title: Utility of non-rule-based visual matching as a strategy to allow novices to achieve skin lesion diagnosis.
abstract: Non-analytical reasoning is thought to play a key role in dermatology diagnosis. Considering its potential importance, surprisingly little work has been done to research whether similar identification processes can be supported in non-experts. We describe here a prototype diagnostic support software, which we have used to examine the ability of medical students (at the beginning and end of a dermatology attachment) and lay volunteers, to diagnose 12 images of common skin lesions. Overall, the non-experts using the software had a diagnostic accuracy of 98% (923/936) compared with 33% for the control group (215/648) (Wilcoxon p < 0.0001). We have demonstrated, within the constraints of a simplified clinical model, that novices' diagnostic scores are significantly increased by the use of a structured image database coupled with matching of index and referent images. The novices achieve this high degree of accuracy without any use of explicit definitions of likeness or rule-based strategies.
authors: Department of Dermatology, University of Edinburgh, Scotland.
authors: R Benjamin
authors: RB
authors: Aldridge
authors: Dominik
authors: D
authors: Glodzik
authors: Lucia
authors: L
authors: Ballerini
authors: Robert B
authors: RB
authors: Fisher
authors: Jonathan L
authors: JL
authors: Rees
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002983:Clinical Competence; D016208:Databases, Factual; D003661:Decision Support Techniques; D003880:Dermatology / Q000193:education*; D003936:Diagnosis, Computer-Assisted; D003937:Diagnosis, Differential; D004504:Education, Medical, Undergraduate; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010364:Pattern Recognition, Visual; D011237:Predictive Value of Tests; D011340:Problem Solving; D012606:Scotland; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology*; D012871:Skin Diseases / Q000175:diagnosis* / Q000473:pathology; D012984:Software; D055815:Young Adult