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Sentinel lymph node biopsy for in situ melanoma is unlikely in Australia
  1. Rachael L Morton1,2,
  2. John F Thompson2
  1. 1 NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, Australia
  2. 2 Melanoma Institute Australia, North Sydney, New South Wales, Australia
  1. Correspondence to Associate Professor Rachael L Morton, NHMRC Clinical Trials Centre, Camperdown, NSW 2050, Australia; rachael.morton{at}

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We commend Badgery-Parker and colleagues for their comprehensive review of ‘low-value’ healthcare provided at public hospitals in New South Wales (NSW), Australia and support their initiative to identify low-value care.1 In relation to melanoma in situ, we agree completely with the Evaluating Evidence Enhancing Efficiences (EVOLVE) guidelines2 that there is no evidence that sentinel node (SN) biopsy for this entity is beneficial and also agree that it would constitute low-value care if performed. However, there appears to be a serious methodological flaw in the study by Badgery-Parker et al which may have led to the erroneous claim that SN biopsy for melanoma in situ is being performed in NSW public hospitals and ‘requires action to reverse increasing trends’.

The authors used public hospital admitted-patient data to identify SN biopsy procedures and International Statistical Classification of Diseases and …

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  • Contributors RLM and JFT conceived the letter in response to Badgery-Parker et al (2018). RLM wrote the first draft and this was reviewed and refined by JFT. Both authors approved the final submitted version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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