Increase in the sensitivity for melanoma diagnosis by primary care physicians using skin surface microscopy
✍ Scribed by K. Westerhoff; W.H. Mccarthy; S.W. Menzies
- Book ID
- 104459607
- Publisher
- John Wiley and Sons
- Year
- 2000
- Tongue
- English
- Weight
- 234 KB
- Volume
- 143
- Category
- Article
- ISSN
- 0007-0963
No coin nor oath required. For personal study only.
✦ Synopsis
Background:
Skin surface microscopy (oil epiluminescence microscopy, dermoscopy, dermatoscopy) has been shown to increase the diagnostic accuracy of melanoma. however, all studies to date have been in an expert setting.
Objectives:
To determine whether primary care physicians (pcp) (general practitioners) could improve their melanoma diagnosis using surface microscopy after a short education intervention.
Methods:
Seventy-four practising pcp completed a pretest of 50 melanomas and 50 atypical non-melanoma pigmented skin lesions (psl) containing matched clinical and surface microscopy photographs. pcp were randomized between a surface microscopy education intervention or control group, followed by an identical post-test.
Results:
Following training there was a significant improvement in the post-test vs. pretest in both clinical melanoma diagnosis (62.7% vs. 54.6%; p = 0.007) and surface microscopy melanoma diagnosis (75.9% vs. 57.8%; p = 0.000007). no difference was found in the control group between the post-test vs. pretest clinical melanoma diagnosis (53.7% vs. 50.6%; p = 0.21) or the surface microscopy melanoma diagnosis (54.8% vs. 52.9%; p = 0.56). following training there was a significant improvement in the diagnosis of melanoma using surface microscopy vs. clinical diagnosis (75.9% vs. 62.7%; p = 0.000007), which was absent in the control group (54.8% vs. 53.7%; p = 0.59). no significant difference was found in clinical vs. surface microscopy post-test results for non-melanoma psl in either the intervention group or control group. improvement in the sensitivity for the diagnosis of melanoma with surface microscopy was seen without a decrease in specificity; this indicated that the effect should occur without increasing the number of needless excisions.
Conclusions:
All pcp in countries where melanoma leads to significant mortality should be trained in skin surface microscopy.