title: Clinical and dermatoscopic diagnosis of malignant melanoma. Assessed by expert and non-expert groups.
abstract: 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.
authors.affiliation: Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark.
authors.forename: H
authors.initials: H
authors.lastname: Lorentzen
authors.forename: K
authors.initials: K
authors.lastname: Weismann
authors.forename: C S
authors.initials: CS
authors.lastname: Petersen
authors.forename: F G
authors.initials: FG
authors.lastname: Larsen
authors.forename: L
authors.initials: L
authors.lastname: Secher
authors.forename: V
authors.initials: V
authors.lastname: Skødt
mesh_terms: 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*