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Sentinel lymph node biopsy for in situ melanoma is unlikely in Australia

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 …