Chia Alvin, Trevena Lyndal
Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia.
School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, 2006, Australia.
J Cancer Educ. 2016 Dec;31(4):730-735. doi: 10.1007/s13187-015-0864-6.
Australia has the highest incidence of melanoma in the world. General practitioners encounter melanoma in 9.9 per 10,000 clinical encounters and play a key role in diagnosis. A systematic review was conducted to study the efficacy of training methods to improve general practitioners' diagnostic skills in melanoma. Article abstracts (1307) were screened, from a Medline search. Four trials met our criteria and were highly variable in their intervention methods and outcome measures. The Cochrane risk of bias tool was used to assess study quality with only one good, one poor, and two of questionable quality. Our results showed limited evidence via one study that training of general practitioners in surface microscopy improved melanoma diagnosis, from a clinical (naked eye) pre-intervention score of 54.6 % to a post-intervention surface microscopy score of 75.9 % in 74 general practitioners. Future work should explore the barriers to implementing this strategy in clinical practice.
澳大利亚是世界上黑素瘤发病率最高的国家。全科医生在每10000次临床诊疗中会遇到9.9例黑素瘤病例,并且在诊断中发挥关键作用。开展了一项系统评价,以研究培训方法对提高全科医生黑素瘤诊断技能的效果。通过检索Medline筛选出1307篇文章摘要。四项试验符合我们的标准,但其干预方法和结果测量差异很大。使用Cochrane偏倚风险工具评估研究质量,只有一项质量良好,一项质量较差,两项质量存疑。我们的结果显示,仅有一项研究提供了有限的证据,表明对74名全科医生进行表面显微镜检查培训可改善黑素瘤诊断,临床(肉眼)干预前评分从54.6%提高到干预后表面显微镜检查评分的75.9%。未来的工作应探索在临床实践中实施该策略的障碍。