Health-Care Delay in Malignant Melanoma: Various Pathways to Diagnosis and Treatment
Table 2
(a) Definition of milestones. (b) Mean, median, and range (in days) between milestones in the clinical pathway of melanoma patients seeking care at either PHCs or Derm clinics.
(a)
Milestones
Event marked by milestone
0 = initial contact
Patient booked the first appointment
A = assessment by physician
The first assessment by a physician
B = preexcision referral
Referral for primary excision
C = primary excision
Primary excision
D = histopathological diagnosis I
Result from first histopathological diagnosis
E = referral for wide excision
Referral for wide excision
F = wide excision
Wide excision surgery
G = histopathological diagnosis II
Result from second histopathological diagnosis
H = follow-up referral
Referral for follow-up
I = follow-up
Follow-up visit
(b)
Milestone transition
PHCs (days)
Derm (days)
Participants ()
Mean
Median
Range
Mean
Median
Range
A → B
11.8
0
0–98
3.0
0
0–13
ns
24
B → C
41.6
35.0
13–131
19.0
20.0
5–34
0.024
24
A → C
19.9
0
0–131
14.1
4.5
0–67
ns
71
C → D
16.0
13.0
1–134
7.2
6.5
1–17
0.001
71
D → E
7.2
5.0
0–28
22.1
4.0
0–121
ns
53
E → F
74.4
50.0
20–374
121.5
57.5
15–528
ns
52
F → G
13.2
12.0
0–64
9.3
8.0
1–25
ns
65
G → H
10.6
7.0
0–60
11.9
2.0
0–63
ns
44**
H → I
63.4
42.5
1–353
54.3
43.0
4–148
ns
43**
Mann-Whitney test.
**Seven patients excluded, as referral was sent before registration of histopathology diagnosis II.
