 |
|
Risks and Benefits of Sequential Imaging of Melanocytic Skin Lesions in Patients With Multiple Atypical Nevi
Harald Kittler, MD;
Michael Binder, MD
Arch Dermatol. 2001;137:1590-1595.
Objective To evaluate the utility of sequential imaging of melanocytic skin lesions.
Design With the use of a computerized test environment, digital images of 80 melanocytic skin lesions (including 10 early melanomas) were presented to 24 dermatologists with different levels of experience in 3 sessions. The 3 sessions were designed to simulate the decision-making process (1) without the possibility of follow-up, (2) with the possibility of follow-up, and (3) after presentation of follow-up images.
Main Outcome Measures Diagnostic performance in terms of sensitivity, specificity, accuracy, treatment threshold, and utility.
Results The possibility of follow-up increased the treatment threshold in all groups of dermatologists compared with decision making without the possibility of follow-up. The increase of the treatment threshold was accompanied by a loss of sensitivity and a gain in specificity. The overall diagnostic accuracy remained unchanged. After presentation of follow-up images, the diagnostic accuracy improved significantly. The sensitivity improved for all readers, but the specificity improved only for the most experienced readers. The utility of sequential imaging depended on the compliance of patients with follow-up. Under the assumption that all patients are compliant with follow-up, the utility of sequential imaging was superior to decision making without follow-up over a broad range of benefit-risk ratios.
Conclusions Sequential imaging of melanocytic skin lesions is a useful procedure for patients with multiple atypical nevi. Uncritical use of sequential imaging cannot be recommended, because the utility of this technique depends on the experience in the interpretation of follow-up images and on the patient's compliance with follow-up.
From the Division of General Dermatology, Department of Dermatology, University of Vienna Medical School, Vienna, Austria. Dr Binder has been involved in the development of the MoleMax II and serves as a consultant to Derma Instruments, Vienna.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
RELATED LETTER
Identification of Incipient Tumors by Means of Sequential Dermoscopy Imaging: A New Way to Inflate the "Epidemic" of Melanoma?—Reply
Harald Kittler and Scott W. Menzies
Arch Dermatol. 2007;143(6):805-806.
EXTRACT
| FULL TEXT
RELATED ARTICLE
Dermoscopy and Early Diagnosis of Melanoma: The Light and the Dark
Paolo Carli, Vincenzo De Giorgi, and Benvenuto Giannotti
Arch Dermatol. 2001;137(12):1641-1644.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Identification of Incipient Tumors by Means of Sequential Dermoscopy Imaging: A New Way to Inflate the "Epidemic" of Melanoma?--Reply
Kittler and Menzies
Arch Dermatol 2007;143:805-806.
FULL TEXT
Digital Epiluminescence Microscopy Monitoring of High-Risk Patients
Robinson and Nickoloff
Arch Dermatol 2004;140:49-56.
ABSTRACT
| FULL TEXT
Accuracy of Computer Diagnosis of Melanoma: A Quantitative Meta-analysis
Rosado et al.
Arch Dermatol 2003;139:361-367.
ABSTRACT
| FULL TEXT
Follow-up of Melanocytic Skin Lesions With Digital Dermoscopy: Risks and Benefits
Kittler and Binder
Arch Dermatol 2002;138:1379-1379.
FULL TEXT
Can Nondermatologists Really Recognize Potentially Dangerous Skin Lesions as Well as Dermatologists?
Bystryn
Arch Dermatol 2002;138:1378-1378.
FULL TEXT
Dermoscopy in Melanoma Screening
Schneider
Arch Dermatol 2002;138:1378-1379.
FULL TEXT
Dermoscopy and Early Diagnosis of Melanoma: The Light and the Dark
Carli et al.
Arch Dermatol 2001;137:1641-1644.
FULL TEXT
|
