Benvenuto-Andrade Cristiane, Dusza Stephen W, Hay Jennifer L, Agero Anna Liza C, Halpern Allan C, Kopf Alfred W, Marghoob Ashfaq A
Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, New York 10022, USA.
Dermatol Surg. 2006 May;32(5):738-44. doi: 10.1111/j.1524-4725.2006.32149.x.
Confidence is an important factor in decision making and may influence patient care.
To evaluate whether short-training-based dermoscopy increases confidence in the diagnosis of skin lesions.
After a 1-hour course on dermoscopy, 20 pairs of clinical and dermoscopic images of lesions were presented to 19 dermatology residents with little or no dermoscopy experience. After viewing the clinical image, they were asked to assess their confidence in the diagnosis in a seven-point scale, with 1 reflecting that the respondent was 100% confident that the lesion was benign, while number 7 reflected 100% confidence that it was malignant. The same technique was used for dermoscopic images.
Ten of the 20 pairs of evaluations showed a significant difference (p<.05). The largest differences were observed in lesions where clinical scores suggested that participants were uncertain about the diagnosis, but tended to decide that the lesion was benign after dermoscopy. Dermoscopy did not improve confidence in the evaluation of dysplastic lesions as well as lesions with obvious clinical diagnoses.
Short-training-based dermoscopy improved confidence in the diagnosis of clinically challenging skin lesions, but the impact was not demonstrable for clinically obvious lesions and dysplastic nevi.
信心是决策的一个重要因素，可能会影响患者护理。
评估基于短期培训的皮肤镜检查是否能提高对皮肤病变诊断的信心。
在进行了1小时的皮肤镜检查课程培训后，向19名几乎没有或没有皮肤镜检查经验的皮肤科住院医师展示了20对病变的临床和皮肤镜图像。在查看临床图像后，要求他们用七点量表评估自己对诊断的信心，1表示受访者100%确信病变为良性，而7表示100%确信病变为恶性。对皮肤镜图像采用相同的方法。
20对评估中有10对显示出显著差异（p<0.05）。在临床评分表明参与者对诊断不确定，但在皮肤镜检查后倾向于判定病变为良性的病变中观察到最大差异。皮肤镜检查在发育异常病变以及具有明显临床诊断的病变评估中并未提高信心。
基于短期培训的皮肤镜检查提高了对临床具有挑战性的皮肤病变诊断的信心，但对临床明显的病变和发育异常痣的影响不明显。
