title: Agreement between dermatologists and primary care practitioners in the diagnosis of malignant melanoma: review of the literature.
abstract: BACKGROUND
  The incidence of melanoma continues to rise in the developed world. It is therefore essential for primary care practitioners (PCPs) to be able to discriminate between malignant and benign cutaneous findings, as most patients present to PCPs first for examination of suspicious lesions.
  
  
  OBJECTIVE
  To compare dermatologists and PCPs in the diagnosis of malignant melanoma.
  
  
  METHODS
  Prospective studies published from January 1950 to August 2010 in MEDLINE, EMBASE, CINAHL, and CancerLit databases were examined. Relevant medical search terms, discussed amongst the authors, were entered into the databases. Only articles comparing dermatologists and PCPs in the diagnosis of malignant melanoma were selected.
  
  
  RESULTS
  Dermatologists were reported as having sensitivities, specificities, and diagnostic accuracies ranging from 0.74 to 1.00, 0.56 to 0.95, and 0.85 to 0.89, respectively. PCPs had sensitivities, specificities, and diagnostic accuracies ranging from 0.25 to 0.88, 0.26 to 0.71, and 0.49 to 0.80, respectively.
  
  
  CONCLUSIONS
  PCPs should receive more training to improve their ability in the diagnosis of malignant melanoma.
authors.affiliation: McMaster University, Hamilton, ON, Canada.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Corbo
authors.forename: Judy
authors.initials: J
authors.lastname: Wismer
mesh_terms: D002983:Clinical Competence; D003880:Dermatology / Q000379:methods*; D003937:Diagnosis, Differential; D005194:Family Practice / Q000379:methods*; D006801:Humans; D008545:Melanoma / Q000175:diagnosis*; D010821:Physicians, Family / Q000592:standards*; D012372:ROC Curve; D012878:Skin Neoplasms / Q000175:diagnosis*