Dermoscopy Training Effect on Diagnostic Accuracy of Skin Lesions in Canadian Family Medicine Physicians Using the Triage Amalgamated Dermoscopic Algorithm

Background: Accurate identification of cutaneous lesions is an essential skill for family medicine physicians (FMPs). Studies show significant improvement in skin cancer detection with dermoscopy use. Frontline FMPs are an ideal target group for dermoscopy training. The 3-step Triage Amalgamated De...

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Autores principales:	Elizabeth A. Sawyers, Donald T. Wigle, Ashfaq A. Marghoob, Andreas Blum
Formato:	article
Lenguaje:	EN
Publicado:	Mattioli1885 2020
Materias:	dermoscopy family/general practice skin cancer medical education Triage Amalgamated Dermoscopic Algorithm Dermatology RL1-803
Acceso en línea:	https://doaj.org/article/d3749c2e4308442080149cae3d153dce
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spelling	oai:doaj.org-article:d3749c2e4308442080149cae3d153dce2021-11-17T08:28:51ZDermoscopy Training Effect on Diagnostic Accuracy of Skin Lesions in Canadian Family Medicine Physicians Using the Triage Amalgamated Dermoscopic Algorithm 10.5826/dpc.1002a352160-9381https://doaj.org/article/d3749c2e4308442080149cae3d153dce2020-04-01T00:00:00Zhttp://dpcj.org/index.php/dpc/article/view/1064https://doaj.org/toc/2160-9381 Background: Accurate identification of cutaneous lesions is an essential skill for family medicine physicians (FMPs). Studies show significant improvement in skin cancer detection with dermoscopy use. Frontline FMPs are an ideal target group for dermoscopy training. The 3-step Triage Amalgamated Dermoscopic Algorithm (TADA) facilitates high sensitivity and specificity for pigmented and nonpigmented skin lesions. Step I requires unequivocal identification of dermoscopic features for 1 of 3 benign skin lesions: angioma, dermatofibroma, or seborrheic keratosis. If absent, steps II and III are applied assessing for features of architectural disorder and malignancies with organized, symmetric patterns, respectively. Objective: To assess FMPs’ diagnostic accuracy of benign and malignant skin lesions before and after training in TADA step I. Methods: In this repeated-measures observational study, 33 dermoscopy-naive FMPs attending an introductory dermoscopy workshop each assessed gross and corresponding dermoscopic photographic images of 50 pigmented and nonpigmented skin lesions (23 benign, 27 malignant) for features of TADA step I lesions before and after training. Analyses compared diagnostic accuracy in relation to training and baseline physician characteristics. Results: Diagnostic accuracy improved from 76.4% to 90.8% (P < 0.001) and from 85.0% to 90.0% (P = 0.01), respectively, for all lesions and for all TADA I lesions. Female sex was significant as a predictor of individual posttraining performance (all lesions combined, P = 0.02). Conclusions: Results show significant improvement in diagnostic accuracies for benign and malignant skin lesions with introductory dermoscopy training using TADA step I. This will reduce unnecessary benign lesion excision and enhance referral sensitivity, conserving specialist resources. Elizabeth A. SawyersDonald T. WigleAshfaq A. MarghoobAndreas BlumMattioli1885articledermoscopyfamily/general practiceskin cancermedical educationTriage Amalgamated Dermoscopic AlgorithmDermatologyRL1-803ENDermatology Practical & Conceptual, Vol 10, Iss 2 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	dermoscopy family/general practice skin cancer medical education Triage Amalgamated Dermoscopic Algorithm Dermatology RL1-803
spellingShingle	dermoscopy family/general practice skin cancer medical education Triage Amalgamated Dermoscopic Algorithm Dermatology RL1-803 Elizabeth A. Sawyers Donald T. Wigle Ashfaq A. Marghoob Andreas Blum Dermoscopy Training Effect on Diagnostic Accuracy of Skin Lesions in Canadian Family Medicine Physicians Using the Triage Amalgamated Dermoscopic Algorithm
description	Background: Accurate identification of cutaneous lesions is an essential skill for family medicine physicians (FMPs). Studies show significant improvement in skin cancer detection with dermoscopy use. Frontline FMPs are an ideal target group for dermoscopy training. The 3-step Triage Amalgamated Dermoscopic Algorithm (TADA) facilitates high sensitivity and specificity for pigmented and nonpigmented skin lesions. Step I requires unequivocal identification of dermoscopic features for 1 of 3 benign skin lesions: angioma, dermatofibroma, or seborrheic keratosis. If absent, steps II and III are applied assessing for features of architectural disorder and malignancies with organized, symmetric patterns, respectively. Objective: To assess FMPs’ diagnostic accuracy of benign and malignant skin lesions before and after training in TADA step I. Methods: In this repeated-measures observational study, 33 dermoscopy-naive FMPs attending an introductory dermoscopy workshop each assessed gross and corresponding dermoscopic photographic images of 50 pigmented and nonpigmented skin lesions (23 benign, 27 malignant) for features of TADA step I lesions before and after training. Analyses compared diagnostic accuracy in relation to training and baseline physician characteristics. Results: Diagnostic accuracy improved from 76.4% to 90.8% (P < 0.001) and from 85.0% to 90.0% (P = 0.01), respectively, for all lesions and for all TADA I lesions. Female sex was significant as a predictor of individual posttraining performance (all lesions combined, P = 0.02). Conclusions: Results show significant improvement in diagnostic accuracies for benign and malignant skin lesions with introductory dermoscopy training using TADA step I. This will reduce unnecessary benign lesion excision and enhance referral sensitivity, conserving specialist resources.
format	article
author	Elizabeth A. Sawyers Donald T. Wigle Ashfaq A. Marghoob Andreas Blum
author_facet	Elizabeth A. Sawyers Donald T. Wigle Ashfaq A. Marghoob Andreas Blum
author_sort	Elizabeth A. Sawyers
title	Dermoscopy Training Effect on Diagnostic Accuracy of Skin Lesions in Canadian Family Medicine Physicians Using the Triage Amalgamated Dermoscopic Algorithm
title_short	Dermoscopy Training Effect on Diagnostic Accuracy of Skin Lesions in Canadian Family Medicine Physicians Using the Triage Amalgamated Dermoscopic Algorithm
title_full	Dermoscopy Training Effect on Diagnostic Accuracy of Skin Lesions in Canadian Family Medicine Physicians Using the Triage Amalgamated Dermoscopic Algorithm
title_fullStr	Dermoscopy Training Effect on Diagnostic Accuracy of Skin Lesions in Canadian Family Medicine Physicians Using the Triage Amalgamated Dermoscopic Algorithm
title_full_unstemmed	Dermoscopy Training Effect on Diagnostic Accuracy of Skin Lesions in Canadian Family Medicine Physicians Using the Triage Amalgamated Dermoscopic Algorithm
title_sort	dermoscopy training effect on diagnostic accuracy of skin lesions in canadian family medicine physicians using the triage amalgamated dermoscopic algorithm
publisher	Mattioli1885
publishDate	2020
url	https://doaj.org/article/d3749c2e4308442080149cae3d153dce
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Dermoscopy Training Effect on Diagnostic Accuracy of Skin Lesions in Canadian Family Medicine Physicians Using the Triage Amalgamated Dermoscopic Algorithm

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