A smartphone application to improve the precision of biopsy site identification: A proof-of-concept study

Abstract

Dermatologists rely on skin biopsies to diagnose cutaneous tumors and rashes. Skin biopsy sites should be accurately identified with conventional anatomical site descriptors in the pathology request form. Reliance upon free-text entries to describe these biopsy sites is prone to user error and can cause medical misadventures such as wrong-site follow-up surgery. We sought to determine whether a smartphone application (RightSite) could improve the precision of biopsy site labeling. We conducted a prospective proof-of-concept study of 100 smartphone-assisted skin biopsy site identifiers with matched comparison to 100 historical controls. Student’s t-test was used to identify significant differences in the precision of anatomic descriptors before and after adoption of the application. We found a 69% improvement in precision of anatomic site labeling with the RightSite smartphone application (P < 0.0001). These data show smartphone-assisted biopsy site labeling improves the precision of anatomic site descriptors. Integrating graphical user interfaces into the electronic health records system could improve health care by standardizing anatomic site nomenclature and site-specific descriptors.

A five-step approach to safer skin surgery

“…Diagrams are a useful adjunct to descriptors and can be in the form of pre-printed standardised diagrams, hand-drawn sketches, or body maps. 11,12 Following our first case of WSS we introduced a triple carbon copy form with a standardised body map, on which the surgical booking and photography request both appear. A copy is uploaded onto the electronic health record (EHR) (Figure 2).…”

“…1 Thirty-two wrong site biopsy or excisions were reported in the NHS for 2020-2021, accounting for 23% of all recorded wrong site surgery (WSS) for that year. 2 This represents a 43% increase (12) in reported skin related WSS compared to the previous year.…”