Publications by authors named "H Peter Soyer"

593 Publications

Consumer Preference and Willingness to Pay for Direct-to-Consumer Mobile Teledermoscopy Services in Australia.

Dermatology 2021 Aug 13:1-10. Epub 2021 Aug 13.

Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia.

Objective: To investigate consumer preference and willingness to pay for mobile teledermoscopy services in Australia.

Methods: Consumers who were taking part in a randomised controlled trial comparing mobile teledermoscopy and skin self-examination were asked to complete a survey which incorporated a discrete choice experiment (DCE) and a contingent valuation question. Responses were used to determine their willingness to pay for mobile teledermoscopy services in Australia and their overall service preferences.

Results: The 199 consumers who responded were 71% female and had a mean age of 42 years (range, 18-73). The DCE results showed that consumers prefer a trained medical professional to be involved in their skin cancer screening. Consumers were willing to pay AUD 41 to change from a general practitioner reviewing their lesions in-person to having a dermatologist reviewing the teledermoscopy images. Additionally, they were willing to pay for services that had shorter waiting times, that reduced the time away from their usual activities, and that have higher accuracy and lower likelihood of unnecessary excision of a skin lesion. When asked directly about their willingness to pay for a teledermoscopy service using a contingent valuation question, the majority (73%) of consumers selected the lowest two value brackets of AUD 1-20 or AUD 21-40.

Conclusion: Consumers are willing to pay out of pocket to access services with attributes such as a dermatologist review, improved accuracy, and fewer excisions.
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http://dx.doi.org/10.1159/000517257DOI Listing
August 2021

Skin cancer classification via convolutional neural networks: systematic review of studies involving human experts.

Eur J Cancer 2021 Sep 8;156:202-216. Epub 2021 Sep 8.

First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece.

Background: Multiple studies have compared the performance of artificial intelligence (AI)-based models for automated skin cancer classification to human experts, thus setting the cornerstone for a successful translation of AI-based tools into clinicopathological practice.

Objective: The objective of the study was to systematically analyse the current state of research on reader studies involving melanoma and to assess their potential clinical relevance by evaluating three main aspects: test set characteristics (holdout/out-of-distribution data set, composition), test setting (experimental/clinical, inclusion of metadata) and representativeness of participating clinicians.

Methods: PubMed, Medline and ScienceDirect were screened for peer-reviewed studies published between 2017 and 2021 and dealing with AI-based skin cancer classification involving melanoma. The search terms skin cancer classification, deep learning, convolutional neural network (CNN), melanoma (detection), digital biomarkers, histopathology and whole slide imaging were combined. Based on the search results, only studies that considered direct comparison of AI results with clinicians and had a diagnostic classification as their main objective were included.

Results: A total of 19 reader studies fulfilled the inclusion criteria. Of these, 11 CNN-based approaches addressed the classification of dermoscopic images; 6 concentrated on the classification of clinical images, whereas 2 dermatopathological studies utilised digitised histopathological whole slide images.

Conclusions: All 19 included studies demonstrated superior or at least equivalent performance of CNN-based classifiers compared with clinicians. However, almost all studies were conducted in highly artificial settings based exclusively on single images of the suspicious lesions. Moreover, test sets mainly consisted of holdout images and did not represent the full range of patient populations and melanoma subtypes encountered in clinical practice.
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http://dx.doi.org/10.1016/j.ejca.2021.06.049DOI Listing
September 2021

The Impact of SARS-CoV-2 (COVID-19) Pandemic on International Dermatology Conferences in 2020.

Front Med (Lausanne) 2021 5;8:726037. Epub 2021 Aug 5.

Department of Dermatology, Seoul National University Hospital, Seoul, South Korea.

To limit the spread of the SARS-CoV-2 (COVID-19) outbreak, humans have been significantly restricted in their ability to travel and interact with others worldwide. Consequently, dermatology conferences were forced to adapt to such changes. The aim of this study is to investigate the impact of COVID-19 on international dermatology conferences. We retrospectively investigated decisions made for international dermatology conferences scheduled for 2020. Thirty-three major conferences were analyzed. Their data were obtained from their respective websites (data was accessed 2 June 2021). Among 33 conferences analyzed, 13 (39.4%) were conducted as scheduled, nine (27.3%) were canceled, eight (24.3%) were postponed to 2021 or 2022, and three (9.1%) were delayed but conducted in 2020. The number of the cancellation (44.4%) and postponement (75%) was the largest in the second quarter of the year. During the fourth quarter, most conferences were held on schedule (70%) but were run virtually. Eight out of 13 virtual conferences shortened their duration (61.5%). Most (90.9%) conferences have decided on the schedule of their meetings for 2021 or 2022 while three (9.1%) remain undecided. Twelve (40%) are planned to run virtually, eight (26.7%) have opted for a hybrid form, five (16.7%) are planned to run in-person, four (13.3%) have not decided on the format, and one (3.3%) has been canceled. Virtual and hybrid conference formats have facilitated people to share knowledge despite the travel restrictions posed by the COVID-19 pandemic. Such formats are environmentally friendly, are able to attract a large audience, and save delegates time and costs involved in attending. Therefore, virtual platforms should continue to be integrated within conferences in the post-pandemic era.
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http://dx.doi.org/10.3389/fmed.2021.726037DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8374890PMC
August 2021

Optimizing Texting Interventions for Melanoma Prevention and Early Detection: A Latin Square Crossover RCT.

Am J Prev Med 2021 09 21;61(3):348-356. Epub 2021 Jul 21.

Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia. Electronic address:

Introduction: Text messaging is an effective way to reach large populations with health promotion support. This study aims to establish the optimal text messaging intervention to achieve behavior change in young adults at risk of skin cancer.

Study Design: Latin square crossover RCT.

Setting/participants: Participants were women and men aged 18-40 years living in Queensland, Australia who owned a smartphone and had ≥2 skin cancer risk factors.

Intervention: Participants were enrolled from December 2018 to February 2019 and completed an eligibility survey. Eligible participants were randomized to 4 different text message interventions using a Latin square design with varying personalization, interactivity, and message frequency (February 2019‒July 2019). Each intervention lasted for 1 month; between interventions, participants had a 1-week washout period in which they completed an online questionnaire. Participants completed a 6-month follow-up online survey in January 2020.

Main Outcome Measures: Measures included self-reported sun protection habits and sunburns.

Results: A total of 277 (71.2% response rate) participants completed the 6-month follow-up. The sun protection habits index was significantly higher in all the 4 text messaging interventions (p<0.01 for each intervention) than at baseline, with similar sun protection habits improvements among all interventions (p=0.27). Sunburn rates decreased significantly over time (p<0.01 each intervention), with all the 4 interventions achieving reductions in sunburn rates during the intervention periods (p=0.78). Overall, the sunburn rates decreased from 40.3% at baseline to 7.0% at the end of the intervention, and at 6-month follow-up, it remained significantly below baseline levels at 23.5% (p<0.01).

Conclusions: Regular text messaging interventions result in significantly increased sun protection and decreased sunburn in young adults.

Trial Registration: This study is registered at the Australian and New Zealand Clinical Trials Registry ACTRN12618001299291.
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http://dx.doi.org/10.1016/j.amepre.2021.03.024DOI Listing
September 2021

A first-in-human study of BLZ-100 (tozuleristide) demonstrates tolerability and safety in skin cancer patients.

Contemp Clin Trials Commun 2021 Sep 4;23:100830. Epub 2021 Aug 4.

The University of Queensland Diamantina Institute, The University of Queensland, Dermatology Research Centre, Brisbane, Queensland, Australia.

BLZ-100 (tozuleristide) is an intraoperative fluorescent imaging agent that selectively detects malignant tissue and can be used in real time to guide tumor resection. The purpose of this study was to assess the safety, tolerability, and pharmacokinetics of BLZ-100 and to explore the pharmacodynamics of fluorescence imaging of skin tumors. In this first-in-human study, BLZ-100 was administered intravenously to 21 adult patients 2 days before excising known or suspected skin cancers. Doses were 1, 3, 6, 12, and 18 mg, with 3-6 patients/cohort. Fluorescence imaging was conducted before and up to 48 h after dosing. BLZ-100 was well tolerated. There were no serious adverse events, deaths, or discontinuations due to adverse events, and no maximum tolerated dose (MTD) was identified. Headache (n = 2) and nausea (n = 2) were the only BLZ-100 treatment-related adverse events reported for >1 patient. Median time to maximal serum concentration was <0.5 h. Exposure based on maximal serum concentrations increased in a greater than dose-proportional manner. For intermediate dose-levels (3-12 mg), 4 of 5 basal cell carcinomas and 4 of 4 melanomas were considered positive for BLZ-100 fluorescence. BLZ-100 was well tolerated at all dose levels tested and these results support further clinical testing of this imaging agent in surgical oncology settings. Clinicaltrials.gov: NCT02097875.
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http://dx.doi.org/10.1016/j.conctc.2021.100830DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8355837PMC
September 2021
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