Value of Dermoscopy in a Population-Based Screening Sample by Dermatologists

Background: The use of dermoscopy improves the diagnosis of skin cancer significantly in trained dermatologists. However, to evaluate its cost-effectiveness in daily practice, not only sensitivity but also the excision rate is important. Objective: We examined the diagnostic accuracy of cases fr...

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Autores principales:	Isabelle Hoorens, Katrien Vossaert, Sven Lanssens, Laurence Dierckxsens, Giuseppe Argenziano, Lieve Brochez
Formato:	article
Lenguaje:	EN
Publicado:	Mattioli1885 2019
Materias:	dermoscopy screening melanoma basal cell carcinoma squamous cell carcinoma Dermatology RL1-803
Acceso en línea:	https://doaj.org/article/ba45eb7482ae4d2cbe166d7d13ec4a06
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spelling	oai:doaj.org-article:ba45eb7482ae4d2cbe166d7d13ec4a062021-11-17T08:29:27ZValue of Dermoscopy in a Population-Based Screening Sample by Dermatologists10.5826/dpc.0903a052160-9381https://doaj.org/article/ba45eb7482ae4d2cbe166d7d13ec4a062019-07-01T00:00:00Zhttp://dpcj.org/index.php/dpc/article/view/732https://doaj.org/toc/2160-9381 Background: The use of dermoscopy improves the diagnosis of skin cancer significantly in trained dermatologists. However, to evaluate its cost-effectiveness in daily practice, not only sensitivity but also the excision rate is important. Objective: We examined the diagnostic accuracy of cases from a true population-based sample scored by general dermatologists. Methods: One hundred twenty-six dermatologists were randomly assigned to 145 digital cases of lesions detected at a skin cancer screening. This resulted in 4,655 case evaluations using a web application. Accuracy of diagnosis and treatment was correlated with the histological diagnosis or expert opinion. Results: The larger portion (89.7%) of the participating dermatologists reported using their dermatoscope daily. The odds of making a correct diagnosis of melanoma using dermoscopy was 5.38 compared with naked-eye examination (NEE). Dermoscopy increased sensitivity for skin cancer diagnosis from 70.6% to 84.6%, but this was associated with a small but significant decrease in specificity of 3.5%. To detect 1 skin cancer, 5.23 lesions had to be biopsied/excised in this sample and this was not significantly improved by dermoscopic evaluation. Dermoscopy significantly increased the confidence about making a correct diagnosis, especially in seborrheic keratosis, Bowen disease, and melanoma. Conclusions: Dermoscopy significantly improved diagnostic accuracy, the sensitivity of skin cancer detection, and the confidence in diagnosis especially for seborrheic keratosis, Bowen disease, and melanoma. However, this finding was not reflected in a significant reduction in the number needed to excise in this sample. Isabelle HoorensKatrien VossaertSven LanssensLaurence DierckxsensGiuseppe ArgenzianoLieve BrochezMattioli1885articledermoscopyscreeningmelanomabasal cell carcinomasquamous cell carcinomaDermatologyRL1-803ENDermatology Practical & Conceptual, Vol 9, Iss 2 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	dermoscopy screening melanoma basal cell carcinoma squamous cell carcinoma Dermatology RL1-803
spellingShingle	dermoscopy screening melanoma basal cell carcinoma squamous cell carcinoma Dermatology RL1-803 Isabelle Hoorens Katrien Vossaert Sven Lanssens Laurence Dierckxsens Giuseppe Argenziano Lieve Brochez Value of Dermoscopy in a Population-Based Screening Sample by Dermatologists
description	Background: The use of dermoscopy improves the diagnosis of skin cancer significantly in trained dermatologists. However, to evaluate its cost-effectiveness in daily practice, not only sensitivity but also the excision rate is important. Objective: We examined the diagnostic accuracy of cases from a true population-based sample scored by general dermatologists. Methods: One hundred twenty-six dermatologists were randomly assigned to 145 digital cases of lesions detected at a skin cancer screening. This resulted in 4,655 case evaluations using a web application. Accuracy of diagnosis and treatment was correlated with the histological diagnosis or expert opinion. Results: The larger portion (89.7%) of the participating dermatologists reported using their dermatoscope daily. The odds of making a correct diagnosis of melanoma using dermoscopy was 5.38 compared with naked-eye examination (NEE). Dermoscopy increased sensitivity for skin cancer diagnosis from 70.6% to 84.6%, but this was associated with a small but significant decrease in specificity of 3.5%. To detect 1 skin cancer, 5.23 lesions had to be biopsied/excised in this sample and this was not significantly improved by dermoscopic evaluation. Dermoscopy significantly increased the confidence about making a correct diagnosis, especially in seborrheic keratosis, Bowen disease, and melanoma. Conclusions: Dermoscopy significantly improved diagnostic accuracy, the sensitivity of skin cancer detection, and the confidence in diagnosis especially for seborrheic keratosis, Bowen disease, and melanoma. However, this finding was not reflected in a significant reduction in the number needed to excise in this sample.
format	article
author	Isabelle Hoorens Katrien Vossaert Sven Lanssens Laurence Dierckxsens Giuseppe Argenziano Lieve Brochez
author_facet	Isabelle Hoorens Katrien Vossaert Sven Lanssens Laurence Dierckxsens Giuseppe Argenziano Lieve Brochez
author_sort	Isabelle Hoorens
title	Value of Dermoscopy in a Population-Based Screening Sample by Dermatologists
title_short	Value of Dermoscopy in a Population-Based Screening Sample by Dermatologists
title_full	Value of Dermoscopy in a Population-Based Screening Sample by Dermatologists
title_fullStr	Value of Dermoscopy in a Population-Based Screening Sample by Dermatologists
title_full_unstemmed	Value of Dermoscopy in a Population-Based Screening Sample by Dermatologists
title_sort	value of dermoscopy in a population-based screening sample by dermatologists
publisher	Mattioli1885
publishDate	2019
url	https://doaj.org/article/ba45eb7482ae4d2cbe166d7d13ec4a06
work_keys_str_mv	AT isabellehoorens valueofdermoscopyinapopulationbasedscreeningsamplebydermatologists AT katrienvossaert valueofdermoscopyinapopulationbasedscreeningsamplebydermatologists AT svenlanssens valueofdermoscopyinapopulationbasedscreeningsamplebydermatologists AT laurencedierckxsens valueofdermoscopyinapopulationbasedscreeningsamplebydermatologists AT giuseppeargenziano valueofdermoscopyinapopulationbasedscreeningsamplebydermatologists AT lievebrochez valueofdermoscopyinapopulationbasedscreeningsamplebydermatologists
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Value of Dermoscopy in a Population-Based Screening Sample by Dermatologists

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