Department of Oral Medicine, Sedation and Imaging, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
J Oral Pathol Med. 2022 Sep;51(8):747-754. doi: 10.1111/jop.13343. Epub 2022 Aug 23.
Considering that early detection of squamous cell carcinoma (SCC) improves prognosis and clinical examination is the primary detection method, we identified factors related to the clinical evaluation of oral mucosal lesions. Due to the growing role of telehealth, our study was based on clinical image evaluation.
Oral medicine specialists and dental students evaluated six images of benign, potentially malignant, or SCC lesions (18 images in total). We analyzed the role of personal factors of the examiners and the visual pathological features of the lesion upon which the participants based their evaluation.
One hundred thirty-three subjects participated. Half of the benign images were correctly evaluated. On average 1.2 (±SD1.3) cancer pictures were recognized correctly and 3.66 (±SD1.42) images were considered potentially malignant. Potentially malignant lesions were correctly evaluated at an average of 4.08 (±SD1.48) images. For cancer and potentially malignant lesion images, there were significantly better results among clinicians with the worst results from the fourth-year students. Student results correlated significantly with years of study, number of weeks spent in the oral medicine clinic, and interest in oral pathology. Consideration of lesion irregularity yielded a correct diagnosis, whereas wrong answers were based on color changes. Lesion size and margins were considered equally important.
Using clinical images as part of the diagnostic process provides good results, though increased clinical experience for graduates and undergraduates may be necessary to improve accuracy. Therefore, emphasizing the important visual parameters of malignancy may be valuable in the current telehealth era.
鉴于早期检测鳞状细胞癌 (SCC) 可改善预后，而临床检查是主要的检测方法，因此我们确定了与口腔黏膜病变临床评估相关的因素。由于远程医疗的作用日益增强，我们的研究基于临床图像评估。
口腔医学专家和牙科学生评估了六张良性、可能恶性或 SCC 病变的图像（共 18 张图像）。我们分析了检查者个人因素和病变的视觉病理特征对参与者评估的影响。
共有 133 名受试者参与了研究。一半的良性图像得到了正确评估。平均有 1.2（±SD1.3）张癌症图片被正确识别，3.66（±SD1.42）张被认为是可能恶性的。潜在恶性病变的平均正确评估图像数为 4.08（±SD1.48）。对于癌症和潜在恶性病变的图像，临床医生的评估结果最差，而四年级学生的结果最差。学生的结果与学习年限、在口腔医学诊所的周数以及对口腔病理学的兴趣显著相关。考虑病变不规则性可得出正确的诊断，而错误的答案则基于颜色变化。病变大小和边缘被认为同等重要。
将临床图像作为诊断过程的一部分可提供良好的结果，但可能需要增加毕业生和本科生的临床经验以提高准确性。因此，在当前的远程医疗时代，强调恶性的重要视觉参数可能具有价值。
