Date of Award

January 2014

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Jennifer N. Choi

Subject Area(s)

Medicine

Abstract

Many oncology patients experience dermatologic toxicities that can interfere with their cancer treatment regimen. Other authors have suggested that prompt dermatologic evaluation may improve oncologic outcomes. Patients seen at the Yale Oncodermatology Clinic between January 2009 and December 2011 were retrospectively studied to determine the average wait time patients experienced for obtaining a clinic appointment as compared to the national average. In addition, we analyzed the patient population and the impact the Clinic had on patients' oncologic treatment. Patient demographics, dermatologic history, and appointment schedules were abstracted through extensive chart review. Data was analyzed using t-tests and logistic and negative binomial regressions. Younger people had a shorter wait time to attended appointment. The clinic was more likely to have an impact on patients' cancer treatment if they received dermatologic treatment from the clinic and if a culture was done. Whether or not a biopsy was taken was not likely to have an impact on cancer treatment. Increased wait time until attended appointment, female gender, biopsies and cultures taken at the visit, and prescription of dermatologic treatments were associated with an increased likelihood of an incidental dermatologic finding. The study's limitations include its single institutional nature and the lack of a comparable non-oncodermatologic patient group. That the difference in appointment wait time between the oncodermatology clinic and national averages is statistically significant is a testament to the goals of the clinic, which include providing oncology patients with dermatologic care early in their disease course.

Comments

This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.

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