Commentary on "Limitations in the literature regarding Mohs surgery and staged excision for melanoma: A critical review of quality and data reporting".

To the Editor: Adalsteinsson et al1 assessed the risk for bias in 48 publications that reported local recurrence rates (LRRs) for melanomas treated with Mohs micrographic surgery (MMS; n = 24), staged excision (SE; n = 23), or both MMS and SE (n = 1). Using a modified Risk of Bias in Non-randomized Studies–of Interventions (ROBINS-I) tool (Table I of their manuscript), they detected serious or critical bias in 47 (97.9%) of 48 studies, most commonly due to poorly defined outcomes. They conclude that improved reporting and prospective data are necessary.