Baade Peter D, Del Mar Chris B, Lowe John B, Stanton Warren R, Balanda Kevin P
Cancer Prevention Research Centre, University of Queensland.
Aust Fam Physician. 2005 Jan-Feb;34(1-2):79-83.
The ability of general practitioners to make important clinical decisions about the diagnosis and management of skin lesions is poorly understood.
A questionnaire on the diagnosis and management of eight photographed skin lesions was sent to 150 GPs in southeast Queensland.
The questionnaire was completed by 114 GPs (response rate 77%). General practitioners' provisional diagnoses and management of photographed skin lesions were mostly or always correct, and there was general high consistency between diagnosis and intended management. Pigmented seborrhoeic keratoses were the most difficult lesions for GPs to diagnose correctly. Whether a lesion was different to usual moles appears to have the strongest association with clinical diagnosis.
The high ability of GPs as measured in this artificial study is encouraging. The strong association between identifying moles that appear different to usual and correct clinical diagnoses suggest that unless GPs can increase the number of skin lesions they see as part of their typical workload, their clinical ability may not increase further.
全科医生对皮肤病变的诊断和管理做出重要临床决策的能力了解不足。
向昆士兰东南部的150名全科医生发送了一份关于8种皮肤病变照片的诊断和管理的问卷。
114名全科医生完成了问卷（回复率77%）。全科医生对皮肤病变照片的初步诊断和管理大多或总是正确的，并且诊断和预期管理之间总体一致性较高。色素性脂溢性角化病是全科医生最难正确诊断的病变。病变是否与寻常痣不同似乎与临床诊断的关联最强。
在这项人为研究中所衡量的全科医生的高能力令人鼓舞。识别出与寻常痣不同的痣与正确临床诊断之间的强关联表明，除非全科医生能够增加他们在典型工作量中所见皮肤病变的数量，否则他们的临床能力可能不会进一步提高。
