CAPABLE: A Scoring System Utilizing Patient-Reported Measures to Evaluate Patient Experience After Mohs Surgery.

BACKGROUND: Patient experience metrics are gaining prominence in health care. We introduce the CAPABLE survey to assess postoperative experiences of Mohs surgery patients. OBJECTIVE: We sought to determine whether CAPABLE scores aligned with overall patient satisfaction in Mohs surgery. METHODS: This was a cross-sectional, survey-based study of patients presenting for their first postoperative visit after Mohs surgery. The CAPABLE survey included questions on postoperative instructions, activity limitations, pain control, provider accessibility, and bleeding, followed by 2 overall satisfaction questions taken from the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems survey. The pilot study took place at the University of Texas Dell Medical School (DMS), followed by a validation study ( n = 206) at DMS and Oregon Health and Science University (OHSU). We assessed for correlations between CAPABLE scores and overall satisfaction. RESULTS: In the pilot study ( n = 137), overall CAPABLE scores and scores of individual CAPABLE components correlated positively with overall satisfaction.In the multisite validation study ( n = 206) spanning DMS and OHSU, CAPABLE scores correlated positively with overall satisfaction. CONCLUSION: The CAPABLE survey is a concise tool for assessing specific, actionable components of the postoperative patient experience in Mohs surgery, while correlating with overall patient satisfaction.

Psychosocial and quality-of-life factors associated with depigmentation therapy for vitiligo.

BACKGROUND: There is a paucity of data examining the psychosocial factors relevant to depigmentation therapy, an irreversible treatment for vitiligo. This study explores patients' perspective and experience while undergoing depigmentation therapy and quality-of-life effects of such therapy. METHODS: An online instrument assessing the impact of depigmentation therapy on various psychosocial variables and including the validated Dermatology Life Quality Index (DLQI) were administered to two groups of participants with vitiligo: (1) those who are currently undergoing or have completed depigmentation therapy and (2) those with vitiligo who have not undergone depigmentation therapy but had considered it. Data were collected on psychosocial factors such as length of time until depigmentation therapy was offered, duration, financial burden, level of satisfaction, impact on life activities, and challenges faced during and after depigmentation therapy. DLQI scores were also measured. RESULTS: Thirty-five vitiligo patients who did not undergo depigmentation and 42 patients who did undergo depigmentation therapy were included in the study. Baseline characteristics were comparable between groups. Mean DLQI was higher for patients who did not undergo depigmentation than for those who underwent depigmentation (10.2 versus 5.3, p = 0.002), indicating worse quality-of-life in those not depigmenting. Patients who underwent depigmentation reported significantly less discomfort in various social situations after undergoing depigmentation therapy compared to how they felt before undergoing therapy and reported significantly less discomfort in these situations than patients who did not undergo depigmentation therapy. CONCLUSIONS: Despite potential challenges, depigmentation therapy appears to augment quality-of-life across various domains in individuals with vitiligo.