Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
Views 274
Citations 0
Comment & Response
July 2013

Concerns Regarding Results of a Randomized Controlled Trial to Promote Skin Self-Examination and Sun Protection Behaviors

Author Affiliations
  • 1The Cancer Institute of New Jersey, New Brunswick
  • 2Department of Medicine, UMDNJ–Robert Wood Johnson Medical School, New Brunswick, New Jersey
  • 3Department of Health Education and Behavioral Science, UMDNJ–School of Public Health, Piscataway, New Jersey
  • 4Department of Biostatistics, UMDNJ–School of Public Health, Piscataway, New Jersey

Copyright 2013 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Dermatol. 2013;149(7):883-884. doi:10.1001/jamadermatol.2013.718

To the Editor We write regarding 2 articles by Aneja and colleagues1,2 describing results of a randomized trial to promote skin self-examination (SSE) and sun-protection behaviors among individuals attending dermatology clinics. A key concern is that imbalance in baseline levels of each behavioral outcome (ie, performance of SSE, use of sun-protective clothing, and sunscreen use) may explain or attenuate treatment arm differences at follow-up. For example, use of sun-protective clothing at the follow-up was significantly higher among intervention than control group participants.2 However, 40.2% of intervention group participants reported always or frequently using sun-protective clothing at baseline compared with 28.6% of control group participants.1 A prudent approach should include sensitivity regression analyses (akin to those summarized in Table 31 and the Table2) estimating intervention effects on behavioral outcomes at the 3-month follow-up after controlling for the baseline levels. If baseline adjustments yielded nonsignificant results, then intervention effects would need to be interpreted with more caution.

First Page Preview View Large
First page PDF preview
First page PDF preview