Hauschild Axel, Chen Suephy C, Weichenthal Michael, Blum Andreas, King Hadley C, Goldsmith Jeff, Scharfstein Daniel, Gutkowicz-Krusin Dina
University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany.
J Dtsch Dermatol Ges. 2014 Jul;12(7):606-14. doi: 10.1111/ddg.12362. Epub 2014 Jun 18.
To determine the biopsy sensitivity to melanoma of dermatologists in Germany and the impact of MelaFind® on their decisions to biopsy melanomas.
Randomized two-armed online reader study presenting case information, clinical/dermatoscopic images of pigmented skin lesions and MelaFind results (Arm 2).
Each participant was asked to review 130 pigmented skin lesions. Biopsy decisions of dermatologists without MelaFind versus MelaFind and dermatologists without MelaFind versus dermatologists with MelaFind were compared.
Dermatologists without MelaFind had average sensitivity to melanoma of 69.5 % and average specificity of 55.9 %. MelaFind had greater sensitivity than dermatologists alone (96.9 % vs. 69.5 %, one-sided p < 0.00001) and lower specificity (9.2 % vs. 55.9 %, one-sided p < 0.00001). Dermatologists with MelaFind had higher sensitivity than those without MelaFind (78 % vs. 69.5 %, one-sided p < 0.00001) and a lower specificity (45.8 % vs. 55.9 %, one-sided p < 0.00001). The number of dermatologists detecting over 90 % of melanomas increased from 3 of 101 without MelaFind to 22 of 101 with MelaFind (p = 0.00006) while specificity remained relatively equivalent (23 % vs. 21 %, p = 0.99).
The MelaFind information, when incorporated into the final biopsy decision, can improve biopsy sensitivity with modest effect on biopsy specificity.
确定德国皮肤科医生对黑色素瘤活检的敏感性，以及MelaFind®对他们活检黑色素瘤决策的影响。
随机双臂在线读者研究，呈现病例信息、色素沉着性皮肤病变的临床/皮肤镜图像以及MelaFind结果（第二组）。
要求每位参与者查看130个色素沉着性皮肤病变。比较了未使用MelaFind的皮肤科医生与使用MelaFind的皮肤科医生的活检决策，以及未使用MelaFind的皮肤科医生之间的活检决策。
未使用MelaFind的皮肤科医生对黑色素瘤的平均敏感性为69.5%，平均特异性为55.9%。MelaFind的敏感性高于单独的皮肤科医生（96.9%对69.5%，单侧p<0.00001），特异性较低（9.2%对55.9%，单侧p<0.00001）。使用MelaFind的皮肤科医生比未使用MelaFind的皮肤科医生具有更高的敏感性（78%对69.5%，单侧p<0.00001）和更低的特异性（45.8%对55.9%，单侧p<0.00001）。检测出超过90%黑色素瘤的皮肤科医生数量从101名未使用MelaFind的医生中的3名增加到101名使用MelaFind的医生中的22名（p = 0.00006），而特异性保持相对相当（23%对21%，p = 0.99）。
将MelaFind信息纳入最终活检决策时，可提高活检敏感性，对活检特异性影响不大。
