Jeffrey F. Scott’s research while affiliated with Johns Hopkins University and other places

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Publications (99)


Incidence and characteristics of acral lentiginous melanoma in Asian Americans and Pacific Islanders
  • Article

September 2023

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25 Reads

Journal of the American Academy of Dermatology

Angela H. Wei

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Bryan T. Carroll

Predictors of patient satisfaction with Mohs micrographic surgery at time of surgery and three months post-surgery: a prospective cohort study

July 2023

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20 Reads

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3 Citations

Journal of the American Academy of Dermatology

Background: Despite the importance of patient satisfaction in ensuring high-quality care, studies investigating patient satisfaction in Mohs micrographic surgery (MMS) are limited. Objective: We investigated the factors associated with patient satisfaction in MMS for non-melanoma skin cancer and how patient satisfaction changes in the post-operative period. Methods: In this prospective cohort study including 100 patients, patient satisfaction surveys were administered at the time of surgery and at three months post-surgery. Sociodemographic characteristics, medical history, and surgical parameters were collected by chart review. Univariate linear and logistic regression models were created to examine these relationships. Results: Decreased satisfaction was observed in patients requiring three or more MMS stages both at the time of surgery (p=0.047) and at three months post-surgery (p=0.0244). Patients with morning procedures ending after 1:00 PM had decreased satisfaction at the time of surgery (p=0.019). A decrease in patient satisfaction between the time of surgery and three months post-surgery was observed in patients with surgical sites on the extremities (p=0.036), larger pre-operative lesion sizes (p=0.012), and larger defect sizes (p=0.033). Limitations: Single-institution data, self-selection bias, and recall bias. Conclusion: Patient satisfaction for MMS is impacted by numerous factors and remains dynamic over time.


Prevalence and predictors of transportation barriers to healthcare among U.S. adults with a history of skin cancer
  • Article
  • Full-text available

April 2022

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266 Reads

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9 Citations

Journal of the American Academy of Dermatology

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Trends in prevalence, cost of care, and length of stay for newborns with congenital cutaneous hemangioma. a Trends in prevalence of congenital cutaneous hemangioma. b Trends in cost of care of congenital cutaneous hemangioma. c Trends in length of stay for congenital cutaneous hemangioma
Impact of congenital cutaneous hemangiomas on newborn care in the United States

October 2021

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90 Reads

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4 Citations

Archives of Dermatological Research

Little is known regarding the characteristics of newborns with congenital cutaneous hemangioma (CH) and the burden of CH on newborn care. The objective of this study is to describe the burden of CH on newborn inpatient stays in the United States. Specific aims include characterizing newborns with CH, assessing factors predictive of CH and procedures performed during hospitalization, determining characteristics associated with increased cost of care and length of stay in newborns with CH, and investigating trends in prevalence, length of stay, and cost of care. This is a nationally representative retrospective cohort study (National Inpatient Sample, 2009–2015). Sociodemographic factors associated with CH and risk factors for increased cost of care/length of stay were evaluated using weighted multivariable regression models. Overall prevalence of CH is 17.0 per 10,000 newborns. Cost of care and length of stay for newborns with CH are increasing over time. Controlling for all covariates, white (aOR 1.69), female (aOR 1.52) newborns from higher income families (aOR 1.44) were more likely to be born with CH (p < 0.001). Newborns with CH who were premature (aOR 3.88), underwent more procedures (aOR 8.81), and born in urban teaching hospitals (aOR 2.66) had the greatest cost of care (p < 0.001). Premature (aOR 3.74) newborns with CH in urban teaching hospitals (aOR 1.31) had the longest hospital stays (p < 0.001). The burden of CH in newborns is substantial and increasing over time. Understanding contributors to costly hospital stays is critical in developing evidence-based guidelines to reduce the growing impact of CH on newborn care.


Inflation-Adjusted Trends in Medicare Reimbursement for Common Dermatologic Procedures, 2007-2021

September 2021

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62 Reads

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18 Citations

JAMA Dermatology

Importance Medicare enrollment, dermatologist utilization of Medicare, and dermatologic procedural volume have all increased over time. Despite this, there are limited studies evaluating changes in Medicare reimbursement within dermatology. Objective To identify trends in Medicare reimbursement for 46 common dermatologic procedures from 2007 to 2021. Design, Setting, and Participants In this cross-sectional study, reimbursement data were obtained from the Centers for Medicare & Medicaid Services Physician Fee Schedule for commonly used dermatologic Current Procedural Terminology (CPT) codes from 2007 to 2021. The CPT codes in several major dermatologic categories were analyzed, including skin biopsy, shave removal, benign/premalignant/malignant destruction, benign/malignant excision, Mohs micrographic surgery, simple/intermediate/complex repair, flap, graft, and laser/phototherapy. All procedure prices were adjusted for inflation to January 2021 dollar value. Main Outcomes and Measures The primary outcomes were percentage changes and cumulative annual growth rates of pricing for each dermatologic procedure. Results From 2007 to 2021, there was a mean decrease in dermatologic procedure reimbursement of −4.8% after adjusting for inflation. Mean inflation-adjusted changes in reimbursements during this time period significantly varied by procedure type, including skin biopsy (+30.3%), shave removal (+24.5%), benign/premalignant/malignant destruction (−7.5%), Mohs micrographic surgery (−14.4%), benign/malignant excision (−3.9%), simple/intermediate/complex repair (−9.9%), flap repair (−14.1%), graft repair (−12.0%), and laser/phototherapy (−6.6%; P < .001). Changes in reimbursement did not vary by anatomical risk categories. Conclusions and Relevance The findings of this cross-sectional analysis suggest that changes in Medicare reimbursement can have several downstream effects, including concomitant private insurance changes and decreased patient access. Future adjustments in reimbursement should balance high-value care with sustainable pricing to optimize patient access.






Citations (69)


... Identifying demographic factors that affect psychosocial outcomes of MMS may help classify those at an increased risk of post-surgical impact. Baseline patient demographics have shown variable influence throughout the literature [9,10]. ...

Reference:

Predictors of psychosocial outcomes of Mohs micrographic surgery: a review
Predictors of patient satisfaction with Mohs micrographic surgery at time of surgery and three months post-surgery: a prospective cohort study
  • Citing Article
  • July 2023

Journal of the American Academy of Dermatology

... There was also no association of significant difference in primary surgery noted on the DID analysis. The lack of statistically significant difference in use of immunotherapy and primary surgery can be attributed to various factors: patients may face additional barriers to receiving melanoma care, such as transportation issues, lack of health education and awareness of treatment options, harmful health-seeking behaviors/attitudes of newly insured patients, or further socioeconomic barriers [23,24]. Moreover, the capacity of healthcare facilities and availability of specialists to perform melanoma surgeries or provide immunotherapy may not have increased proportionally with the expanded Medicaid coverage which may contribute to the lack of significance in the use of immunotherapy and primary surgery in our results. ...

Prevalence and predictors of transportation barriers to healthcare among U.S. adults with a history of skin cancer

Journal of the American Academy of Dermatology

... Dear Editor, Food insecurity, defined as a lack of consistent, dependable access to food, is associated with various poor health outcomes, including greater odds of hospitalization. 1 Previous research has linked food insecurity and paediatric atopic dermatitis (AD), suggesting that food insecurity may play a role in the development of AD, or exacerbate the financial stress associated with the disease. 2,3 However, it is unclear which patients with AD are at highest risk of food insecurity. Thus, the aim of this study was to identify the sociodemographic characteristics and predictors of food insecurity within a large, nationally representative cohort of children with AD in the USA. ...

Association of Food Insecurity With Atopic Dermatitis: A Cross-sectional Analysis of a National Sample of Pediatric Patients
  • Citing Article
  • November 2021

Dermatitis

... Medicare covers Americans aged 65 and older and some individuals younger than 65 with specific disabilities or conditions, including permanent kidney failure; Medicaid provides coverage for some low-income individuals with limited resources, children, and pregnant women [35]. Prior research has demonstrated a decline in dermatologists' financial compensation for the evaluation and treatment of Medicare patients [36][37][38]. One study used current procedural terminology code payments for common dermatology services to assess Medicare reimbursement rates over 20 years [36]. ...

Inflation-Adjusted Trends in Medicare Reimbursement for Common Dermatologic Procedures, 2007-2021
  • Citing Article
  • September 2021

JAMA Dermatology

... The COVID-19 pandemic has accelerated the rise of online health education tools and telehealth platforms, expanding the reach of providers beyond the constraints of traditional clinical settings. 1 This rapid expansion of digital technology has introduced an unprecedented amount of health information within reach of patients. With convenient access to online health educational materials (HEMs), patients can stay informed about their health conditions and treatment choices. ...

Bridging the digital divide among advanced age skin cancer patients

Journal of Plastic Reconstructive & Aesthetic Surgery

... Tumors involving the lip had the highest cumulative incidence of MCC-specific mortality among MCC with regional and distant metastasis (56.7% and 82.1%, respectively). The probability of MCC disease-specific death varies by primary site and may be a useful prognostic marker for MCC [100]. ...

Tumor primary site as a prognostic factor for Merkel cell carcinoma disease-specific death

Journal of the American Academy of Dermatology

... Cases are believed to be more sporadic in high-income countries and hospital data may provide a window through which the population disease burden can be glimpsed. In the United States, based on the National Inpatient Sample, scabies was diagnosed in 29.3 per 100,000 admissions [27]. Thus, our findings of scabies diagnosed in 51.65 per 100,000 patient encounters suggest a much higher burden of the scabies infestation in Hong Kong compared with the West. ...

Sociodemographic factors associated with scabies in the inpatient setting

American Journal of Infection Control

... functional status, risk tolerance) or surgeon-level (e.g., experience, preoperative risk assessment) factors influencing decisions regarding SLNB. Second, clinical oncology databases such as the NCDB are subject to coding errors [12], and therefore it is possible that instances of SLNB miscoding exist within our cohort. Third, the small proportion (4.6%) of Hispanic and other race/ethnicity patients within our cohort limits our ability to draw conclusions regarding disparities faced by these individuals; however, the overwhelming majority of patients being non-Hispanic White likely reflects the higher risk of melanoma in fair-skinned patients. ...

Inconsistencies in Cutaneous Melanoma Staging Within SEER Registries

... Twitter, in particular, facilitates rapid knowledge dissemination transcending distance and traditional hierarchies and can increase engagement in hard-to-reach audiences. The users of the #dermtwitter hashtag to facilitate academic discussion amongst dermatology practitioners have evolved into a thriving educational community [2]. ...

#DermTwitter and digital mentorship in the COVID-19 era

Journal of the American Academy of Dermatology

... telemedicine services allowing patients to send images of suspicious lesions to their clinicians) have been crucial in allowing skin cancer patients to meet pandemicrelated challenges. 1 While health information technology (HIT) use among skin cancer patients has significantly increased within the past decade, there remains a "digital divide" in both the access to and utilization of HIT across various demographics of skin cancer patients. 2 We consider that the technological advances made during the pandemic, while potentially beneficial for skin cancer management, may also have the unintended consequence of exacerbating this digital divide. ...

COVID-19 and the Surveillance, Epidemiology, and End Results Program: Future Considerations for Skin Cancer Research

Journal of Plastic Reconstructive & Aesthetic Surgery