Factors important in the correct evaluation of oral high‐risk lesions during the telehealth era

Abstract

Background: Considering that early detection of squamous cell carcinoma (SCC) improves prognosis and clinical examination is the primary detection method, we identified factors related to the clinical evaluation of oral mucosal lesions. Due to the growing role of telehealth, our study was based on clinical image evaluation.Subjects and Methods: Oral medicine specialists and dental students evaluated six images of benign, potentially malignant, or SCC lesions (18 images in total). We analyzed the role of personal factors of the examiners and the visual pathological features of the lesion upon which the participants based their evaluation.Results: One hundred thirty-three subjects participated. Half of the benign images were correctly evaluated. On average 1.2 (±SD1.3) cancer pictures were recognized correctly and 3.66 (±SD1.42) images were considered potentially malignant. Potentially malignant lesions were correctly evaluated at an average of 4.08 (±SD1.48) images. For cancer and potentially malignant lesion images, there were significantly better results among clinicians with the worst results from the fourth-year students.Student results correlated significantly with years of study, number of weeks spent in the oral medicine clinic, and interest in oral pathology. Consideration of lesion irregularity yielded a correct diagnosis, whereas wrong answers were based on color changes. Lesion size and margins were considered equally important.Conclusions: Using clinical images as part of the diagnostic process provides good results, though increased clinical experience for graduates and undergraduates may be necessary to improve accuracy. Therefore, emphasizing the important visual parameters of malignancy may be valuable in the current telehealth era.clinical image, early detection, high risk, oral cancer, telehealth | INTRODUCTIONClinical examination is the recommended method for detection of squamous cell carcinoma (SCC) and high-risk oral lesions. 1 Early detection is a major factor for improved prognosis, 2 and is based on visual and tactile features of the lesion, symptoms, and patient history. Because the ability to recognize potentially malignant disorders or SCC is important, we wanted to study the factors affecting correct evaluation.Potentially malignant disorders include a variety of pathologies with distinctive manifestations, so their clinical appearance is an

Comparison of virtual clinical scenario and role play in learning oral pathology among dental students

“…In contrast, Czerninski et al, reported a different perspective, wherein surface appearance was considered as the most important parameter, while size was regarded as least important. They also noted that irregularity of the lesion emerged as the most crucial factor in diagnosis [ 28 ]. This discrepancy may be attributed to differences in case selection.…”

“…For example, we utilized clinical images of nicotine stomatitis, geographic tongue, aphthous ulcer, hairy tongue, oral candidiasis, and lichen planus. In contrast, the previous study focused on clinical images of high-risk lesions such as oral squamous cell carcinoma [ 28 ].…”

Oral leukoplakia evaluation through clinical photography

“…This finding could be justified because, besides color, OL classification contemplates other clinical aspects, such as surface texture and lesions boundaries. Another study revealed that besides color, other features in the clinical evaluation were also important, meaning size, margin, surface appearance, and irregularity 11 . Another fact is that during the questionary, it became notable that the experts based the classification mostly on their own experience and did not really hold on to the 3D plot interpretation.…”

Telehealth for high‐risk lesions: Asian perspective

“…Czerninski et al 1 used clinical pictures to distinguish benign lesions from potentially malignant and malignant pathologies. In context to Asia and Southeast Asia region, large population of patients suffering from oral submucous fibrosis (OSMF) might exhibit oral squamous cell carcinoma (OSMF-OSCC) concomitantly.…”