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We thank Drs Morton and Thompson1 for their comments on our indicator for low-value sentinel lymph node biopsy (SLNB). They provide a plausible explanation for our finding that SLNB appears to be used for melanoma in situ in public hospitals in New South Wales (NSW). Their explanation is based on an understanding of care processes that cannot be inferred from our data. We hoped to gain such understanding through our clinician workshop, for which invitations were sent out widely through various channels. We agree it is unfortunate that no dermatologists, pathologists or oncologists chose to participate.
Morton and Thompson suggest that melanoma in situ is recorded when a wide-excision specimen is taken from a site that was previously biopsied and found to have invasive melanoma. If the wide-area specimen has residual melanoma in situ, this diagnosis is recorded, while the SLNB is done because of …
Contributors TBP drafted the letter. All authors revised the letter and approved the final 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 AGE holds a HCF Research Foundation Professorial Research Fellowship and receives income as a Ministerial appointee to the (Australian) Medicare Benefits Schedule (MBS) Review Taskforce, as a Board Member of the NSW Bureau of Health Information (BHI) and as a consultant to Private Healthcare Australia and the Queensland and Victoria state health departments. TB-P has received consulting fees from Queensland Health and the Victorian Department of Health and Human Services.
Patient consent Not required.
Provenance and peer review Not commissioned; internally peer reviewed.