Reflectance confocal microscopy for diagnosing keratinocyte skin cancers in adults

Dinnes, Jacqueline; Deeks, Jonathan J; Chuchu, Naomi; Saleh, Daniel; Bayliss, Sue; Takwoingi, Yemisi; Davenport, Clare; Patel, Lopa; Matin, Rubeta; O'Sullivan, Colette; Patalay, Rakesh; Williams, Hywel C

doi:10.1002/14651858.cd013191

Cited by 54 publications

(46 citation statements)

References 196 publications

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“…Cutaneous squamous cell carcinoma and basal cell carcinoma are locally invasive with better outcomes if treated at an early stage. Several diagnostic technologies are available to help general practitioners and dermatologists accurately identify melanomas by minimising delays in diagnosis 78. The success of these technologies is reliant on people with new or changing skin lesions seeking early advice from medical professionals.…”

Section: Introductionmentioning

confidence: 99%

Algorithm based smartphone apps to assess risk of skin cancer in adults: systematic review of diagnostic accuracy studies

Freeman

Dinnes

Chuchu

et al. 2020

BMJ

Self Cite

184

161

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Objective To examine the validity and findings of studies that examine the accuracy of algorithm based smartphone applications (“apps”) to assess risk of skin cancer in suspicious skin lesions. Design Systematic review of diagnostic accuracy studies. Data sources Cochrane Central Register of Controlled Trials, MEDLINE, Embase, CINAHL, CPCI, Zetoc, Science Citation Index, and online trial registers (from database inception to 10 April 2019). Eligibility criteria for selecting studies Studies of any design that evaluated algorithm based smartphone apps to assess images of skin lesions suspicious for skin cancer. Reference standards included histological diagnosis or follow-up, and expert recommendation for further investigation or intervention. Two authors independently extracted data and assessed validity using QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies 2 tool). Estimates of sensitivity and specificity were reported for each app. Results Nine studies that evaluated six different identifiable smartphone apps were included. Six verified results by using histology or follow-up (n=725 lesions), and three verified results by using expert recommendations (n=407 lesions). Studies were small and of poor methodological quality, with selective recruitment, high rates of unevaluable images, and differential verification. Lesion selection and image acquisition were performed by clinicians rather than smartphone users. Two CE (Conformit Europenne) marked apps are available for download. No published peer reviewed study was found evaluating the TeleSkin skinScan app. SkinVision was evaluated in three studies (n=267, 66 malignant or premalignant lesions) and achieved a sensitivity of 80% (95% confidence interval 63% to 92%) and a specificity of 78% (67% to 87%) for the detection of malignant or premalignant lesions. Accuracy of the SkinVision app verified against expert recommendations was poor (three studies). Conclusions Current algorithm based smartphone apps cannot be relied on to detect all cases of melanoma or other skin cancers. Test performance is likely to be poorer than reported here when used in clinically relevant populations and by the intended users of the apps. The current regulatory process for awarding the CE marking for algorithm based apps does not provide adequate protection to the public. Systematic review registration PROSPERO CRD42016033595.

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Section: Introductionmentioning

confidence: 99%

Algorithm based smartphone apps to assess risk of skin cancer in adults: systematic review of diagnostic accuracy studies

Freeman

Dinnes

Chuchu

et al. 2020

BMJ

Self Cite

184

161

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“…For example, the differentiation of melanocytes from langerhans cells in melanocytic lesions lacks specificity, the misdiagnosis due to specific lesion or missed detection because of sampling error, as well as the clinical experience of the doctors (63) . There were four records in Cancer-CSR concentrated on the applying of RCM for diagnosing skin cancer in adults with any suspicious lesion which was all published in 2018 (64)(65)(66)(67) .…”

Section: Research Hotspotsmentioning

confidence: 99%

Trends analysis of cancer topic of Cochrane systematic reviews: a bibliometric analysis

Yang

Gao

Cai

et al. 2019

Preprint

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Purpose: To analyze the scientific outputs of the cancer topic of Cochrane systematic reviews (Cancer-CSR) in order to have a comprehensive understanding and lay the foundation for the following research. Patients and methods: Cochrane Database of Systematic Review and Web of Science Core Collection were retrieved limited from Jan. 1, 2009 to Dec. 12, 2018. CiteSpace IV and Excel 2018 were applied to analyze and visualize the literature information. Results: Ultimately, 607 Cancer-CSR were retrieved, 32 countries, 179 institutions and 260 authors involved. The number of publications in Cancer-CSR has been increasing over the past decades (25(2009)-77(2018)). UK, USA, Canada, Australia, and Germany worked closely with other countries, especially the UK (n=361) has taken the lead in this field. The top 10 contributive institutions, which were almost came from developed countries, collaborated closely with other institutions. Cochrane Database Syst Rev, C Hdb Sys and J Clin Oncol were the top three journals with the highest co-citation. The top three co-cited references were the two different version of Cochrane handbook for systematic reviews and the guidelines of Review Manager. The biggest cluster of keywords “cytoreductive surgery (CRS)” and the latest clusters “visual inspection” and “non-steroidal anti-inflammatory drug” were the most promising hotspots. Conclusions: Cancer-CSR has been increasing. Most of the reviews were came from the developed countries as well as the institutes in these countries. The knowledge base of was the methodology studies of systematic review, epidemiological data of cancer, and the reporting guideline of systematic reviews. The adjuvant therapy combined CRS, the screening of skin cancer and the management of cancer-related pain were the hotspots. Reasons that influence the author's preference for Cancer-CSR also deserve further investigation.

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“…3 Similarly, in the Psoriasis Longitudinal Assessment and Registry, a cohort of psoriasis patients either receiving or who are candidates for systemic agents, the annual birth rate of childbearing-aged females was lower (15.4 births per 1000 women) compared to the general population (63.2 per 1000 women). 4 The root of this discrepancy remains unclear. Perhaps psoriasis patients are uninformed or uninterested in registry participation.…”

mentioning

confidence: 99%

“…1 High levels of diagnostic accuracy are reached with the combined use of dermoscopy and RCM for BCC diagnosis that is based on a set of distinct confocal features. [2][3][4] Furthermore, new handled devices allowed to speed up the confocal examination at patient's bedside, making easier and faster the systematic use of RCM for atypical skin lesions. 5 Nevertheless, in some cases, the differential diagnosis between BCC and other benign and malignant skin lesions may be difficult even combining dermoscopic and confocal findings.…”

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confidence: 99%

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‘Eternal sunshine of the spotless islands’: how dermoscopy may influence confocal microscopy when dealing with squamous cells carcinoma simulating basal cell carcinoma

Cornacchia

Longo

Piana

et al. 2019

Acad Dermatol Venereol

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Reflectance confocal microscopy for diagnosing keratinocyte skin cancers in adults

Abstract: Trusted evidence. Informed decisions. Better health.

Cited by 54 publications

References 196 publications

Algorithm based smartphone apps to assess risk of skin cancer in adults: systematic review of diagnostic accuracy studies

Algorithm based smartphone apps to assess risk of skin cancer in adults: systematic review of diagnostic accuracy studies

Trends analysis of cancer topic of Cochrane systematic reviews: a bibliometric analysis

‘Eternal sunshine of the spotless islands’: how dermoscopy may influence confocal microscopy when dealing with squamous cells carcinoma simulating basal cell carcinoma

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