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皮肤科医生和初级保健医生在恶性黑色素瘤诊断中的一致性:文献回顾。

Agreement between dermatologists and primary care practitioners in the diagnosis of malignant melanoma: review of the literature.

机构信息

McMaster University, Hamilton, ON, Canada.

出版信息

J Cutan Med Surg. 2012 Sep-Oct;16(5):306-10. doi: 10.1177/120347541201600506.

Abstract

BACKGROUND

The incidence of melanoma continues to rise in the developed world. It is therefore essential for primary care practitioners (PCPs) to be able to discriminate between malignant and benign cutaneous findings, as most patients present to PCPs first for examination of suspicious lesions.

OBJECTIVE

To compare dermatologists and PCPs in the diagnosis of malignant melanoma.

METHODS

Prospective studies published from January 1950 to August 2010 in MEDLINE, EMBASE, CINAHL, and CancerLit databases were examined. Relevant medical search terms, discussed amongst the authors, were entered into the databases. Only articles comparing dermatologists and PCPs in the diagnosis of malignant melanoma were selected.

RESULTS

Dermatologists were reported as having sensitivities, specificities, and diagnostic accuracies ranging from 0.74 to 1.00, 0.56 to 0.95, and 0.85 to 0.89, respectively. PCPs had sensitivities, specificities, and diagnostic accuracies ranging from 0.25 to 0.88, 0.26 to 0.71, and 0.49 to 0.80, respectively.

CONCLUSIONS

PCPs should receive more training to improve their ability in the diagnosis of malignant melanoma.

摘要

背景

在发达国家,黑色素瘤的发病率持续上升。因此,初级保健医生(PCP)必须能够区分恶性和良性皮肤病变,因为大多数患者首先向 PCP 就诊以检查可疑病变。

目的

比较皮肤科医生和 PCP 在恶性黑色素瘤诊断中的表现。

方法

检索 1950 年 1 月至 2010 年 8 月 MEDLINE、EMBASE、CINAHL 和 CancerLit 数据库中发表的前瞻性研究。作者讨论了相关的医学检索词,并将其输入到数据库中。仅选择比较皮肤科医生和 PCP 在恶性黑色素瘤诊断中的文章。

结果

皮肤科医生的敏感性、特异性和诊断准确性的报道范围分别为 0.74 至 1.00、0.56 至 0.95 和 0.85 至 0.89。PCP 的敏感性、特异性和诊断准确性的报道范围分别为 0.25 至 0.88、0.26 至 0.71 和 0.49 至 0.80。

结论

PCP 应接受更多的培训,以提高其诊断恶性黑色素瘤的能力。

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