Validation and Application of the Webb and Rivera Score in the Academic Setting

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In Mohs micrographic surgery (MMS), there is variation in the number of stages required to clear a tumor and the length of time needed to complete each case, making it difficult to allocate resources efficiently for a MMS clinic. The Webb and Rivera (WAR) score was developed as a preoperative assessment tool and was validated with data from private dermatology practices but has not been assessed for use in the academic setting. The WAR score assigns a numerical value to each surgical case based on 4 criteria: greatest dimension size, tumor recurrence, location, and aggressiveness and was found to correlate moderately well with both number of stages per MMS case (ρs = 0.41, p < .001) and length of time per MMS case (ρs = 0.34, p < .001) in the private setting.1 Our study aimed to validate the WAR score using data from an academic MMS clinic, evaluate covariates present in the academic setting that may affect the correlation, and modify the WAR score, if needed.
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