title: Negative predictive value of pigmented lesion evaluation by multispectral digital skin lesion analysis in a community practice setting.
abstract: OBJECTIVE
  To determine if the high negative predictive value of a multispectral digital skin lesion analysis that has been previously found in an academic-based trial would be similar in a community-based setting with its expected different distribution of pigmented lesions.
  
  
  METHODS
  Data were collected from patients undergoing routine skin examinations over a one-year period at a community-based practice in Florida. All lesions that were selected for biopsy to rule out melanoma were also imaged with multispectral digital skin lesion analysis prior to biopsy. Histopathological diagnoses and multispectral digital skin lesion analysis results were reviewed and compared with findings from a prior primarily academic center-based multispectral digital skin lesion analysis trial.
  
  
  METHODS
  Community-based clinical setting in Florida.
  
  
  METHODS
  Negative predictive value, sensitivity, and specificity.
  
  
  RESULTS
  One hundred thirty-seven consecutive lesions were selected for biopsy and also analyzed via multispectral digital skin lesion analysis. All 21 cases with multispectral digital skin lesion analysis "Low Disorganization" readings were all histologically benign (100% negative predictive value, 95% lower confidence boundary = 96.9%). The negative predictive value and the sensitivity were not significantly different than what was found in the prior academic-based multispectral digital skin lesion analysis trial. Multispectral digital skin lesion analysis also correctly identified all high-risk lesions, which were subsequently confirmed via histology to be one invasive melanoma and 15 moderately dysplastic nevi (100% sensitivity). Specificity with multispectral digital skin lesion analysis was significantly higher than reported in the academic-based multispectral digital skin lesion analysis trial (18% vs. 10%, p=0.02).
  
  
  CONCLUSIONS
  Because of the high negative predictive value achieved by multispectral digital skin lesion analysis, lesions with readings of "Low Disorganization" may be considered for observation versus biopsy. Similar to what was noted in the academic center setting, multispectral digital skin lesion analysis may help dermatologists reduce the number of unnecessary biopsies while improving diagnostic accuracy.
authors: Rigel Dermatology, New York, New York;
authors: Richard R
authors: RR
authors: Winkelmann
authors: Department of Dermatology, New York University School of Medicine, New York, New York;
authors: Darrell S
authors: DS
authors: Rigel
authors: Center for Clinical and Cosmetic Research, Aventura, Florida;
authors: Emily
authors: E
authors: Kollmann
authors: Center for Clinical and Cosmetic Research, Aventura, Florida;
authors: Nicole
authors: N
authors: Swenson
authors: MELA Sciences Inc., Irvington, New York;
authors: Natalie
authors: N
authors: Tucker
authors: University of Miami Miller School of Medicine, Department of Dermatology and Cutaneous Surgery, Miami, Florida.
authors: Mark S
authors: MS
authors: Nestor