Dermatologia e pesquisa científica: análise das publicações em hospital de ensino no sul do Brasil / Dermatology and scientific research: analysis of publications in a teaching hospital in southern Brazil

Introdução: a Dermatologia destaca-se entre as especialidades médicas por seu pioneirismo na descoberta e ca-racterização de afecções da pele, tornando-se proeminente a compreensão da conjuntura da produção científica na especialidade. Objetivo: analisar o perfil das publicações científicas do Serviço de Dermatologia da Santa Casa de Porto Alegre/Universidade Federal de Ciências da Saúde de Porto Alegre. Método: estudo transversal e descritivo realizado a partir da análise das publicações do Serviço de Dermatologia, no período de janeiro de 2019 a dezembro de 2020. Resultados: a partir do levantamento de dados,foram identificadas 54 publicações no período, constituídas 81,5% (n = 44) por artigos e 18,5% (n = 10) por capítulos de livro. A maioria dos artigos foi 'relato de casos' (56,8%; n = 25). Cerca de 46,3% das publicações contaram com a participação de residentes e/ou especializandos, principal-mente no 3º ano dos programas. Conclusão: a análise das publicações científicas revelou predomínio de artigos em periódicos, principalmente em veículos nacionais, com expressiva participação de especializandos. O desenvolvimento científico da Dermatologia pressupõe a valorização das atividades de pesquisa no âmbito dos programas de especiali-zação e residência, com potencial de contribuição para a melhoria dos serviços de saúde e produtividade acadêmica. (AU)

Background: Dermatology stands out among the medical specialties for its pioneering role in the discovery and characterization of skin conditions, making the understanding of the conjuncture of scientific production in the spe-cialty prominent. Objective: the study aimed to analyze the profile of scientific publications of the Dermatology Service of Santa Casa of Porto Alegre / Federal University of Health Sciences of Porto Alegre. Method: this cross-sectional and descriptive study was conducted from the analysis of publications of the Dermatology Service from January 2019 to December 2020. Results: from the data collection, 54 publications were identified in the analyzed period, consisting of 81.5% (n = 44) of articles and 18.5% (n = 10) of book chapters. Most articles were 'case reports' (56.8%; n = 25). About 46.3% of the publications had the participation of residents and/or trainees, mainly in the 3rd year of the programs. Conclusion: the analysis of scientific publications revealed a predominance of articles in journals, mainly in national vehicles, with a significant participation of students. The scientific development of Dermatology presupposes the valorization of research activities within the scope of specialization and residency programs, with the potential to contribute to the improvement of health services and academic productivity. (AU)

Do People Favor Artificial Intelligence Over Physicians? A Survey Among the General Population and Their View on Artificial Intelligence in Medicine.

OBJECTIVES: To investigate the general population's view on artificial intelligence (AI) in medicine with specific emphasis on 3 areas that have experienced major progress in AI research in the past few years, namely radiology, robotic surgery, and dermatology. METHODS: For this prospective study, the April 2020 Online Longitudinal Internet Studies for the Social Sciences Panel Wave was used. Of the 3117 Longitudinal Internet Studies For The Social Sciences panel members contacted, 2411 completed the full questionnaire (77.4% response rate), after combining data from earlier waves, the final sample size was 1909. A total of 3 scales focusing on trust in the implementation of AI in radiology, robotic surgery, and dermatology were used. Repeated-measures analysis of variance and multivariate analysis of variance was used for comparison. RESULTS: The overall means show that respondents have slightly more trust in AI in dermatology than in radiology and surgery. The means show that higher educated males, employed or student, of Western background, and those not admitted to a hospital in the past 12 months have more trust in AI. The trust in AI in radiology, robotic surgery, and dermatology is positively associated with belief in the efficiency of AI and these specific domains were negatively associated with distrust and accountability in AI in general. CONCLUSIONS: The general population is more distrustful of AI in medicine unlike the overall optimistic views posed in the media. The level of trust is dependent on what medical area is subject to scrutiny. Certain demographic characteristics and individuals with a generally positive view on AI and its efficiency are significantly associated with higher levels of trust in AI.

Pilot Survey of Adoption of Telemedicine in Mohs Surgery During the COVID-19 Pandemic.

BACKGROUND: The Covid-19 Pandemic prompted the widespread implementation of telemedicine across healthcare. OBJECTIVE: To analyze telemedicine adoption by Mohs Micrographic surgeons (MMS) during the COVID-19 pandemic; to analyze the attitudes and perceived barriers to its long-term continuation by MMS practices. METHODS AND MATERIALS: An online multiple-choice survey was distributed to members of the American College of Mohs Surgeons. RESULTS: 86.1% of surveyed Mohs surgeons initiated telemedicine during the pandemic surge. The most common uses for telemedicine amongst respondents were post-surgery management (77.4%), "spot checks" (60.9%), and surgical consultations (59.1%). 73.1% report patients were receptive to telemedicine. 68.6% believe that telemedicine has a place in dermatologic surgery; 49.5% plan to incorporate telemedicine into their surgical practices long-term. Physical exam limitations, fitting telemedicine into practice workflow, and patient reception/patient training were viewed as the most significant barriers to long-term implementation. CONCLUSIONS: While valuable use cases for telemedicine were identified with most Mohs surgeon respondents feeling that telemedicine has a place in their practices, there is uncertainty in how to implement telemedicine into the dermatologic surgery practice workflow.

Extreme winter weather: A force to be remembered in dermatopathology.

It is important for the dermatopathologist to be adept in differentiating tissue artifacts from normal tissue variants and pathologies. Numerous tissue artifacts have been described to date; however, once we are familiar with the common artifacts that appear in our practice, we may not immediately recognize other confounders. For example, dermatopathologists in more temperate regions of the country may not be familiar with freezing artifact. In this case series, we present three common diagnoses in dermatopathology that were obscured by the extreme winter weather that severely impacted the Southern United States in February 2021 and discuss methods to prevent these artifacts.

Visualising the past to plan the future: a network analysis of the largest European dermatology conference.

BACKGROUND: The annual conference of the European Academy of Dermatology and Venereology is one the largest dermatology conferences worldwide. OBJECTIVES: Network analysis can be used for in-depth insight into trending topics and underlying trends at the congress. MATERIALS & METHODS: Network analysis was employed to assess the entirety of the submitted abstracts to the congress in 2019. The data were processed, analysed, and visualised using easy-to-understand network graphs. Topics were then compared to their respective global burden (Disease Adjusted Life Years [DALYs]) and the number of respective publications on PubMed in the year 2018. RESULTS: Overall, 1,280 lecture titles and 1,941 poster titles were included in the final analysis. The most frequently used terms were "patients" (n = 473), "treatment" (n = 301), and "psoriasis" (n = 335). Relative to DALYs, "psoriasis" (+21.9%) among others, was rather over-represented, while "fungal skin diseases" (-7.6%) and "urticaria" (-6.4%) were under-represented. Compared to the relative number of PubMed publications in 2018, "psoriasis" (+20.3%), "acne" (+7.9%), and "alopecia" (+3.1%) were over-represented, while "melanoma" (-22.5%), "dermatitis" (-4.2%) and "pruritus" (-3.4%) were rather under-represented. CONCLUSION: The network analysis showed that the congress was a patient and therapy-centred event. An explanation for the particular focus on chronic inflammatory skin diseases and melanoma would be the introduction of new therapies at the congress. To delineate trends over time, a longitudinal network analysis including several congresses should be conducted and could be used to determine additional topics to be included in future events.

Employment and Migration Patterns of Recent Micrographic Surgery and Dermatologic Oncology Fellowship Graduates.

BACKGROUND: There is currently an uneven distribution of the Mohs surgery workforce, with a dearth in nonurban areas. The relationship between training and employment locations of Mohs surgeons has not been studied. OBJECTIVE: To analyze the employment location of recent micrographic surgery and dermatologic oncology (MSDO) graduates in reference to residency and fellowship locations. MATERIALS AND METHODS: Data collection of training and practice locations of 421 MSDO fellowship graduates from 2012 to 2017. RESULTS: Thirty-two percent (n = 136) and 53% (n = 225) of MSDO fellowship graduates' first employment locations were located within 10 and 100 miles of either their residency or fellowship locations. Ninety-six percent of graduates were employed in a metropolitan location. Female graduates worked closer to training sites than male graduates, with 62% (n = 124) versus 46% (n = 102) working within 100 miles of either training site. Analysis by fellowship census region showed that graduates clustered around training sites in all regions, with 45% to 60% of graduates working within 100 miles of either training site. CONCLUSION: The majority of graduates chose to work in a metropolitan area. Training location strongly predicts employment location. More than 45% of graduates in any region worked within 100 miles of their residency or fellowship site, and a sizeable portion worked within 10 miles.

Patient safety in dermatology: a ten-year update.

OBJECTIVE: We update and expand our 2010 article in this journal, Patient safety in dermatology: A review of the literature [4][DH1]. METHODS: PubMed at the National Center for Biotechnology Information (NCBI), United States National Library of Medicine (NLM) was searched September 2019 for English language articles published between 2009 and 2019 concerning patient safety and medical error in dermatology. Potentially relevant articles and communications were critically evaluated by the authors with selected references from 2020 added to include specific topics: medication errors, diagnostic errors including telemedicine, office-based surgery, wrong-site procedures, infections including COVID-19, falls, laser safety, scope of practice, and electronic health records. SUMMARY: Hospitals and clinics are adopting the methods of high-reliability organizations to identify and change ineffective practice patterns. Although systems issues are emphasized in patient safety, people are critically important to effective teamwork and leadership. Advancements in procedural and cosmetic dermatology, organizational and clinical guidelines, and the revolution in information technology and electronic health records have introduced new sources of potential error. CONCLUSION: Despite the growing number of dermatologic patient safety studies, our review supports a continuing need for further studies and reports to reduce the number of preventable errors and provide optimal care.

Definitions, survey methods, and findings of patient satisfaction studies in teledermatology: a systematic review.

Remote consultations likely will grow in importance if the COVID-19 pandemic continues. This review analyzes which methods of teledermatology patients prefer by categorizing how recent studies have defined satisfaction, conducted surveys and concluded patients respond to the different modalities of teledermatology. Using PubMed and Cochrane databases, we reviewed studies from April 5th, 2010 to April 5th, 2020 that included the search terms patient satisfaction and teledermatology. All studies that included patient satisfaction as an outcome were included, but studies not published in English were excluded. We examined domains of satisfaction, survey method, study characteristics (including patient population, country, age, study design and evidence score), findings and statistical comparisons. We thoroughly reviewed 23 studies. Definitions of satisfaction varied, but all concluded patients were satisfied with the live-interactive and store-and-forward modalities. The studies reveal that store-and-forward is appropriate for clinicians with established patients who require regular follow-up. Verified areas of care include treatment of chronic conditions, topical skin cancer therapy, wound monitoring, and post-procedural follow-up. Only four studies conducted statistical analyses. One of those studies compared patient preference for each modality of teledermatology with face-to-face dermatology. While this study reported high satisfaction with each mode of teledermatology, patients still preferred face-to-face. Favorable responses to remote diagnostic capabilities suggest that these offerings improve preference for teledermatology. With only one study evaluating preference between each modality and face-to-face dermatology, more studies should address the discrepancy. Surveys that cover all domains of satisfaction may improve assessments and identify where gaps in preference exist.

Screening for cardiovascular comorbidity in United States outpatients with psoriasis, hidradenitis, and atopic dermatitis.

Psoriasis, hidradenitis, and atopic dermatitis (AD) are associated with increased cardiometabolic comorbidities. Yet, little is known about screening rates for cardiometabolic comorbidities in patients with these disorders. The objective of this study is to determine rates and predictors of cardiovascular screening among patients with psoriasis, AD, and hidradenitis in the United States. Data from the 2006-2015 National Ambulatory Medical Care Survey were analyzed, including 67,581 pediatric and 322,957 adult outpatient visits. Overall, blood pressure screening was performed less commonly in psoriasis (36.4% [31.0-42.2%]) and AD (41.9% [39.3-44.7%] of visits) compared to other visits (62.5% [61.5-63.6%]) (P < 0.0001). Cholesterol screening was performed more often (adjusted odds ratio [95% confidence interval]) in psoriasis (1.82 [1.20-2.76], P = 0.005) but less often in hidradenitis (0.03 [0.00-0.23], P = 0.001) and AD (0.72 [0.55-0.94], P = 0.02). Obesity screening increased from 2006-2007 to 2014-2015 in AD (31.1% [25.8-36.4%]-44.5% [37.0-81.5%], P = 0.01), psoriasis (19.0% [9.4-28.6%] to 42.8% [30.5-73.3%], P = 0.01), and hidradenitis (28.6% [1.7-55.6%] to 74.2% [55.3-100.0%], P = 0.001), but screening for blood pressure, cholesterol, or diabetes did not. Screening rates for cardiometabolic comorbidities are suboptimal. Future interventions are needed to improve screening rates for cardiometabolic comorbidities.