Exploration of diagnostic techniques for malignant melanoma: an integrative review.
The aim of this study is to explore the various diagnostic techniques for melanoma and assess their usefulness in the clinical practice of nurse practitioners. After a systematic review of the literature, 55 articles were closely reviewed, and from these, 26 studies were selected. These were original studies in English that examined diagnostic techniques that would improve accuracy for melanoma detection with a formal methods and results section. Six general categories dealing with diagnostic techniques for melanoma were found in the literature. These were naked-eye clinical examination alone, clinical examination with the aid of total-body photographs, epiluminescence microscopy (ELM), digital ELM, computer-assisted techniques, and teledermatology. Because of the research citing the poor diagnostic accuracy (DA) of nondermatologists, increased DA with dermatologists experienced in ELM techniques, and the importance of early melanoma diagnosis, the recommendation is to refer patients with suspicious pigmented skin lesions to experienced dermatologists, preferably those who use ELM or digital ELM.
Brown
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Barnes College School of Nursing, and Phelps County Regional Medical Center Health Services, Inc., Home Health, St. Louis, Missouri, USA. brown5@wavecomputers.net
D003936:Diagnosis, Computer-Assisted / Q000295:instrumentation / Q000379:methods / Q000592:standards; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation / Q000379:methods / Q000592:standards; D008545:Melanoma / Q000175:diagnosis*; D008853:Microscopy / Q000295:instrumentation / Q000379:methods / Q000592:standards; D009722:Nurse Practitioners; D010781:Photography / Q000295:instrumentation / Q000379:methods / Q000592:standards; D010808:Physical Examination / Q000295:instrumentation / Q000379:methods / Q000592:standards; D011320:Primary Health Care / Q000379:methods* / Q000592:standards; D012017:Referral and Consultation; D019114:Remote Consultation / Q000295:instrumentation / Q000379:methods / Q000592:standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis*