To excise or not: impact of MelaFind on German dermatologists' decisions to biopsy atypical lesions. (18th June 2014)

• Record Type: Journal Article
• Authors: Hauschild, Axel; Chen, Suephy C.; Weichenthal, Michael; Blum, Andreas; King, Hadley C.; Goldsmith, Jeff; Scharfstein, Daniel; Gutkowicz‐Krusin, Dina
• Is Part Of: Journal der Deutschen Dermatologischen Gesellschaft. Volume 12:Number 7(2014)
• Page Start: 606
• Page End: 614
• Publication Date: 2014-06-18
• Subjects: Skin -- Diseases -- Periodicals; Dermatology -- Periodicals; 616.5005
• DOI: 10.1111/ddg.12362
• Languages: English
• ISSNs: 1610-0379

Abstract

<abstract abstract-type="main"> <title>Summary</title> <sec id="ddg12362-sec-0010" sec-type="section"> <title>Objectives</title> <p>To determine the biopsy sensitivity to melanoma of dermatologists in Germany and the impact of MelaFind® on their decisions to biopsy melanomas.</p> </sec> <sec id="ddg12362-sec-0020" sec-type="section"> <title>Design</title> <p>Randomized two‐armed online reader study presenting case information, clinical/dermatoscopic images of pigmented skin lesions and MelaFind results (Arm 2).</p> </sec> <sec id="ddg12362-sec-0030" sec-type="section"> <title>Methods</title> <p>Each participant was asked to review 130 pigmented skin lesions. Biopsy decisions of dermatologists without MelaFind versus MelaFind and dermatologists without MelaFind versus dermatologists with MelaFind were compared.</p> </sec> <sec id="ddg12362-sec-0040" sec-type="section"> <title>Results</title> <p>Dermatologists without MelaFind had average sensitivity to melanoma of 69.5 % and average specificity of 55.9 %. MelaFind had greater sensitivity than dermatologists alone (96.9 % vs. 69.5 %, one‐sided p < 0.00001) and lower specificity (9.2 % vs. 55.9 %, one‐sided p < 0.00001). Dermatologists with MelaFind had higher sensitivity than those without MelaFind (78 % vs. 69.5 %, one‐sided p < 0.00001) and a lower specificity (45.8 % vs. 55.9 %, one‐sided p < 0.00001). The number of dermatologists detecting over 90 % of melanomas increased from 3 of 101 without MelaFind to 22 of 101 with MelaFind (p = 0.00006) while specificity remained relatively equivalent (23 % vs. 21 %, p = 0.99).</p> </sec> <sec id="ddg12362-sec-0050" sec-type="section"> <title>Conclusions</title> <p>The MelaFind information, when incorporated into the final biopsy decision, can improve biopsy sensitivity with modest effect on biopsy specificity.</p> </sec> </abstract>