Skin Cancer Surgery PSP Question Verification Form

The purpose of this Question Verification Form is to enable Priority Setting Partnerships (PSPs) to describe clearly how they checked that their questions were unanswered, before starting the interim prioritisation stage of the process.

The JLA requires PSPs to be transparent and accountable in defining their own scope and evidence checking process. This will enable researchers and other stakeholders to understand how individual PSPs decided that their questions were unanswered, and any limitations of their evidence checking.

Name of the PSP

The Skin Cancer Surgery JLA Priority Setting Partnership

Please describe the scope of the PSP

Our Scope was defined as:

• Uncertainties relevant to skin cancer surgery for all types of suspected primary skin cancer.

• Uncertainties relevant to surgery for local and regional skin cancer recurrence.

• Uncertainties related to service delivery or the patient path-way / multi-disciplinary teams (MDTs) which result in delivering skin cancer surgery.

• Examples include anything related to the consent, anaesthesia, antibiotics, variations in the procedure, scar outcomes, wound care, follow-up related to scar outcome or surgical outcome.

If research questions were submitted which did not fit this scope, for example, were related to the causes of skin cancer rather than being related to skin cancer surgery, they were excluded.

Please provide a brief overview of your approach to checking whether the questions were unanswered

The questions were categorised into topics such as teaching, scarring, reconstruction and the environment. Each category was allocated to a team of two evidence checkers. Each submission within the category was individually appraised to ensure it was a true ‘uncertainty’ through evidence checking of the types of evidence detailed in the next question. The JLA definition of an evidence uncertainty is that (i) no up-to-date, reliable systematic reviews of research evidence addressing the uncertainty exist and/or (ii) up-to-date systematic reviews of research evidence show that uncertainty exists. Once appraised each category was presented to the group of six evidence checkers to ensure consensus opinion. Where a decision could not be made this was discussed with the Steering Group for a final decision.

Please list the type(s) of evidence you used to verify your questions as unanswered

Systematic reviews, Cochrane reviews, meta-analysis, scoping reviews, clinical guidelines.

Please list the sources that you searched in order to identify that evidence

Embase, Pubmed, Cochrane, Google scholar, Clinicaltrials.gov, Google

What search terms did you use?

Skin cancer; skin cancer surgery; wound infections; surgical site infections; scarring; radiotherapy; complications; sentinel lymph node biopsy; lymph node dissection; teaching; skin graft; skin flaps; melanoma; squamous cell carcinoma; basal cell carcinoma; keratinocyte cancer; secondary intention; sutures

Please describe the parameters of the search (eg time limits, excluded sources, country/language) and the rationale for any limitations

No time restrictions.

English language/translated articles only. No articles were identified that were not already translated.
Worldwide articles used. No geographical restrictions.

Names of individuals who undertook the evidence checking

Aaron Wernham, David Veitch, Alistair Brown, Jasmine Mann, Stela Ziaj, Eleanor Earp

On what date was the question verification process completed?

14th October 2021

Any other relevant information

NA