Department of Plastic Surgery, University Hospitals of North Midlands NHS Trust, Stoke on Trent, UK.
Br J Hosp Med (Lond). 2020 Oct 2;81(10):1-5. doi: 10.12968/hmed.2020.0128. Epub 2020 Oct 16.
BACKGROUND/AIMS: Melanoma is the most aggressive skin malignancy with an ever-increasing caseload, especially in the western world. Recently developed immunotherapeutic modalities have substantially improved the prognosis of advanced melanoma. The association between serum levels of vitamin D and prognosis of melanoma has been a focus of ongoing research, with some evidence of vitamin D's potential as an adjunctive modality to immunotherapy. The National Institute for Health and Care Excellence guidelines clearly recommend that assessment of vitamin D levels and relevant advice should be an inherent aspect of the management of patients with melanoma at the secondary care level. METHOD: A service improvement project was conducted to ensure full compliance of practice in the authors' skin unit with the current National Institute for Health and Care Excellence guidelines on the management of vitamin D status in patients with melanoma. RESULTS: After two reaudits the unit's practice complied with National Institute for Health and Care Excellence guidelines by using a multidisciplinary team approach. CONCLUSIONS: The authors propose that the simple and reliable pathway used to achieve and sustain the results could be easily adopted to ensure universal adherence to these guidelines.
背景/目的:黑色素瘤是最具侵袭性的皮肤恶性肿瘤,其发病率不断上升,尤其是在西方国家。最近开发的免疫治疗方法大大改善了晚期黑色素瘤的预后。血清维生素 D 水平与黑色素瘤预后之间的关系一直是正在进行的研究的重点,有证据表明维生素 D 作为免疫治疗的辅助手段具有一定的潜力。英国国家卫生与保健优化研究所的指南明确建议,在二级保健水平上管理黑色素瘤患者时,评估维生素 D 水平并提供相关建议应成为其固有内容。
方法:进行了一项服务改进项目,以确保作者所在皮肤科单位的实践完全符合英国国家卫生与保健优化研究所关于黑色素瘤患者维生素 D 状态管理的现行指南。
结果:经过两次再审核,该单位采用多学科团队方法,符合英国国家卫生与保健优化研究所的指南。
结论:作者提出,为实现和维持这些结果而采用的简单而可靠的方法,可以很容易地被采用,以确保普遍遵守这些指南。
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