title: Novice identification of melanoma: not quite as straightforward as the ABCDs.
abstract: The "ABCD" mnemonic to assist non-experts' diagnosis of melanoma is widely promoted; however, there are good reasons to be sceptical about public education strategies based on analytical, rule-based approaches--such as ABCD (i.e. Asymmetry, Border Irregularity, Colour Uniformity and Diameter). Evidence suggests that accurate diagnosis of skin lesions is achieved predominately through non-analytical pattern recognition (via training examples) and not by rule-based algorithms. If the ABCD are to function as a useful public education tool they must be used reliably by untrained novices, with low inter-observer and intra-diagnosis variation, but with maximal inter-diagnosis differences. The three subjective properties (the ABCs of the ABCD) were investigated experimentally: 33 laypersons scored 40 randomly selected lesions (10 lesions × 4 diagnoses: benign naevi, dysplastic naevi, melanomas, seborrhoeic keratoses) for the three properties on visual analogue scales. The results (n = 3,960) suggest that novices cannot use the ABCs reliably to discern benign from malignant lesions.
authors.affiliation: Department of Dermatology, University of Edinburgh, Edinburgh EH3 9HA, UK.
authors.forename: R Benjamin
authors.initials: RB
authors.lastname: Aldridge
authors.forename: Matteo
authors.initials: M
authors.lastname: Zanotto
authors.forename: Lucia
authors.initials: L
authors.lastname: Ballerini
authors.forename: Robert B
authors.initials: RB
authors.lastname: Fisher
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Rees
mesh_terms: D000293:Adolescent; D000328:Adult; D003657:Decision Making; D004416:Dysplastic Nevus Syndrome / Q000175:diagnosis; D005260:Female; D006801:Humans; D017492:Keratosis, Seborrheic / Q000175:diagnosis; D007858:Learning; D008297:Male; D008545:Melanoma / Q000175:diagnosis*; D008875:Middle Aged; D010364:Pattern Recognition, Visual; D012878:Skin Neoplasms / Q000175:diagnosis*; D013334:Students; D055815:Young Adult