Hansen Craig, Wilkinson David, Hansen Mary, Argenziano Giuseppe
School of Medicine, University of Queensland, Queensland, Australia.
J Am Acad Dermatol. 2009 Oct;61(4):599-604. doi: 10.1016/j.jaad.2009.04.021. Epub 2009 Aug 6.
The number needed to treat (NNT) is a key measure of the quality of melanoma diagnosis. There are few data on this measure from primary care skin cancer clinics in Australia.
We sought to report the NNT from a large pathology database and examine several patient characteristics.
We calculated NNT by doctor and clinic among 10,612 lesions, 6796 patients, 57 doctors, and 15 clinics from a pathology database. NNT was calculated with and without seborrheic keratoses.
Overall NNT was 30 (with seborrheic keratoses) and 23 (without seborrheic keratoses). Excluding the 4 doctors with NNT greater than 60, total NNT decreased from 30 to 21 and from 23 to 15, respectively (with and without seborrheic keratoses). NNT was higher for female patients and younger patients (<30 years). NNT varied by doctor from 0 to 192 and 117, respectively (with and without seborrheic keratoses).
Given the retrospective design, we were unable to examine doctor characteristics such as age, sex, medical training, and patient pressure to excise.
Substantial variability in individual doctor NNT produced an overall NNT similar to that reported from mainstream general practice, and higher than specialist practice.
需治疗人数（NNT）是黑色素瘤诊断质量的关键指标。澳大利亚基层医疗皮肤癌诊所关于该指标的数据较少。
我们试图报告来自大型病理数据库的需治疗人数，并研究若干患者特征。
我们从一个病理数据库中的10612个病变、6796名患者、57名医生和15家诊所计算医生和诊所的需治疗人数。需治疗人数在包含和不包含脂溢性角化病的情况下进行计算。
总体需治疗人数在包含脂溢性角化病时为30，不包含时为23。排除需治疗人数大于60的4名医生后，总需治疗人数分别从30降至21，从23降至15（包含和不包含脂溢性角化病时）。女性患者和年轻患者（<30岁）的需治疗人数更高。不同医生的需治疗人数分别从0到192和117不等（包含和不包含脂溢性角化病时）。
鉴于回顾性设计，我们无法研究医生的特征，如年龄、性别、医学培训以及切除患者的压力。
个体医生需治疗人数的显著差异导致总体需治疗人数与主流全科医疗报告的相似，且高于专科医疗。
