title: Effect of preoperative evaluation by a dermatologist on diagnostic accuracy.
abstract: BACKGROUND
  The accuracy of the diagnosis of skin lesions has an important effect in outcomes in treatment selection and prioritization of the treatment.
  
  
  OBJECTIVE
  To assess the effect of preoperative evaluations by dermatologists on the diagnostic accuracy of plastic surgeons.
  
  
  METHODS
  A retrospective analysis was performed on 1,146 biopsies that were excised by plastic surgeons in our secondary State Hospital. The histopathologic diagnoses were divided into 2 groups according to the preoperative dermatological evaluation, with Group 1 being the lesions that were evaluated by a dermatologist before excision and Group 2 being the lesions that were not evaluated by a dermatologist before excision. The sensitivity and positive predictive values (PPVs) were calculated and compared between the 2 groups using Fisher exact test.
  
  
  RESULTS
  The PPVs of the malignant lesions of Groups 1 and 2 were 53.8% and 25.0%, respectively (p = .001). When Group 1 was contrasted with Group 2, the PPVs for the premalignant lesions were 71.4% and 46.8%, respectively (p = .015). The PPV for the benign lesions was 86.3% in Group 1 and 72.6% in Group 2 (p < .001).
  
  
  CONCLUSIONS
  This study demonstrated that the diagnostic accuracy of plastic surgeons was affected positively by preoperative evaluations by a dermatologist.
authors.affiliation: *Department of Dermatology, Yunus Emre Government Hospital, Eskisehir, Turkey; †Department of Dermatology, Eskisehir Military Hospital, Eskisehir, Turkey; Departments of ‡Pathology and §Plastic Surgery, Yunus Emre Government Hospital, Eskisehir, Turkey.
authors.forename: Memet Ersan
authors.initials: ME
authors.lastname: Bilgili
authors.forename: Hamza
authors.initials: H
authors.lastname: Yildiz
authors.forename: Betul Peker
authors.initials: BP
authors.lastname: Cengiz
authors.forename: Ibrahim Mutlu
authors.initials: IM
authors.lastname: Saydam
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D002648:Child; D003880:Dermatology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012871:Skin Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery