title: Near infrared and skin impedance spectroscopy - a possible support in the diagnostic process of skin tumours in primary health care.
abstract: OBJECTIVE
  The global incidence of skin cancer has increased drastically in recent decades, especially in Australia and Northern Europe. Early detection is crucial for good prognosis and high survival rates. In general, primary care physicians have considerably lower sensitivity and specificity rates for detection of skin cancer, compared to dermatologists. A probable main reason for this is that current diagnostic tools are subjective in nature, and therefore diagnostic skills highly depend on experience. Illustratively, in Sweden, approximately 155 500 benign skin lesions are excised unnecessarily every year. An objective instrument, added to the clinical examination, might improve the diagnostic accuracy, and thus promote earlier detection of malignant skin tumours, as well as reduce medical costs associated with unnecessary biopsies and excisions. The general aim of this study was to investigate the usefulness of the combination of near infrared (NIR) and skin impedance spectroscopy as a supportive tool in the diagnosis and evaluation of skin tumours in primary health care.
  
  
  METHODS
  Near infrared and skin impedance data were collected by performing measurements on suspect malignant, premalignant and benign tumours in the skin of patients seeking primary health care for skin tumour evaluation. The obtained data were analysed using multivariate analysis and compared with the diagnosis received by the conventional diagnostic process.
  
  
  RESULTS
  The observed sensitivity and specificity rates were both 100%, when discriminating malignant and premalignant skin tumours from benign skin tumours, and the observed sensitivity and specificity for separating malignant skin tumours from premalignant and benign skin tumours were also 100%, respectively.
  
  
  CONCLUSIONS
  The results of this study indicate that the NIR and skin impedance spectroscopy may be a useful supportive tool for the general practitioner in the diagnosis and evaluation of skin tumours in primary health care, as a complement to the visual assessment.
authors.affiliation: Department of Medical and Health Sciences, Division of Community Medicine, Primary Care, Linköping University, Linköping, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Hägerlind
authors.affiliation: Department of Medical and Health Sciences, Division of Community Medicine, Primary Care, Linköping University, Linköping, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Falk
authors.affiliation: Computational Solutions, Umeå, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Löfstedt
authors.affiliation: Department of Chemistry, Umeå University, Umeå, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Lindholm-Sethson
authors.affiliation: Ivida AB, Umeå, Sweden.
authors.forename: I
authors.initials: I
authors.lastname: Bodén
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D058266:Dielectric Spectroscopy / Q000379:methods*; D055088:Early Detection of Cancer / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015588:Observer Variation; D011320:Primary Health Care; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis*; D019265:Spectroscopy, Near-Infrared / Q000379:methods*
keywords: diagnostic tool; early detection; primary care; skin cancer diagnosis