Dermoscopic diagnosis by a trained clinician vs. a clinician with minimal dermoscopy training vs. computer-aided diagnosis of 341 pigmented skin lesions: a comparative study
✍ Scribed by D. Piccolo; A. Ferrari; K. Peris; R. Daidone; B. Ruggeri; S. Chimenti
- Publisher
- John Wiley and Sons
- Year
- 2002
- Tongue
- English
- Weight
- 67 KB
- Volume
- 147
- Category
- Article
- ISSN
- 0007-0963
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✦ Synopsis
Background:
In the last few years digital dermoscopy has been introduced as an additional tool to improve the clinical diagnosis of pigmented skin lesions.
Objective:
To evaluate the validity of digital dermoscopy by comparing the diagnoses of a dermatologist experienced in dermoscopy (5 years of experience) with those of a clinician with minimal training in this field, and then comparing these results with those obtained using computer-aided diagnoses.
Methods:
Three hundred and forty-one pigmented melanocytic and non-melanocytic skin lesions were included. all lesions were surgically excised and histopathologically examined. digital dermoscopic images of all lesions were framed and analysed using software based on a trained artificial neural network. cohen's kappa statistic was calculated to assess the validity with regard to the correct diagnoses of melanoma and non-melanoma.
Results:
Sensitivity was high for the experienced dermatologist and the computer (92%) and lower for the inexperienced clinician (69%). specificity of the diagnosis by the experienced dermatologist was higher (99%) than that of the inexperienced clinician (94%) and the computer assessment (74%). notably, computer analysis gave a higher number of false positives (26%) compared with the experienced dermatologist (0.6%) and the inexperienced clinician (5.5%).
Conclusions:
Our results indicate that analysis either by a trained dermatologist or an artificial neural network-trained computer can improve the diagnostic accuracy of melanoma compared with that of an inexperienced clinician and that the computer diagnosis might represent a useful tool for the screening of melanoma, particularly at centres not experienced in dermoscopy.