Annette Cyr, Melanoma Canada Founder  

I’m proud to share that I contributed to an important study and publication,  Defining Melanoma Quality Indicators: A Modified Delphi Approach, focused on improving melanoma care in Ontario. Working alongside medical experts and international specialists, we identified 23 indicators that show what high-quality care looks like for melanoma patients — from diagnosis and treatment to patient experience and survivorship.   

As a patient advocate, my role was to make sure that the patient perspective was central in shaping these indicators. The goal is simple: to ensure melanoma patients receive consistent, high-quality treatment across the province. By defining these quality indicators, we’re helping healthcare providers and policymakers track progress, identify gaps, and ultimately improve outcomes for people living with melanoma.  

This work is an important step toward a more patient-focused healthcare system — one that listens to those it serves and delivers care that is both effective and compassionate.  

What the Study Did  

  • The study aimed to define quality indicators for melanoma care in Ontario. 
  • We used a modified Delphi process — experts and patient voices worked together through surveys and meetings to agree on what “good care” should look like. 
  • The panel included doctors from many specialties, health system leaders, and, most importantly, me as a patient advocate, ensuring the patient perspective remained central. 

What Was Found  

  • We reviewed 29 possible indicators covering diagnosis, treatment, pathology, patient experience, symptom management, and survivorship.  
  • After rounds of review and discussion, 23 indicators were agreed upon as reflecting high-quality melanoma care.  Examples of indicators include:  
  • Timely diagnosis and treatment: measuring how quickly patients move from referral to their first surgery.  
  • Biopsy quality: ensuring the initial biopsy fully removes the suspicious spot with clear margins.  
  • Patient education: tracking how many patients and their partners are taught to check their skin and lymph nodes for signs of recurrence.   
  • Treatment timelines: ensuring wide local excision happens within 84 days of diagnosis and that adjuvant therapy begins within 12 weeks after surgery.  
  • Only 4 indicators of the 23 indicators can currently be measured using Ontario’s health databases (like wait times, survival rates, and emergency visits after surgery). More work is needed to track all of them.  
  • These indicators will be included in Ontario’s Cancer System Quality Index (CSQI) report, which tracks how well the cancer system is performing.  

  

Why It Matters  

  • Melanoma rates are rising in Ontario and worldwide, so consistent, high-quality care is critical.  
  • These indicators help identify where the system is doing well and where improvements are needed.  
  • Including patient voices, the study ensures care standards reflect real patient needs and experiences, not just clinical outcomes.  

Our Role  

Having a patient advocate at the table helped shape measures that reflect what matters most — things like timely diagnosis, clear communication, and support during treatment and survivorship. Our contribution helps ensure the healthcare system is not only clinically effective but also compassionate and patient-centered.  

 Find support for melanoma and skin cancer.  

Source: European Journal of Cancer www.journals.elsevier.com/ejc-skin-cancer