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10.1001/jamadermatol.2016.0624

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suck abstract from ncbi


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pmid27074267
      JAMA+Dermatol 2016 ; 152 (7 ): 798-806
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  • Validity and Reliability of Dermoscopic Criteria Used to Differentiate Nevi From Melanoma: A Web-Based International Dermoscopy Society Study #MMPMID27074267
  • Carrera C ; Marchetti MA ; Dusza SW ; Argenziano G ; Braun RP ; Halpern AC ; Jaimes N ; Kittler HJ ; Malvehy J ; Menzies SW ; Pellacani G ; Puig S ; Rabinovitz HS ; Scope A ; Soyer HP ; Stolz W ; Hofmann-Wellenhof R ; Zalaudek I ; Marghoob AA
  • JAMA Dermatol 2016[Jul]; 152 (7 ): 798-806 PMID27074267 show ga
  • IMPORTANCE: The comparative diagnostic performance of dermoscopic algorithms and their individual criteria are not well studied. OBJECTIVES: To analyze the discriminatory power and reliability of dermoscopic criteria used in melanoma detection and compare the diagnostic accuracy of existing algorithms. DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective, observational study of 477 lesions (119 melanomas [24.9%] and 358 nevi [75.1%]), which were divided into 12 image sets that consisted of 39 or 40 images per set. A link on the International Dermoscopy Society website from January 1, 2011, through December 31, 2011, directed participants to the study website. Data analysis was performed from June 1, 2013, through May 31, 2015. Participants included physicians, residents, and medical students, and there were no specialty-type or experience-level restrictions. Participants were randomly assigned to evaluate 1 of the 12 image sets. MAIN OUTCOMES AND MEASURES: Associations with melanoma and intraclass correlation coefficients (ICCs) were evaluated for the presence of dermoscopic criteria. Diagnostic accuracy measures were estimated for the following algorithms: the ABCD rule, the Menzies method, the 7-point checklist, the 3-point checklist, chaos and clues, and CASH (color, architecture, symmetry, and homogeneity). RESULTS: A total of 240 participants registered, and 103 (42.9%) evaluated all images. The 110 participants (45.8%) who evaluated fewer than 20 lesions were excluded, resulting in data from 130 participants (54.2%), 121 (93.1%) of whom were regular dermoscopy users. Criteria associated with melanoma included marked architectural disorder (odds ratio [OR], 6.6; 95% CI, 5.6-7.8), pattern asymmetry (OR, 4.9; 95% CI, 4.1-5.8), nonorganized pattern (OR, 3.3; 95% CI, 2.9-3.7), border score?of 6 (OR, 3.3; 95% CI, 2.5-4.3), and contour asymmetry (OR, 3.2; 95% CI, 2.7-3.7) (P?
  • |*Algorithms [MESH]
  • |*Dermoscopy [MESH]
  • |Diagnosis, Differential [MESH]
  • |Humans [MESH]
  • |Internet [MESH]
  • |Melanoma/*diagnostic imaging [MESH]
  • |Nevus/*diagnostic imaging [MESH]
  • |Observer Variation [MESH]
  • |ROC Curve [MESH]
  • |Random Allocation [MESH]
  • |Reproducibility of Results [MESH]
  • |Retrospective Studies [MESH]


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