Lorentzen H, Weismann K, Petersen C S, Larsen F G, Secher L, Skødt V
Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark.
Acta Derm Venereol. 1999 Jul;79(4):301-4. doi: 10.1080/000155599750010715.
We investigated the nosographic and diagnostic probabilities and likelihood ratios of dermatoscopy in order to evaluate the method's role in decision-making regarding melanoma. Clinical slides and dermatoscopic photos were obtained from 232 patients referred for dermatoscopy. Four dermatoscopy "experts" and 5 "non-experts" assessed the slides. Diagnoses were compared with histopathology. Sensitivity of the clinical assessments was 0.78 vs. 0.69 ("experts" vs. "non-experts"), sensitivity of dermatoscopy assessment was 0.83 vs. 0.69 (p = 0.04). The expert group demonstrated increased specificity (from 0.89 to 0.94) when applying dermatoscopy compared with clinical assessment alone (p=0.03). Positive likelihood ratios were doubled in the "expert group" and the negative likelihood ratios improved 25% with dermatoscopy compared with clinical assessment.
我们研究了皮肤镜检查的疾病分类及诊断概率和似然比，以评估该方法在黑色素瘤决策制定中的作用。从232名转诊进行皮肤镜检查的患者处获取了临床幻灯片和皮肤镜照片。4名皮肤镜“专家”和5名“非专家”对幻灯片进行了评估。将诊断结果与组织病理学结果进行比较。临床评估的敏感性为0.78，而“专家”组为0.69，“非专家”组为0.69；皮肤镜评估的敏感性为0.83，“专家”组为0.69，“非专家”组为0.69（p = 0.04）。与仅进行临床评估相比，专家组在应用皮肤镜检查时特异性有所提高（从0.89提高到0.94）（p = 0.03）。与临床评估相比，“专家组”的阳性似然比增加了一倍，皮肤镜检查的阴性似然比提高了25%。
