyzed for correctness of statistical methods and reporting of results. Results: Of the 207 studies published, 155 included statistical analysis, with 59 (38%) of these studies containing either errors or omissions in the methods or reporting of statistical tests. Thirty-seven percent of the errors were considered more significant than they were in the methods used, 69% contained an error in presentation of the data, and 7% contained an error in both. Conclusion: Misuse of statistical methods is prevalent in the dermatology literature as in other medical specialties. Appropriate use of statistics is an integral part of all studies performed and published, and readers should critically analyze both the methods and results derived from studies in the dermatology literature.
Objective: The ICARE program aims to describe how patients get sunburns and their knowledge of the consequences of sun exposure. Method: Patients suffering sunburn going to their pharmacy for their first treatment were asked to complete a questionnaire and to return it by mail. Results: Men and women behave differently toward sun exposure. If 41% are exposed to sun more than 2 hours per day (women 40%, men 43%) and if slightly more than 50% are exposed between 11:00 AM and 4:00 PM, more than 70% are exposed to sun after 4:00 PM. The only difference concerns sun exposure before 11:00 AM; that is, 35% of women and only 19% of men are exposed to sun at that time (P = .03). With regard to sun protection with protective skin lotions, 59% of women report applying them regularly, whereas only 53% of men do so (P = .003). Back and arms are the most frequent parts of the body to protect from sunburns according to women (50% and 43%, respectively), whereas men report preferentially protecting the back and face (52% and 38%, respectively). Eight percent admitted that their sunburn interfered with their vacation, 38% reported sleep disturbance, and 26% weren’t able to do what they wanted because of their sunburn. Assessment of quality of life using the Dermatology Life Quality Index (DLQI) showed evidence of stronger impairment of quality of life for women than for men; the mean DLQI total scores were 4.35 and 2.69, respectively (P \.05). Discussion: Sunburn appears to be instructive for those who suffer from it; 43% of patients reported that they will ask advice from a specialist before their next sun exposure, and 65% reported that they will change their sun exposure habits. This information suggests a need for greater educational efforts directed toward changing public attitudes about preventing sunburn, especially those of men, that currently lead to high-risk sunbathing behavior.
Nothing to disclose.
50% supported by Avene Laboratory
P1327 USE OF A CONSULTATION/PRESCRIPTION FORM TO IMPROVE COMMUNICATION WITH REFERRING DOCTORS Chris Guest, BS, Center for Dermatology Research, Wake Forest University School of Medicine, Winston-Salem, NC, United States; Diane Hawes, MD, Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States; Vishal Khanna, MA, Steven Feldman, MD, PhD, Center for Dermatology Research, Wake Forest University School of Medicine, Winston-Salem, NC, United States Background: Delays in reporting from consultants to referring physicians has the potential to impede patients’ health status and progress. Prompt reporting reduces the confusion that occurs when patients return to the referring physician before the report is received.
P1325 SUNBURNS AND ACTIVITY Pascale Guitera, MD, Hopital St Louis, Paris, France; Charles Taieb, MD, Eric Myon, PhD; Public Health, Quality of Life and Health Economics, Boulogne Billancourt, France; Louis Dubertret, MD, Hopital St Louis, Paris, France Objective: The ICARE program aims to describe how patients get sunburns and their knowledge of the consequences of sun exposure. Method: Patients suffering sunburn going to their pharmacy for the first treatment were asked to complete a questionnaire and to return it by mail. Results: Among patients suffering sunburn, only 37% received it during voluntary sun exposure; 63% outside a sun exposure: 27.7% during a walk or a promenade, 17.8% during a sport activity, and 12.8% performing odd jobs or gardening. Body location of sunburn differ according to the patient’s activity. The back was the most area sunburned during gardening (62%) and sun exposure (33%); the arms during sport activity (58%) or walking (59%). The mean number of sunburned areas (impact) was 2.51, 2.81, 2.43, and 1.58 for sun exposure, sport activity, walking, and gardening, respectively. Quality of life measured by the Dermatology Life Quality Index (DLQI) showed evidence of impairment after sunburn; mean total DLQI scores were 4.50, 4.38, 4.34, and 3.13 for sun exposure, sport activity, walking, and gardening, respectively. Discussion: Education of patients on the risk of sun exposure may no longer be sufficient. Today everyone should be aware of the necessity of protecting themselves from the sun during any outside activity. Our population, with a DLQI mean score of 4.0, reflects a profound impairment of quality of life compared with the ranges Finlay and Khan determined when initially validating the DLQI; for example, in the Finlay and Khan study, for patients with acne, the mean DLQI score was 4.3; it was 6.7 for patients with viral warts and 3.4 for patients with solar keratosis (Finlay AY, 1994). 50% supported by Avene Laboratory
P108
J AM ACAD DERMATOL
Objective: To develop and test a consultation/prescription form designed to streamline the reporting process between dermatologists and primary care physicians. Method: We compiled medications prescribed from January 2003 to May 2004 in the office of a single dermatologist practicing in a small town in North Carolina. A consultation/prescription form was created that included a section for listing the diagnosis; a silhouette for marking location of skin lesions/eruptions; and a listing of the most frequently prescribed medications, the prescribed amount of medication, frequency of administration, and duration of treatment. The form was then reviewed by the prescribing dermatologist and a primary care doctor to help assure it met both the consulting and referring physician’s needs. The form was also reviewed by a pharmacist to assure that the form could be utilized as a prescription as well. We qualitatively measured the effectiveness of this consultation/prescription form through feedback from primary care physicians regarding their experiences with utilizing this tool. Results: There were 1483 prescriptions recorded over the study interval. The top 21 treatments accounted for 85% of all prescribed medications. Topical triamcinolone was the most frequently prescribed medication, accounting for 14% of the prescriptions, followed by topical fluocinonide and topical tacrolimus. The response from doctors regarding the effectiveness of the form was positive. The doctors interviewed stated that delay in referral reporting is a definite problem and that this form would both eliminate reporting delay and keep referring physicians informed. Suggestions for improving the form include increasing the size of the diagram and allowing more room for description of the problem. Conclusion: The fact that there is a high frequency of prescription of certain medications by dermatologists allows one to create a limited form that accounts for much of dermatology treatment. The form aids in script writing and facilitates the conveying of information to referring physicians. Steven Feldman has been a speaker for Galderma Laboratories, LP. The Center for Dermatology Research is supported by an unrestricted educational grant from Galderma Laboratories, LP.
MARCH 2005
P1326
SUNBURNS ACCORDING TO GENDER Pascale Guitera, MD, Hopital St Louis, Paris, France; Charles Taieb, MD, Eric Myon, PhD, Public Health, Quality of Life and Health Economics, Boulogne Billancourt, France; Louis Dubertret, MD, Hopital St Louis, Paris, France
THE MISUSE OF STATISTICS IN THE DERMATOLOGY LITERATURE Julie Neville, MD, Wei Lang, PhD, Alan Fleischer Jr, MD, Wake Forest University, Winston-Salem, NC, United States Introduction: A large percentage of the articles published in the medical literature contain statistical errors. The objective of this study was to determine the incidence of errors in the dermatology literature. Methods: All original studies from January through December 2003 appearing in Archives of Dermatology and Journal of the American Academy of Dermatology were analyzed for correctness of statistical methods and reporting of results. Results: Of the 207 studies published, 155 included statistical analysis, with 59 (38%) of these studies containing either errors or omissions in the methods or reporting of statistical tests. Thirty-seven percent of the errors were considered more significant than they were in the methods used, 69% contained an error in presentation of the data, and 7% contained an error in both. Conclusion: Misuse of statistical methods is prevalent in the dermatology literature as in other medical specialties. Appropriate use of statistics is an integral part of all studies performed and published, and readers should critically analyze both the methods and results derived from studies in the dermatology literature.
Objective: The ICARE program aims to describe how patients get sunburns and their knowledge of the consequences of sun exposure. Method: Patients suffering sunburn going to their pharmacy for their first treatment were asked to complete a questionnaire and to return it by mail. Results: Men and women behave differently toward sun exposure. If 41% are exposed to sun more than 2 hours per day (women 40%, men 43%) and if slightly more than 50% are exposed between 11:00 AM and 4:00 PM, more than 70% are exposed to sun after 4:00 PM. The only difference concerns sun exposure before 11:00 AM; that is, 35% of women and only 19% of men are exposed to sun at that time (P = .03). With regard to sun protection with protective skin lotions, 59% of women report applying them regularly, whereas only 53% of men do so (P = .003). Back and arms are the most frequent parts of the body to protect from sunburns according to women (50% and 43%, respectively), whereas men report preferentially protecting the back and face (52% and 38%, respectively). Eight percent admitted that their sunburn interfered with their vacation, 38% reported sleep disturbance, and 26% weren’t able to do what they wanted because of their sunburn. Assessment of quality of life using the Dermatology Life Quality Index (DLQI) showed evidence of stronger impairment of quality of life for women than for men; the mean DLQI total scores were 4.35 and 2.69, respectively (P \.05). Discussion: Sunburn appears to be instructive for those who suffer from it; 43% of patients reported that they will ask advice from a specialist before their next sun exposure, and 65% reported that they will change their sun exposure habits. This information suggests a need for greater educational efforts directed toward changing public attitudes about preventing sunburn, especially those of men, that currently lead to high-risk sunbathing behavior.
Nothing to disclose.
50% supported by Avene Laboratory
P1327 USE OF A CONSULTATION/PRESCRIPTION FORM TO IMPROVE COMMUNICATION WITH REFERRING DOCTORS Chris Guest, BS, Center for Dermatology Research, Wake Forest University School of Medicine, Winston-Salem, NC, United States; Diane Hawes, MD, Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States; Vishal Khanna, MA, Steven Feldman, MD, PhD, Center for Dermatology Research, Wake Forest University School of Medicine, Winston-Salem, NC, United States Background: Delays in reporting from consultants to referring physicians has the potential to impede patients’ health status and progress. Prompt reporting reduces the confusion that occurs when patients return to the referring physician before the report is received.
P1325 SUNBURNS AND ACTIVITY Pascale Guitera, MD, Hopital St Louis, Paris, France; Charles Taieb, MD, Eric Myon, PhD; Public Health, Quality of Life and Health Economics, Boulogne Billancourt, France; Louis Dubertret, MD, Hopital St Louis, Paris, France Objective: The ICARE program aims to describe how patients get sunburns and their knowledge of the consequences of sun exposure. Method: Patients suffering sunburn going to their pharmacy for the first treatment were asked to complete a questionnaire and to return it by mail. Results: Among patients suffering sunburn, only 37% received it during voluntary sun exposure; 63% outside a sun exposure: 27.7% during a walk or a promenade, 17.8% during a sport activity, and 12.8% performing odd jobs or gardening. Body location of sunburn differ according to the patient’s activity. The back was the most area sunburned during gardening (62%) and sun exposure (33%); the arms during sport activity (58%) or walking (59%). The mean number of sunburned areas (impact) was 2.51, 2.81, 2.43, and 1.58 for sun exposure, sport activity, walking, and gardening, respectively. Quality of life measured by the Dermatology Life Quality Index (DLQI) showed evidence of impairment after sunburn; mean total DLQI scores were 4.50, 4.38, 4.34, and 3.13 for sun exposure, sport activity, walking, and gardening, respectively. Discussion: Education of patients on the risk of sun exposure may no longer be sufficient. Today everyone should be aware of the necessity of protecting themselves from the sun during any outside activity. Our population, with a DLQI mean score of 4.0, reflects a profound impairment of quality of life compared with the ranges Finlay and Khan determined when initially validating the DLQI; for example, in the Finlay and Khan study, for patients with acne, the mean DLQI score was 4.3; it was 6.7 for patients with viral warts and 3.4 for patients with solar keratosis (Finlay AY, 1994). 50% supported by Avene Laboratory
P108
J AM ACAD DERMATOL
Objective: To develop and test a consultation/prescription form designed to streamline the reporting process between dermatologists and primary care physicians. Method: We compiled medications prescribed from January 2003 to May 2004 in the office of a single dermatologist practicing in a small town in North Carolina. A consultation/prescription form was created that included a section for listing the diagnosis; a silhouette for marking location of skin lesions/eruptions; and a listing of the most frequently prescribed medications, the prescribed amount of medication, frequency of administration, and duration of treatment. The form was then reviewed by the prescribing dermatologist and a primary care doctor to help assure it met both the consulting and referring physician’s needs. The form was also reviewed by a pharmacist to assure that the form could be utilized as a prescription as well. We qualitatively measured the effectiveness of this consultation/prescription form through feedback from primary care physicians regarding their experiences with utilizing this tool. Results: There were 1483 prescriptions recorded over the study interval. The top 21 treatments accounted for 85% of all prescribed medications. Topical triamcinolone was the most frequently prescribed medication, accounting for 14% of the prescriptions, followed by topical fluocinonide and topical tacrolimus. The response from doctors regarding the effectiveness of the form was positive. The doctors interviewed stated that delay in referral reporting is a definite problem and that this form would both eliminate reporting delay and keep referring physicians informed. Suggestions for improving the form include increasing the size of the diagram and allowing more room for description of the problem. Conclusion: The fact that there is a high frequency of prescription of certain medications by dermatologists allows one to create a limited form that accounts for much of dermatology treatment. The form aids in script writing and facilitates the conveying of information to referring physicians. Steven Feldman has been a speaker for Galderma Laboratories, LP. The Center for Dermatology Research is supported by an unrestricted educational grant from Galderma Laboratories, LP.
MARCH 2005