title: Patient acceptance and diagnostic utility of automated digital image analysis of pigmented skin lesions.
abstract: BACKGROUND
  Computerized analysis of pigmented skin lesions may help to increase diagnostic accuracy for melanoma, help to avoid unnecessary procedures and reduce health care costs.
  
  
  OBJECTIVE
  We evaluated both the patient acceptance and diagnostic utility of such an analysis tool in a real clinical setting.
  
  
  METHODS
  Two hundred nine consecutive patients (median age: 34 years, range: 2-73 years), who were concerned about a pigmented skin lesion, answered a questionnaire about their attitude towards computerized analysis and their confidence in the resulting findings. Using a dermoscopy analyser, their skin lesions (n = 219) were then grouped into the categories, benign, suspicious and malignant, and results were compared with those obtained by in-person examination of dermato-oncologic experts.
  
  
  RESULTS
  More than half of the patients (n = 114) would accept the use of computer analysis for melanoma screening; although 16 (14.0%) patients would accept this method solely, 98 (86.0%) patients would prefer an additional in-person examination by a dermatologist. Of the 219 pigmented skin lesions, the dermoscopic experts rated 171 (78.1%) as benign, 36 (16.4%) as suspicious and 12 (5.5%) as malignant, whereas computer analysis revealed 102 (46.6%) benign, 78 (35.6%) suspicious and 39 (17.8%) malignant lesions. At the expense of specificity (48.8%), the sensitivity of computerized analysis was excellent (100%) and equal to that of in-person examination.
  
  
  CONCLUSIONS
  Most patients would accept computer analysis for melanoma screening, some of them even without reservations. However, due to a high rate of false positive computer assessments, it cannot be recommended as a screening tool at this time.
authors.affiliation: Department of Dermatology, Medical University of Graz, Graz, Austria.
authors.forename: J
authors.initials: J
authors.lastname: Frühauf
authors.forename: B
authors.initials: B
authors.lastname: Leinweber
authors.forename: R
authors.initials: R
authors.lastname: Fink-Puches
authors.forename: V
authors.initials: V
authors.lastname: Ahlgrimm-Siess
authors.forename: E
authors.initials: E
authors.lastname: Richtig
authors.forename: I H
authors.initials: IH
authors.lastname: Wolf
authors.forename: A
authors.initials: A
authors.lastname: Niederkorn
authors.forename: F
authors.initials: F
authors.lastname: Quehenberger
authors.forename: R
authors.initials: R
authors.lastname: Hofmann-Wellenhof
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002280:Basal Cell Carcinoma / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D046169:Dermoscopy / Q000379:methods*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008545:Melanoma / Q000175:diagnosis*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010859:Pigmentation Disorders / Q000175:diagnosis*; D012878:Skin Neoplasms / Q000175:diagnosis*; D011795:Surveys and Questionnaires