Baseline Characteristics from the MEL‑SELF Trial Relevant to Patient‑Led Surveillance

Baseline data from the randomized MEL‑SELF trial describe participants entering a comparison of patient-led surveillance (usual care plus reminders to perform skin self-examination, a mobile dermatoscope, teledermatologist assessment, and fast-tracked unscheduled clinic visits) vs clinician-led surveillance (usual care). The authors state that 1226 patients were screened and 504 were randomized, with 251 assigned to the patient-led surveillance arm and 253 to the clinician-led surveillance arm. The report frames baseline characteristics across several domains, including skin self-examination (SSE) behaviors, psychological measures centered on fear of recurrence, and self-reported confidence using digital devices. Together, these measures outline participant characteristics and concerns at the start of trial participation.

Baseline SSE practice spanned a wide range of self-monitoring patterns. The authors report that 103 participants (20%) had not performed SSE in the previous 12 months, while 160 (32%) reported weekly or monthly SSE. The study also reports a confidence gap: 252 of 503 participants (50%) lacked confidence in performing SSE. These distributions describe the range of self-monitoring behaviors and self-assessed capability at trial entry.

Psychological baseline findings in the abstract include a high prevalence of clinically significant fear of melanoma recurrence (FCR), reported in 232 participants (46%). The authors note that clinically significant FCR was associated with female sex, younger age, and higher depression, anxiety, and stress scores, as described in their baseline analysis. The abstract also distinguishes perceived vs calculated melanoma risk, reporting that FCR was associated with higher perceived lifetime melanoma risk but not with participants’ calculated risk of a subsequent new primary melanoma (OR, 1.00; 95% CI, 0.99–1.01). Overall, the abstract characterizes FCR at baseline as clustering with demographic and psychological factors and aligning more with perceived than calculated risk.

Alongside behavioral and psychological measures, the abstract reports high self-reported comfort with technology: 460 participants (91%) were confident in using digital devices. The authors present this digital-device confidence together with baseline SSE and FCR measures as part of the entry profile for a pathway that includes teledermatology components in the patient-led surveillance arm. In the abstract’s baseline description, SSE practices varied, fear of recurrence was reported in a sizeable subgroup, and confidence using digital devices was generally high.

Key Takeaways:

• Baseline SSE behavior and self-reported confidence were heterogeneous, with the abstract reporting both nonperformance over the prior year and regular (weekly/monthly) checks, alongside a substantial group lacking confidence.
• Clinically significant FCR was reported in nearly half of participants and, in the abstract, was associated with demographic and psychological characteristics and with perceived—but not calculated—subsequent melanoma risk.
• High self-reported confidence using digital devices was reported at baseline in the abstract, presented alongside SSE and FCR measures as part of the trial’s participant profile.