title: The Impact of Multispectral Digital Skin Lesion Analysis on German Dermatologist Decisions to Biopsy Atypical Pigmented Lesions with Clinical Characteristics of Melanoma.
abstract: OBJECTIVE
  To determine the impact of multispectral digital skin lesion analysis on German dermatologist biopsy decisions of atypical pigmented skin lesions.
  
  
  METHODS
  Participants were shown high-resolution clinical images of 12 atypical pigmented skin lesions previously analyzed by multispectral digital skin lesion analysis. Participants were asked if they would biopsy the lesion based on clinical images and high-resolution dermoscopy images and again when subsequently shown multispectral digital skin lesion analysis probability information.
  
  
  METHODS
  Forty-one dermatologists at a skin cancer conference in Germany in September 2014.
  
  
  METHODS
  Sensitivity, specificity, diagnostic accuracy, percent biopsying all melanomas, and overall biopsy rates.
  
  
  RESULTS
  Sensitivity for the detection of melanoma following clinical evaluation was 64 percent. After receipt of multispectral digital skin lesion analysis probability information, sensitivity decreased nonsignificantly to 62 percent. Specificity with clinical evaluation was 57 percent and increased to 73 percent using multispectral digital skin lesion analysis. Overall biopsy accuracy increased from 60 percent with clinical evaluation to 68 percent with multispectral digital skin lesion analysis. The percentage of low-grade dysplastic nevi chosen for biopsy decreased from 43 percent after clinical evaluation to 27 percent with multispectral digital skin lesion analysis. Finally, the overall percentage of lesions biopsied decreased from 52 percent with clinical evaluation to 42 percent after multispectral digital skin lesion analysis.
  
  
  CONCLUSIONS
  Multispectral digital skin lesion analysis can be used reliably to detect melanoma as well as clinical evaluation. Dermatologists can confidently use multispectral digital skin lesion analysis to significantly improve specificity and reduce their overall number of biopsies while increasing overall diagnostic accuracy.
authors.affiliation: Melanoma Clinical Research Fellow, National Society for Cutaneous Medicine, New York, New York;
authors.forename: Richard R
authors.initials: RR
authors.lastname: Winkelmann
authors.affiliation: Department of Dermatology, Allergology, and Venerology, University of Kiel, Kiel, Germany;
authors.forename: Axel
authors.initials: A
authors.lastname: Hauschild
authors.affiliation: MELA Sciences Inc, Irvington, New York;
authors.forename: Natalie
authors.initials: N
authors.lastname: Tucker
authors.affiliation: Iris Interactive Systems, Cody, Wyoming;
authors.forename: Richard
authors.initials: R
authors.lastname: White
authors.affiliation: Department of Dermatology, New York University School of Medicine, New York, New York.
authors.forename: Darrell S
authors.initials: DS
authors.lastname: Rigel