title: The Webb and Rivera (WAR) score: a preoperative Mohs surgery assessment tool.
abstract: OBJECTIVE
  To make available a simple, quantitative formula for preoperative assessment of both the complexity and the associated time required to complete Mohs surgical cases. It will improve office efficiency, technical performance, and resource management.
  
  
  METHODS
  Surveys were sent to 94 Mohs surgeons requesting information on 10 consecutive cases, including tumor size, recurrence, location, aggressiveness, stages required, and case duration. The data were then aggregated, scored, and statistically evaluated.
  
  
  METHODS
  Private practice dermatology offices performing Mohs surgery were included.
  
  
  METHODS
  Sequential randomized selection of Mohs College and Mohs Society fellows was used for inclusion. Sequential selection of patients for data acquisition was performed by the surgeons.
  
  
  METHODS
  The statistical significance of a proposed preoperative assessment tool was to be determined.
  
  
  RESULTS
  The score ρ values were 0.34 and 0.41 for the time and number of stages, respectively. In addition, the Mohs score obtained a statistically significant P value of <.001 for both the time and number of stages required.
  
  
  CONCLUSIONS
  The Webb and Rivera (WAR) score is a low-effort, efficient, reproducible tool to be used in preoperative Mohs surgery planning and office efficiency improvement. The components of the score include maximum tumor dimension, recurrence, location, and aggressiveness. Each is assigned a numerical value that is totaled, resulting in a final quantitative score.
authors.affiliation: Department of Dermatology, Northeast Regional Medical Center, Kirksville, Missouri, USA. bo_rivera@yahoo.com
authors.forename: Albert E
authors.initials: AE
authors.lastname: Rivera
authors.forename: J Michael
authors.initials: JM
authors.lastname: Webb
authors.forename: Lloyd J
authors.initials: LJ
authors.lastname: Cleaver
mesh_terms: D001071:Appointments and Schedules; D003625:Data Collection; D003880:Dermatology / Q000458:organization & administration; D006801:Humans; D015580:Mohs Surgery; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D010347:Patient Care Planning; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D057234:Preoperative Period; D011897:Random Allocation; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*; D018709:Statistics, Nonparametric; D013997:Time Factors; D047368:Tumor Burden