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Ade Adamson, MD MPP Profile picture
Ade Adamson, MD MPP
@AdeAdamson
Dermatologist | Health Services Researcher | Alum: @Morehouse @HarvardMed @MIT_HST @Kennedy_School | I'm a naive EBM aficionado
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Jun 8, 2023 • 15 tweets • 5 min read
NEW 🚨research🚨 where we show that patients diagnosed with melanoma in situ (MIS) live LONGER overall than age/sex/race matched individuals (112% relative survival) without MIS. jamanetwork.com/journals/jamad… this suggests MIS may mostly be a marker of health seeking behavior. Image Melanoma in situ (MIS) also known as stage 0 melanoma is the FASTEST growing cancer in the US with a 50-fold increased incidence since 1975. It now accounts for HALF of all melanoma diagnoses. However, little is known about its association with survival statistics. Image
Mar 20, 2022 • 9 tweets • 3 min read
The wildest thing about this paper is we wrote it in 2017, then shelved it because of the initial push back in peer review. This experience taught me A LOT about when colleagues are ready to accept ideas that challenge their thinking. 🧵
1/9 To me the idea that melanoma overdiagnosis exists is an idea that is readily apparent. It’s a phenomenon seen in other cancers, the epidemiologic signatures are consistent, and people have written about it before.
2/9
Mar 16, 2022 • 15 tweets • 5 min read
Over HALF of new melanoma diagnoses among white Americans in the United States likely represent overdiagnosis. New research out in @JAMADerm. THREAD! 🧵
jamanetwork.com/journals/jamad… The incidence of melanoma has risen 6-fold in the past 40 years in the US, while mortality has remained largely flat, an epidemiological signature consistent with overdiagnosis, as we detailed in a @NEJM article last year.
Jan 7, 2021 • 31 tweets • 10 min read
This tweet got a bit derailed by the attempted coup yesterday...but Gil Welch, @BenMazer and me in this week's @NEJM where we explain how UV exposure CAN'T explain the rapid rise in melanoma which is likely an epidemic of diagnosis and NOT disease nejm.org/doi/full/10.10… THREAD👇🏾 I’m somewhat nervous about the reaction from dermatologists (i.e. my medical tribe). But here goes nothing…let’s dive right in!
Dec 16, 2020 • 12 tweets • 5 min read
Last year the @TODAYshow said I was wrong about sunscreen and skin cancer in Black people. Here is our latest publication in @JAMADerm showing why I was right.
Let me explain.... Image It all started with this article I wrote in the @washingtonpost challenging the idea that sunscreen would have saved Bob Marley who died of melanoma on his foot.
Jan 21, 2020 • 18 tweets • 6 min read
Effect of Sunscreen Application on Plasma Concentration of Sunscreen Active Ingredients: jamanetwork.com/journals/jama/… PART-2 of a study on chemical sunscreen absorbing into the blood. This is surely going to stir up more controversy. Let me break it down in this thread #tweetorial 👇🏾 In May 2019 the same group of investigators published a study in @JAMA_current asking the question: What is the concentration of chemical sunscreen that gets in the blood if used under maximal conditions (i.e. Used 4 times per day for 4 days)? Study here: jamanetwork.com/journals/jama/…
Dec 11, 2019 • 14 tweets • 4 min read
Machine Learning and the Cancer-Diagnosis Problem — No Gold Standard: nejm.org/doi/full/10.10…
My latest work in @NEJM with Dr. Gil Welch in which we discuss how machine learning cannot overcome a central problem in cancer diagnosis and we suggest a way forward. #tweetorial 👇🏾👇🏾👇🏾 Machine learning (ML) is a potential powerful tool that may help clinicians deliver faster and more consistent diagnoses and improve patient care. But there are inherent limitations.
Oct 2, 2019 • 29 tweets • 8 min read
What are the Epidemiologic Signatures in Cancer? A new special report out in NEJM by Gil Welch, Barnett Kramer, and William Black is so good I had to do a #tweetorial. nejm.org/doi/full/10.10…
👇🏾👇🏾👇🏾 TL;DR -- The MAJOR takeaway doctors and trainees should get from this article is this:
Cancer incidence is an UNRELIABLE measure of cancer burden.
Jul 23, 2019 • 13 tweets • 4 min read
Skin cancer better diagnosed by deep learning than doctors aiin.healthcare/topics/diagnos… Press releases like these really irritate me. Let’s a take a dive into this study. Here is a link to it: ejcancer.com/article/S0959-…
May 16, 2019 • 8 tweets • 3 min read
Randomized phase 3 evaluation of trifarotene 50 μg/g cream treatment of moderate facial and truncal acne.
Link: jaad.org/article/S0190-…
These types of studies are so frustrating because the control arm is NOT a reflection of standard of care. A thread. #tweetorial 👇🏾 In this study investigators randomized patients to a new retinoid (trifarotene)
for acne treatment or vehicle (basically a cream/moisturizer). Of course they showed superior improvement with the new medication.
May 6, 2019 • 32 tweets • 8 min read
Effect of Sunscreen Application on Plasma Concentration of Active Ingredients bit.ly/2vD3w9V This provocative study in JAMA about sunscreen deserves a #tweetorial. Bear with me as I take you through the controversy and discuss sunscreen in general. 👇🏾👇🏾👇🏾 TL; DR – certain chemical sunscreens are absorbed after application; we don’t know what this means for human health. This does not mean you should abandon sunscreen use nor does it mean sunscreens are unsafe.
Dec 31, 2018 • 21 tweets • 5 min read
I’m glad that this article was written, it makes a LOT of great points about sun exposure and melanoma, but I think a few things need further discussion.

My final #tweetorial of 2018! 👇🏾👇🏾👇🏾 In order to appreciate the complexity of this relationship (i.e. sun exposure and melanoma), one must remember that measuring sun exposure over time is HARD.
Nov 21, 2018 • 11 tweets • 4 min read
New @JAMADerm cost-effectiveness study on use of combination Talmogene Laherparepvec (Tvec) + ipilimumab (ipi) vs ipi alone. Cost of 1 year of life w/o tumor growth was $2.2 million!!! Blistering editorial by Zeke Emanuel and @sarah_dimagno thread👇🏾
jamanetwork.com/journals/jamad… This cost effectiveness analysis was based on a 2018 Phase II study of stage III/IV unresectable melanoma patients randomized to ipi alone or ipi + Tvec
here: ncbi.nlm.nih.gov/pmc/articles/P…
Oct 11, 2018 • 26 tweets • 6 min read
This study is yet another one in a growing list demonstrating that dysplastic nevi are NOT obligate precursor lesions for melanoma. Let me give you a brief history/discussion of the 40 year old controversy.

A thread/#Tweetorial 👇🏾👇🏾👇🏾 Dysplastic nevi are atypical looking moles that appear on the skin that can look like melanoma.
Sep 19, 2018 • 20 tweets • 4 min read
Study: African Americans Are More Burdened by Atopic Dermatitis Severity mdmag.com/medical-news/s… the conclusions of this study are deeply problematic and show the authors don't quite understand how to think about race.

A thread 👇🏾👇🏾👇🏾 The first flag for me was this statement:
Jul 9, 2018 • 17 tweets • 4 min read
There are a lot of misconceptions about sunscreen and whether or not dark-skinned people need to wear it to prevent skin cancer. This NPR piece does a POOR job presenting the actual evidence. I think a TWEETORIAL is in order. Melanoma is a potentially deadly form of skin cancer that has been linked to over exposure to UV rays from the sun. Thus, the promotion of sunscreen as an effective intervention to prevent melanoma is a reasonable public health message.