A risk scoring system for the differentiation between melanoma with regression and regressing nevi

Rubegni, Pietro; Tognetti, Linda; Argenziano, Giuseppe; Nami, Niccolò; Brancaccio, Gabriella; Cinotti, Élisa; Miracco, Clelia; Fimiani, Michele; Cevenini, Gabriele

doi:10.1016/j.jdermsci.2016.04.012

Cited by 24 publications

(39 citation statements)

References 27 publications

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“…19 Furthermore, a recent study of the International Dermoscopy Society (IDS) aimed to compare together six algorithms (i.e. 22,27,32 Scoring system classifier is particularly suitable for dermoscopy, where a high number of qualitative subjective variables, that is the presence or absence of morphological/colorimetric parameters, can be binarized according to a defined outcome (risk = malignant, no risk = benign). dermatologists, residents and general practitioners): 20 all of these methods demonstrated low diagnostic accuracy expressed by AUC values ranging from 0.60 to 0.66 (95% CI) in a subset of 447 MSL (namely 119 MMs and 351 nevi) irrespective to knowledge; of note, Menzies methods got here the highest SE (95.1%) and the lowest SP (24.8%).…”

Section: Discussionmentioning

confidence: 99%

“…Menzies method, ABCD rule, 3-point checklist, 7-point checklist, CASH and chaos and clues) in three groups with different dermoscopy knowledge (i.e. 22,27 The idea of combining data from dermoscopic pattern analysis (i.e. 20 Thus, beside more or less complicated algorithms and checklists, the classic pattern analysis still represents the most reliable tool for poorly to moderately trained dermoscopists.…”

Section: Discussionmentioning

confidence: 99%

“…22,27 Thus, the scoring system was derived by rounding the regression coefficients of the previous logistic classifier to their nearest integer values and then summed to obtain the final total score S. 28 A decision score threshold S t was then chosen to classify lesion as malignant for S > S t with maximum sensitivity and the less as possible specificity. First: a stepwise logistic regression approach was adopted to select a subset of interdependently significant dermoscopic variables with highest discriminant power for malignancy; the number of the selected dermoscopic features identified in each lesion was be expressed as 'dermoscopy sum' -Dsum.…”

Section: Integrated Clinical-anamnestic and Dermoscopic Databasementioning

confidence: 99%

“…First: a stepwise logistic regression approach was adopted to select a subset of interdependently significant dermoscopic variables with highest discriminant power for malignancy; the number of the selected dermoscopic features identified in each lesion was be expressed as 'dermoscopy sum' -Dsum. 22,27 Concerning body site, the majority of nevi (53%) were located in the group C (upper trunk), followed by the group D, B and A ( Table 2). 22,27 Thus, the scoring system was derived by rounding the regression coefficients of the previous logistic classifier to their nearest integer values and then summed to obtain the final total score S. 28 A decision score threshold S t was then chosen to classify lesion as malignant for S > S t with maximum sensitivity and the less as possible specificity.…”

Section: Integrated Clinical-anamnestic and Dermoscopic Databasementioning

confidence: 99%

“…early melanoma -MMvs. 22 In this study, we aimed to test the accuracy of a new non-invasive diagnostic approach for the differential diagnosis of early MM and atypical nevi, based on an integrated clinical-anamnestic dermoscopic risk scoring system (i.e. 7,[17][18][19][20] Moreover, these dermoscopic algorithms do not take into consideration neither clinical parameter nor patient personal data which are of pivotal importance in orienting the clinical diagnosis in front of difficult PSL, where the morphologic appearance is sufficient.…”

Section: Introductionmentioning

confidence: 99%

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An integrated clinical‐dermoscopic risk scoring system for the differentiation between early melanoma and atypical nevi: the iDScore

Tognetti

Cevenini

Moscarella³

et al. 2018

Acad Dermatol Venereol

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Integrated Clinical-anamnestic and Dermoscopic Databasementioning

confidence: 99%

Section: Integrated Clinical-anamnestic and Dermoscopic Databasementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

An integrated clinical‐dermoscopic risk scoring system for the differentiation between early melanoma and atypical nevi: the iDScore

Tognetti

Cevenini

Moscarella³

et al. 2018

Acad Dermatol Venereol

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Skin Cancer Diagnosis by Lesion, Physician, and Examination Type

Chen,

Fernandez,

Fadadu

et al. 2024

JAMA Dermatol

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ImportanceSkin cancer is the most common cancer in the US; accurate detection can minimize morbidity and mortality.ObjectiveTo assess the accuracy of skin cancer diagnosis by lesion type, physician specialty and experience, and physical examination method.Data SourcesPubMed, Embase, and Web of Science.Study SelectionCross-sectional and case-control studies, randomized clinical trials, and nonrandomized controlled trials that used dermatologists or primary care physicians (PCPs) to examine keratinocytic and/or melanocytic skin lesions were included.Data Extraction and SynthesisSearch terms, study objectives, and protocol methods were defined before study initiation. Data extraction was performed by a reviewer, with verification by a second reviewer. A mixed-effects model was used in the data analysis. Data analyses were performed from May 2022 to December 2023.Main Outcomes and MeasuresMeta-analysis of diagnostic accuracy comprised sensitivity and specificity by physician type (primary care physician or dermatologist; experienced or inexperienced) and examination method (in-person clinical examination and/or clinical images vs dermoscopy and/or dermoscopic images).ResultsIn all, 100 studies were included in the analysis. With experienced dermatologists using clinical examination and clinical images, the sensitivity and specificity for diagnosing keratinocytic carcinomas were 79.0% and 89.1%, respectively; using dermoscopy and dermoscopic images, sensitivity and specificity were 83.7% and 87.4%, and for PCPs, 81.4% and 80.1%. Experienced dermatologists had 2.5-fold higher odds of accurate diagnosis of keratinocytic carcinomas using in-person dermoscopy and dermoscopic images compared with in-person clinical examination and images. When examining for melanoma using clinical examination and images, sensitivity and specificity were 76.9% and 89.1% for experienced dermatologists, 78.3% and 66.2% for inexperienced dermatologists, and 37.5% and 84.6% for PCPs, respectively; whereas when using dermoscopy and dermoscopic images, sensitivity and specificity were 85.7% and 81.3%, 78.0% and 69.5%, and 49.5% and 91.3%, respectively. Experienced dermatologists had 5.7-fold higher odds of accurate diagnosis of melanoma using dermoscopy compared with clinical examination. Compared with PCPs, experienced dermatologists had 13.3-fold higher odds of accurate diagnosis of melanoma using dermoscopic images.Conclusions and RelevanceThe findings of this systematic review and meta-analysis indicate that there are significant differences in diagnostic accuracy for skin cancer when comparing physician specialty and experience, and examination methods. These summary metrics of clinician diagnostic accuracy could be useful benchmarks for clinical trials, practitioner training, and the performance of emerging technologies.

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Visual inspection and dermoscopy, alone or in combination, for diagnosing keratinocyte skin cancers in adults

Dinnes

Deeks

Chuchu

et al. 2018

Cochrane Database of Systematic Reviews

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Background Early accurate detection of all skin cancer types is important to guide appropriate management, to reduce morbidity and to improve survival. Basal cell carcinoma (BCC) is almost always a localised skin cancer with potential to infiltrate and damage surrounding tissue, whereas a minority of cutaneous squamous cell carcinomas (cSCCs) and invasive melanomas are higher-risk skin cancers with the potential to metastasise and cause death. Dermoscopy has become an important tool to assist specialist clinicians in the diagnosis of melanoma, and is increasingly used in primary-care settings. Dermoscopy is a precision-built handheld illuminated magnifier that allows more detailed examination of the skin down to the level of the superficial dermis. Establishing the value of dermoscopy over and above visual inspection for the diagnosis of BCC or cSCC in primary-and secondary-care settings is critical to understanding its potential contribution to appropriate skin cancer triage, including referral of higher-risk cancers to secondary care, the identification of low-risk skin cancers that might be treated in primary care and to provide reassurance to those with benign skin lesions who can be safely discharged. Objectives To determine the diagnostic accuracy of visual inspection and dermoscopy, alone or in combination, for the detection of (a) BCC and (b) cSCC, in adults. We separated studies according to whether the diagnosis was recorded face-to-face (in person) or based on remote (imagebased) assessment.

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A risk scoring system for the differentiation between melanoma with regression and regressing nevi

Cited by 24 publications

References 27 publications

An integrated clinical‐dermoscopic risk scoring system for the differentiation between early melanoma and atypical nevi: the iDScore

An integrated clinical‐dermoscopic risk scoring system for the differentiation between early melanoma and atypical nevi: the iDScore

Skin Cancer Diagnosis by Lesion, Physician, and Examination Type

Visual inspection and dermoscopy, alone or in combination, for diagnosing keratinocyte skin cancers in adults

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