CARES : Customized Aftercare Report for Evaluated Skin Cancer Patients

This study is a prospective, parallel-group, open-label, randomized controlled trial designed to evaluate the impact of a personalized discharge letter-with or without digital visual support -on reassurance, knowledge, and self-management in low-risk skin cancer patients following dermatological screening.

Study Arms: Participants will be randomly assigned to one of three groups:

• Group A - Standard of Care: Verbal information only.
• Group B - Personalized Discharge Letter: Tailored written information based on individual risk profile, skin type and consultation findings.
• Group C - Personalized Discharge Letter + digital visual support: Tailored written information plus digital visual support (e.g. annotated images, visual summaries).

Scientific Rationale Current discharge practices for low-risk skin cancer patients often rely on general verbal advice, which may not sufficiently address individual concerns or promote long-term self-care. Evidence from other medical domains suggests that personalized communication improves patient understanding, satisfaction, and adherence to follow-up recommendations.

This study introduces an AI agent trained on validated discharge letters from the hospital's electronic health record system (KWS). The AI helpt collect information from the electronic health record that is relevant for creating personalized letters that are reviewed by a physician before being provided to the patient. These letters aim to improve understanding of personal skin cancer risk, sun protection, and self-monitoring practices.

The addition of visual digital support (IntelliStudio) is hypothesized to further enhance patient engagement and confidence by providing clear, visual explanations of findings and next steps. This design allows for a direct comparison of standard care versus increasingly personalized interventions, enabling the evaluation of both individual and combined effects.

Inclusion criteria

• Voluntary written informed consent of the participant or their legally authorized representative has been obtained prior to any screening procedures
• Low-risk skin cancer patients:

• Negative personal history for melanoma
• Less than 100 naevi
• Less than 5 clinically atypical naevi
• Maximum 1 BCC in history
• Maximum 1 SCC, and at least 5 years ago
• AK: treated and controlled with clinical response
• M Bowen: treated and controlled with clinical response
• Adult subjects (between 18 years of age and 80 years) at time of enrolment

Exclusion criteria

• Presence of dermatological lesions requiring immediate treatment at the time of consultation.
• History of solid organ transplantation (Organ Transplant Recipient, OTR).
• Known carriers or suspected carriers (based on family history) of germline mutations associated with increased skin cancer risk (e.g. CDKN2A, PTCH1, XP genes).
• Failure to meet one or more of the inclusion criteria.
• Any condition or comorbidity that, in the opinion of the investigator, may interfere with study participation or data interpretation (e.g. severe cognitive impairment, language barrier).
• Participation in another interventional clinical trial that may interfere with the outcomes of this study.