Clinical and dermatoscopic diagnosis of malignant melanoma. Assessed by expert and non-expert groups.
We investigated the nosographic and diagnostic probabilities and likelihood ratios of dermatoscopy in order to evaluate the method's role in decision-making regarding melanoma. Clinical slides and dermatoscopic photos were obtained from 232 patients referred for dermatoscopy. Four dermatoscopy "experts" and 5 "non-experts" assessed the slides. Diagnoses were compared with histopathology. Sensitivity of the clinical assessments was 0.78 vs. 0.69 ("experts" vs. "non-experts"), sensitivity of dermatoscopy assessment was 0.83 vs. 0.69 (p = 0.04). The expert group demonstrated increased specificity (from 0.89 to 0.94) when applying dermatoscopy compared with clinical assessment alone (p=0.03). Positive likelihood ratios were doubled in the "expert group" and the negative likelihood ratios improved 25% with dermatoscopy compared with clinical assessment.
Lorentzen
H
H
Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark.
Weismann
K
K
Petersen
C S
CS
Larsen
F G
FG
Secher
L
L
Skødt
V
V
D003627:Data Interpretation, Statistical; D003937:Diagnosis, Differential; D006801:Humans; D008545:Melanoma / Q000175:diagnosis*; D008853:Microscopy / Q000379:methods; D015588:Observer Variation; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis*