Objective: To analyze the accuracy of the clinical examination in the diagnosis of eyelid lesions. Methods: From the observation of thirtyfive photos of benign and malignant eyelid tumors were presented to ophthalmologists, for each picture, it was asked 3 questions: 1) the lesion is malignant or not; 2) if considered malignant, the probably histological type; and 3) the tumor is aggressive or not. The phisicians were divided into 9 groups, according to academic degree (time since graduation and Oculoplastics specialty or not). Answers were compared with the results of the histopathologic study of the surgically resected tumor. Results: In total, one hundred and six ophthalmologists were interviewed. The professional experience influenced the diagnosis of malignancy of the tumor, as the Group 1 (first year residents) had the lowest accuracy (64.5%), with lower estimated agreement (kappa = 0.13), and Group 5 (graduated 5 years ago and with expertise in Oculoplastics) the highest accuracy (77.3%), with better agreement (Kappa = 0.45), and presented the best parameters for other analyzed items. For the histological type diagnosis, accuracy was lower: group 1 had the worst performance, with 51.1% accuracy, while the best was for group 6 (graduated over 5 years and with expertise in Oculoplastics, 77.2% ). As for the criterion of tumor aggressiveness, the results were closer among the different categories. Ophthalmologists trained longer and without expertise in Oculoplastics also showed a low diagnostic accuracy for malignancy and to determine the histological type of tumor. Conclusion: The low accuracy of clinical diagnosis of eyelid tumors in the groups above reinforces the need to improve ophthalmic oncology knowledge in these groups.Keywords: Eyelid neoplasms/diagnosis; Eyelid neoplasms/pathology; Medical oncology; Health knowledge, atitudes, practice
RESUMOObjetivo: Analisar a acurácia do exame clínico no diagnóstico de lesões palpebrais. Métodos: A partir da observação de trinta e cinco fotos de tumores palpebrais benignos e malignos que foram apresentadas a médicos oftalmologistas, para cada foto foram feitas 3 perguntas: 1) lesão maligna ou não? 2) se considerado maligno, o provável tipo histológico; e 3) tumor agressivo ou não? Os médicos foram agrupados em 9 grupos, de acordo com a formação profissional (tempo de formação e especialização ou não em Oculoplástica). As respostas foram comparadas com o resultado do exame histopatológico da peça retirada cirurgicamente. Resultados: No total, cento e seis médicos oftalmologistas participaram do estudo. A experiência do profissional influenciou no diagnóstico de malignidade do tumor, já que o grupo 1 (residentes de primeiro ano) apresentou a menor acurácia (64,5%), com menor concordância estimada (Kappa = 0,13), e o grupo 5 (formados há 5 anos e especializados em Oculoplástica) a maior acurácia (77,3%), com melhor concordância (Kappa = 0,45), além de apresentar as melhores medidas para os demais itens avaliados. Para diagnóstico do tipo histológico, a ac...
