{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T08:36:22Z","timestamp":1709109382548},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T00:00:00Z","timestamp":1611532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Deutsche Derma Gesell"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Regarding skin cancer screening, patients in Germany have the choice between a direct screening by dermatologists or an initial screening by general practitioners followed by dermatological screening if further examination is required. The aim of this study is to evaluate whether screening by general practitioners is associated with risk selection in subsequent dermatological screenings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>We conducted a retrospective observational study based on claims data from a German health insurance company (Barmer GEK). Patient pathways in skin cancer screenings between 2008 and 2016 were analyzed, and differences between the two groups were tested at 95\u00a0% confidence intervals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 495,000 initial and 111,000 secondary examinations by dermatologists were analyzed. The proportion of subsequent excisions was lower in initial screenings by dermatologists. To diagnose one person with non\u2010melanoma skin cancer or melanoma, five or 23 to 42 excisions were necessary, depending on the type of excision considered. The number of examinations to identify one patient ranged from 25 to 53 for non\u2010melanoma skin cancer and 42 to 165 for melanoma. For melanoma, the number of excisions and screenings to diagnose skin cancer was lower in secondary examinations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results indicate a risk selection through initial examinations by general practitioners. However, there are other aspects that should be taken into account when comparing the two pathways.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ddg.14318","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T15:43:38Z","timestamp":1611589418000},"page":"389-398","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Comparison of patient pathways in the early detection of skin cancer \u2013 a claims data analysis"],"prefix":"10.1111","volume":"19","author":[{"given":"Magdalene","family":"Krensel","sequence":"first","affiliation":[{"name":"Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg\u2010Eppendorf (UKE)  Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jana","family":"Petersen","sequence":"additional","affiliation":[{"name":"Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg\u2010Eppendorf (UKE)  Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brigitte","family":"Stephan","sequence":"additional","affiliation":[{"name":"Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg\u2010Eppendorf (UKE)  Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Katalinic","sequence":"additional","affiliation":[{"name":"Institute for Social Medicine and Epidemiology University Medical Center L\u00fcbeck (UKSH)  L\u00fcbeck Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jobst","family":"Augustin","sequence":"additional","affiliation":[{"name":"Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg\u2010Eppendorf (UKE)  Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,1,25]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Robert Koch\u2010Institut (RKI) German Centre for cancer registry data (GEKID). Cancer in Germany 2013\/2014. Available from:https:\/\/www.krebsdaten.de\/Krebs\/EN\/Home\/homepage_node.html[Last accessed August 21 2019]."},{"key":"e_1_2_9_3_1","volume-title":"Das Manual der Krebsregistrierung","author":"Stegmaier C","year":"2019"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2014.10.010"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S151246"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2010.11.016"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2012.22"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2012.893"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2010.03.006"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13559"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.14758"},{"key":"e_1_2_9_12_1","unstructured":"Destatis. Bev\u00f6lkerung und Erwerbst\u00e4tigkeit 2017. Bev\u00f6lkerungsfortschreibung auf Grundlage des Zensus 2011. Available from:https:\/\/www.destatis.de\/DE\/Themen\/Arbeit\/Arbeitsmarkt\/Erwerbstaetigkeit\/Publikationen\/Downloads\u2010Erwerbstaetigkeit\/erwerbsbeteiligung\u2010bevoelkung\u20102010410177004.pdf?__blob=publicationFile&v=4. Updated May 24 2019 [Last accessed July 16 2019]."},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.149.s64.8_65.x"},{"key":"e_1_2_9_14_1","unstructured":"GrobeTG HellerG SzecsenyiJ.BARMER GEK Arztreport 2014. Schwerpunkt: Hautkrebs. Siegburg: Asgard\u2010Verl.\u2010Service 2014."},{"key":"e_1_2_9_15_1","unstructured":"VeitC L\u00fckenF MelsheimerO.Evaluation der Screeninguntersuchungen auf Hautkrebs gem\u00e4\u00df Krebsfr\u00fcherkennungs\u2010Richtlinie des Gemeinsamen Bundesausschusses. Abschlussbericht 2009 \u2013 2010. Available from:www.bqs.de. Updated March 11 2015."},{"key":"e_1_2_9_16_1","unstructured":"L\u00fckenF BatzD KutschmannM.Evaluation der Screeninguntersuchungen auf Hautkrebs gem\u00e4\u00df Krebsfr\u00fcherkennungs\u2010Richtlinie des Gemeinsamen Bundesausschusses. Abschlussbericht der Jahre 2011\u20132013. Available from:www.bqs.de. Updated September 30 2016."},{"key":"e_1_2_9_17_1","unstructured":"BARMER. Kerndaten der BARMER. Available from:www.barmer.de. Updated August 21 2018. [Last accessed Oktober 15 2018]."},{"key":"e_1_2_9_18_1","unstructured":"Gesundheitsberichterstattung des Bundes (GBE\u2010Bund). Members of the Statutory Health insurance annual average. Available from:www.gbe\u2010bund.de. [Last accessed Oktober 16 2018]."},{"key":"e_1_2_9_19_1","unstructured":"Destatis. Sozialleistungen 2015: Angaben zur Krankenversicherung. Ergebnisse des Mikrozensus. Wiesbaden 2016."},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-108647"},{"key":"e_1_2_9_21_1","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1111\/ddg.14002","article-title":"Estimating prevalence and incidence of skin cancer in Germany","volume":"17","author":"Krensel M","year":"2019","journal-title":"J Dtsch Dermatol Ges"},{"key":"e_1_2_9_22_1","unstructured":"Gemeinsamer Bundesausschuss (GBA).Richtlinie des Gemeinsamen Bundesausschusses \u00fcber die Fr\u00fcherkennung von Krebserkrankungen. Krebsfr\u00fcherkennungs\u2010Richtlinie \/ KFE\u2010RL. Available from:https:\/\/www.g\u2010ba.de\/downloads\/62\u2010492\u20102002\/KFE\u2010RL_2019\u201012\u201005_iK\u20102020\u201001\u201001.pdf. Updated December 5 2019. [Last accessed March 16 2020]."},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.317.7154.307"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-126-9-199705010-00007"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/CEJ.0000000000000392"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.144.11.1468"},{"key":"e_1_2_9_27_1","first-page":"215","article-title":"Diagnosing skin cancer in primary care: how do mainstream general practitioners compare with primary care skin clinic doctors?","volume":"187","author":"Youl PH","year":"2007","journal-title":"MAJ"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2011.04228.x"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2012.11091.x"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1275711"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2015.2680"},{"key":"e_1_2_9_32_1","unstructured":"Kassen\u00e4rztliche Bundesvereinigung (KBV).Statistische Informationen aus dem Bundesarztregister. Bundesgebiet gesamt. Available from:https:\/\/www.kbv.de\/media\/sp\/2018_12_31_BAR_Statistik.pdf. Updated December 31 2018. [Last accessed July 16 2019]."},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-018-2955-2"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00103-018-2836-6"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-008158"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2016.05.029"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29755"}],"container-title":["JDDG: Journal der Deutschen Dermatologischen Gesellschaft"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ddg.14318","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ddg.14318","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ddg.14318","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T06:29:04Z","timestamp":1693549744000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ddg.14318"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,25]]},"references-count":36,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1111\/ddg.14318"],"URL":"https:\/\/doi.org\/10.1111\/ddg.14318","archive":["Portico"],"relation":{},"ISSN":["1610-0379","1610-0387"],"issn-type":[{"value":"1610-0379","type":"print"},{"value":"1610-0387","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,25]]},"assertion":[{"value":"2020-01-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-01-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}