MoleMate培训项目用于基层医疗中可疑色素沉着性病变评估的效果评价

Evaluation of the MoleMate training program for assessment of suspicious pigmented lesions in primary care.

作者信息

Wood Annabel, Morris Helen, Emery Jon, Hall Per N, Cotton Symon, Prevost A Toby, Walter Fiona M

机构信息

GP Registrar, Cambridge Vocational Training Scheme, UK.

出版信息

Inform Prim Care. 2008;16(1):41-50. doi: 10.14236/jhi.v16i1.673.

DOI:10.14236/jhi.v16i1.673

PMID:18534076

Abstract

BACKGROUND

Pigmented skin lesions or 'moles' are a common presenting problem in general practice consultations: while the majority are benign, a minority are malignant melanomas. The MoleMate system is a novel diagnostic tool which incorporates spectrophotometric intracutaneous analysis (SIAscopy) within a non-invasive scanning technique and utilises a diagnostic algorithm specifically developed for use in primary care. The MoleMate training program is a short, computer-based course developed to train primary care practitioners to operate the MoleMate diagnostic tool.

OBJECTIVES

This pre-trial study used mixed methods to assess the effectiveness and acceptability of a computer-based training program CD-ROM, developed to teach primary care practitioners to identify the seven features of suspicious pigmented lesions (SPLs) seen with the MoleMate system.

METHOD

Twenty-five practitioners worked through the MoleMate training program: data on feature recognition and time taken to conduct the assessment of each lesion were collected. Acceptability of the training program and the MoleMate system in general was assessed by questionnaire.

RESULTS

The MoleMate training program improved users' feature recognition by 10% (pre-test median 73.8%, p<0.001), and reduced the time taken to complete assessment of 30 SPLs (pre-test median 21 minutes 53 seconds, median improvement 3 minutes 17 seconds, p<0.001). All practitioners' feature recognition improved (21/21), with most also improving their time (18/21). Practitioners rated the training program as effective and easy to use.

CONCLUSION

The MoleMate training program is a potentially effective and acceptable informatics tool to teach practitioners to recognise the features of SPLs identified by the MoleMate system. It will be used as part of the intervention in a randomised controlled trial to compare the diagnostic accuracy and appropriate referral rates of practitioners using the MoleMate system with best practice in primary care.

摘要

背景

色素沉着性皮肤病变或“痣”是全科医疗咨询中常见的就诊问题：大多数是良性的，但少数是恶性黑色素瘤。MoleMate系统是一种新型诊断工具，它将分光光度法皮内分析（SIAscopy）纳入非侵入性扫描技术，并利用专门为初级保健开发的诊断算法。MoleMate培训项目是一个简短的基于计算机的课程，旨在培训初级保健从业者操作MoleMate诊断工具。

目的

这项预试验研究采用混合方法评估一个基于计算机的培训项目光盘的有效性和可接受性，该光盘旨在教导初级保健从业者识别使用MoleMate系统所见可疑色素沉着性病变（SPL）的七个特征。

方法

25名从业者完成了MoleMate培训项目：收集了关于特征识别以及评估每个病变所需时间的数据。通过问卷调查评估培训项目以及总体上MoleMate系统的可接受性。

结果

MoleMate培训项目使使用者的特征识别提高了10%（测试前中位数为73.8%，p<0.001），并缩短了完成30个SPL评估所需的时间（测试前中位数为21分53秒，中位数改善了3分17秒，p<0.001）。所有从业者的特征识别都有提高（21/21），大多数人评估时间也有所缩短（18/21）。从业者将培训项目评为有效且易于使用。