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Chen et al¹ conclude on the basis of a meta-analysis of all published studies that there are no firm data to support the commonly held assumption that dermatologists can identify lesions that may be melanoma more accurately than primary care physicians. The ability of both groups to correctly identify potentially dangerous lesions that warrant biopsy or referral for biopsy was in both cases very high—up to 100%.

However, the ability to recognize lesions as melanoma is entirely dependent on the lesion that is examined. Neither primary care physicians nor dermatologists will have difficulty diagnosing as melanoma advanced lesions that exhibit all the clinical features of this cancer. The fact that diagnostic sensitivity was so high suggests that this was the case in the studies analyzed; and in a setting where everyone passes the test, it becomes difficult to detect differences in diagnostic acumen that may be present between groups.

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