Memorial Sloan-Kettering Cancer Center, New York, NY 10022, USA.
J Am Acad Dermatol. 2010 May;62(5):794-803. doi: 10.1016/j.jaad.2009.09.008. Epub 2010 Mar 12.
Total body photography (TBP) and dermatoscopy are imaging techniques used to treat patients with pigmented lesions.
We sought to describe use, training, logistics, and beliefs about these tools among residency programs and to assess changes during a 10-year period.
Surveys were sent to all directors (n = 111) and chief residents (n = 109) of US dermatology training programs.
A total of 83 (74.8%) attendings answered the questionnaire. In all, 59 (71.1%) reported using TBP, an 11.9% increase (P = .2484) over the past decade. Reasons for using TBP included: reduces patient anxiety (81.4%), helps detect early melanoma (78.0%), and leads to fewer biopsies (66.1%). Logistical (79.2%) and financial (45.8%) constraints were reasons for not using TBP. Seventy respondents (84.3%) reported using dermatoscopy, a 40.0% increase (P = .0001) over the 10-year period. Reasons for dermatoscopy use were consistent over time: helps find melanoma in curable stage (75.7%), reduces patient anxiety (61.4%), and leads to fewer biopsies (57.1%). The most common reason for not using dermatoscopy remained lack of training (38.5%). A total of 92 (84.4%) residents completed their survey, of which 41 (44.6%) and 81 (88.0%) reported using TBP and dermatoscopy, respectively. In all, 62 (67.4%) and 79 (85.9%) respondents would prefer additional training in TBP and dermatoscopy, respectively.
Results may not be applicable to the general dermatology community.
Use of dermatoscopy among residency programs has increased significantly during the last decade. A more modest increase in the use of TBP was observed. Barriers to diffusion of these technologies into practice persist, including insufficient logistics and training.
全身摄影(TBP)和皮肤镜检查是用于治疗色素病变患者的成像技术。
我们旨在描述这些工具在住院医师培训计划中的使用、培训、后勤保障和信念,并评估在十年期间的变化。
向所有皮肤科培训项目的主任(n=111)和住院总医师(n=109)发送了调查问卷。
共有 83 名(74.8%)主治医生回答了问卷。总的来说,有 59 名(71.1%)报告使用了 TBP,比过去十年增加了 11.9%(P=0.2484)。使用 TBP 的原因包括:减少患者焦虑(81.4%)、有助于发现早期黑色素瘤(78.0%)和减少活检(66.1%)。不使用 TBP 的原因包括后勤(79.2%)和财务(45.8%)限制。70 名受访者(84.3%)报告使用皮肤镜检查,在十年期间增加了 40.0%(P=0.0001)。使用皮肤镜检查的原因在一段时间内保持一致:有助于发现可治愈阶段的黑色素瘤(75.7%)、减少患者焦虑(61.4%)和减少活检(57.1%)。不使用皮肤镜检查的最常见原因仍然是缺乏培训(38.5%)。共有 92 名(84.4%)住院医师完成了调查,其中 41 名(44.6%)和 81 名(88.0%)分别报告使用了 TBP 和皮肤镜检查。总的来说,62 名(67.4%)和 79 名(85.9%)受访者希望分别在 TBP 和皮肤镜检查方面接受更多培训。
结果可能不适用于普通皮肤科医生。
在过去十年中,皮肤镜检查在住院医师培训计划中的使用显著增加。TBP 的使用略有增加。将这些技术推广到实践中的障碍仍然存在,包括后勤和培训不足。