Dermatology Department, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, B-1200, Brussels, Belgium.
Institute of Experimental and Clinical Research (IREC), UCLouvain, Brussels, Belgium.
J Cancer Educ. 2022 Aug;37(4):898-904. doi: 10.1007/s13187-020-01897-w. Epub 2020 Oct 19.
To improve early melanoma detection, educational programs have been developed for general practitioners (GPs). This study aimed to determine whether the adjunct of teaching basic knowledge of pigmented skin lesions (PSL) to the training in melanoma diagnosis improves the GPs' diagnostic accuracy of melanoma. An interventional prospective study was conducted over a 3-month period where GPs attended a 2-h training course. The 1 session taught clinical melanoma recognition and the 2 session instructed basic knowledge of PSL. Prior to training, after the 1, and after the 2 session, GPs were asked to select the malignant or benign nature of 15 clinical images associated to their clinical history. In total, 56 GPs participated in this study. The number of GPs identifying correctly ≥ 50% of the melanomas increased the most after the 1 session from 15 (26.8%; CI = (15.2; 38.4)) to 44 (78.6%; CI = (67.8; 89.3)) GPs (P < 0.001). The number of GPs correctly identifying ≥ 50% of the benign PSL only increased after completing the entire training, going from 10 (17.9%; CI = [(7.8; 27.9)) GPs to 50 (89.3%; CI = (81.2; 97.4)) GPs (P < 0.001). In this study, GPs identified benign PSL most accurately after the 2 session. This suggested that teaching GPs the basics of PSL would especially improve their diagnostic accuracy for benign PSL, which could reduce unnecessary referrals to dermatologists. Teaching basic knowledge of PSL in addition to melanoma recognition seemed to enable GPs to triage skin lesions more effectively than when they were only trained to recognize melanoma.
为了提高早期黑素瘤的检测率,已经为全科医生(GP)开发了教育项目。本研究旨在确定在黑素瘤诊断培训中加入教授色素性皮损(PSL)基础知识是否能提高 GP 对黑素瘤的诊断准确性。在为期 3 个月的时间里进行了一项干预性前瞻性研究,GP 参加了 2 小时的培训课程。第 1 节课教授临床黑素瘤识别,第 2 节课教授 PSL 的基础知识。在培训前、第 1 节课后和第 2 节课后,GP 被要求选择与其临床病史相关的 15 个临床图像的良恶性。共有 56 名 GP 参与了这项研究。在第 1 节课后,能够正确识别≥50%黑素瘤的 GP 数量增加最多,从 15 名(26.8%;置信区间(CI)为(15.2;38.4))增加到 44 名(78.6%;CI 为(67.8;89.3))GP(P<0.001)。只有在完成整个培训后,能够正确识别≥50%良性 PSL 的 GP 数量才会增加,从 10 名(17.9%;CI 为[7.8;27.9])增加到 50 名(89.3%;CI 为[81.2;97.4])GP(P<0.001)。在这项研究中,GP 在第 2 节课后对良性 PSL 的识别最为准确。这表明,教授 GP PSL 的基础知识尤其可以提高他们对良性 PSL 的诊断准确性,从而减少不必要的皮肤科转诊。在识别黑素瘤的基础上教授 PSL 的基础知识,似乎使 GP 能够比仅接受黑素瘤识别培训更有效地分诊皮肤病变。