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Biomedical subjects

Daniel M Siegel

Publications and source records attributed to Daniel M Siegel.

6 recordsLinked to original sources
PubMed2006

Mohs math--where the error hides.

BACKGROUND: Mohs surgical technique allows a full view of surgical margins and has a reported cure rate approaching 100%. METHOD: A survey amongst Mohs surgeons was performed to assess operator technique. In addition, an animated clay model was constructed to identify and quantify tissue movement seen during the processing of Mohs surgical specimens. RESULTS: There is variability in technique used in Mohs surgery in regards to the thickness of layers, and the number of blocks layers are cut into. A mathematical model is described which assesses the clinical impact of this variability. CONCLUSION: Our mathematical model identifies key aspects of technique that may contribute to error. To keep the inherent error rate at a minimum, we advocate minimal division and minimal physical thickness of Mohs specimens.

Clinical Competence↗
PubMed2005

The indoor UV tanning industry: a review of skin cancer risk, health benefit claims, and regulation.

BACKGROUND: Nearly 30 million people tan indoors in the United States annually, including 2.3 million adolescents. Despite increased evidence on the dangers of artificial UV radiation, the popularity of indoor tanning is growing. OBJECTIVES: We aim to assess the following 3 entities: (1) the association of indoor tanning with skin cancer; (2) statements regarding the health benefits of indoor tanning, especially regarding the production of vitamin D; and (3) current regulation of the tanning industry in the United States. METHODS: We conducted a narrative review of the literature. RESULTS: Indoor tanning poses great risks. Studies support the role of artificial UV radiation in cutaneous carcinogenesis. Despite claims by the tanning industry, artificial tanning is not a safe or necessary way to increase systemic vitamin D levels. The National Institutes of Health and the World Health Organization have acknowledged the risks of indoor tanning. Nonetheless, regulations limiting tanning in the United States are surprisingly sparse. LIMITATIONS: Systematic review of the literature was not performed. CONCLUSIONS: Health care providers must increase efforts to warn and educate the public and government about the dangers of UV radiation.

Beauty Culture↗
PubMed2004

Patients spend more time with the physician for excision of a malignant skin lesion than for excision of a benign skin lesion.

BACKGROUND: Currently, there is a difference in reimbursement between excision of malignant and benign lesions. There is concern that there is not sufficient rationale for differential reimbursement for these two procedures. OBJECTIVE: To assess whether there is a difference in physician work involved with excision of benign versus malignant skin tumors. METHOD: We searched National Ambulatory Medical Care Survey data for visits at which excision of benign and malignant skin lesions was performed. We compared the time spent with the physician at these two types of visits. To exclude confounding issues unrelated to the excision that would affect the time of visit, we excluded visits at which multiple diagnoses were addressed. RESULTS: The mean time spent with the physician at visits for excision of benign lesions was 22.9 +/- 1.0 minutes. The mean time spent with the physician at visits for excision of malignant lesions was 30.0 +/- 1.7, 30% longer (p<0.001). The longer time for excision of malignant lesions remained significant after controlling for age, gender, and race. CONCLUSION: Excision of malignant lesions involves more physician work than does excision of benign lesions. Elimination of differential compensation for benign versus malignant skin lesion procedures would not enhance the accuracy of reimbursement. In the absence of any compelling rationale to change the existing differential reimbursement, the proposals to do so are not warranted.

Episode of Care↗