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  1. Paul Little,
  2. Martin Keefe,
  3. John White
  1. Research fellow Primary Care, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST
  2. Consultant dermatologist Consultant dermatologist Department of Dermatology, University of Southampton, Southampton

    EDITOR,--When Duncan Keeley states in his commentary to our paper that “feasibility studies … that fail to address these issues [workload, earlier diagnosis, and anxiety] should not be undertaken,”1 he ignores appropriate study design. Ours was a validation study: validity must be proved before money is spent on feasibility studies. Furthermore, such pragmatic outcomes are not appropriate in validation studies because the intensive assessment may well affect patient behaviour.

    Keeley suggests that workload would “substantially increase.” However, opportunistic screening when patients attend for other reasons would …

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