Increase in the sensitivity for melanoma diagnosis by primary care physicians using skin surface microscopy

Westerhoff, Karin; McCarthy, William H.; Menzies, Scott W.

doi:10.1046/j.1365-2133.2000.03836.x

Cited by 163 publications

(148 citation statements)

References 30 publications

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“…Use of dermoscopy as a triage tool for suspicious lesions has been advocated 42 . The Three-Point Checklist, a dermoscopic algorithm (described in the Online Appendix), has been shown to improve the ability of PCPs to triage suspicious lesions 40,[43][44][45][46][47] . Several studies have demonstrated improved diagnostic accuracy when teaching dermoscopy to nondermatologists, supporting that dermoscopy may be a valuable addition to a skin cancer education curriculum 44,47,48 .…”

Section: Discussionmentioning

confidence: 99%

Skin Cancer Education for Primary Care Physicians: A Systematic Review of Published Evaluated Interventions

et al. 2011

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BACKGROUND: Early detection of melanoma may provide an opportunity to positively impact melanoma mortality. Numerous skin cancer educational interventions have been developed for primary care physicians (PCPs) to improve diagnostic accuracy. Standardized training is also a prerequisite for formal testing of melanoma screening in the primary care setting. OBJECTIVE: We conducted a systematic review to determine the extent of evaluated interventions designed to educate PCPs about skin cancer, including melanoma. DESIGN: Relevant studies in the English language were identified through systemic searches performed in MEDLINE, EMBASE, BIOSIS, and Cochrane through December 2010. Supplementary information was obtained from corresponding authors of the included studies when necessary. APPROACH: Studies eligible for inclusion formally evaluated skin cancer education interventions and were designed primarily for PCPs. Excluded studies lacked a specified training intervention, used decision-making software, focused solely on risk factor identification, or did not directly educate or assess participants. Twenty studies met the selection criteria. Data were extracted according to intervention content and delivery format, and study outcomes.KEY RESULTS: All interventions included instructions about skin cancer diagnosis, but otherwise varied in content. Curricula utilized six distinct educational techniques, usually incorporating more than one. Intervention duration varied from 12 min to over 6 h. Eight of the 20 studies were randomized trials. Most studies (18/20, 90%) found a significant improvement in at least one of the following five outcome categories: knowledge, competence, confidence, diagnostic performance, or systems outcomes. Competence was most commonly measured; no study evaluated all categories. Variability in study design, interventions, and outcome measures prevented correlation of outcomes with intervention characteristics. CONCLUSIONS: Despite the development of many isolated educational interventions, few have been tested rigorously or evaluated under sufficient standardized conditions to allow for quantitative comparison. Improved and rigorously tested skin cancer educational interventions for PCPs with outcome measures focusing on changes in performance are needed.

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Section: Discussionmentioning

confidence: 99%

Skin Cancer Education for Primary Care Physicians: A Systematic Review of Published Evaluated Interventions

et al. 2011

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“…Westerhoff et al's RCT evaluated an educational intervention for improving melanoma diagnosis using Intervention did decrease the surface microscopy. 31 The control group did not receive the training. Participants' diagnostic ability on clinical photographs was found to significantly improve in those who had received the microscopy training.…”

Section: Intervention Typementioning

confidence: 99%

“…Some studies had a high risk of selection bias, [13][14][15][16][17]19,20,22,24,25,27,[29][30][31] with little information given (if any) about whether those who participated were different from those who chose not to take part. Almost all studies reported a follow-up period of less than 1 year; 11,14,[17][18][19]21,23,24,27,28,31,33 several tested participants straight after the intervention; 15,16,29,30 and some did not include or state any follow-up period. 20,22,25,32 Therefore, it cannot be determined whether any of the reported improvements persisted.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Interventions to reduce primary care delay in cancer referral: a systematic review

et al. 2011

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“…Further, the gradual introduction of dermatoscopy in general practice may help here as suggested in several studies [15,16]. One issue is to which extent the study populations are representative for GP and academic melanomas.…”

Section: Discussionmentioning

confidence: 99%

Skin Melanomas Excised by General Practitioners: More Often Unsuspected, of Nodular Type and Less of Often Radically Excised Than Those Excised in an Academic Setting

Buis¹,

Kemenade²,

Frijling³

et al. 2011

J Clin Exp Dermatol

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Increase in the sensitivity for melanoma diagnosis by primary care physicians using skin surface microscopy

Abstract: All PCP in countries where melanoma leads to significant mortality should be trained in skin surface microscopy.

Cited by 163 publications

References 30 publications

Skin Cancer Education for Primary Care Physicians: A Systematic Review of Published Evaluated Interventions

Skin Cancer Education for Primary Care Physicians: A Systematic Review of Published Evaluated Interventions

Interventions to reduce primary care delay in cancer referral: a systematic review

Skin Melanomas Excised by General Practitioners: More Often Unsuspected, of Nodular Type and Less of Often Radically Excised Than Those Excised in an Academic Setting

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