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非专业人员对黑色素瘤的检测:一种未被开发的分流潜力?

Melanoma Detection by Non-Specialists: An Untapped Potential for Triage?

作者信息

Cantisani Carmen, Ambrosio Luca, Cucchi Carlotta, Meznerics Fanni Adél, Kiss Norbert, Bánvölgyi András, Rega Federica, Grignaffini Flavia, Barbuto Francesco, Frezza Fabrizio, Pellacani Giovanni

机构信息

Dermatology Clinic, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza Medical School, Sapienza University of Rome, 00185 Rome, Italy.

Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary.

出版信息

Diagnostics (Basel). 2022 Nov 16;12(11):2821. doi: 10.3390/diagnostics12112821.

Abstract

INTRODUCTION

The incidence of melanoma increased considerably in recent decades, representing a significant public health problem. We aimed to evaluate the ability of non-specialists for the preliminary screening of skin lesions to identify melanoma-suspect lesions.

MATERIALS AND METHODS

A medical student and a dermatologist specialist examined the total body scans of 50 patients.

RESULTS

The agreement between the expert and the non-specialist was 87.75% (κ = 0.65) regarding the assessment of clinical significance. The four parameters of the ABCD rule were evaluated on the 129 lesions rated as clinically significant by both observers. Asymmetry was evaluated similarly in 79.9% (κ = 0.59), irregular borders in 74.4% (κ = 0.50), color in 81.4% (κ = 0.57), and diameter in 89.9% (κ = 0.77) of the cases. The concordance of the two groups was 96.9% (κ = 0.83) in the case of the detection of the Ugly Duckling Sign.

CONCLUSIONS

Although the involvement of GPs is part of routine care worldwide, emphasizing the importance of educating medical students and general practitioners is crucial, as many European countries lack structured melanoma screening training programs targeting non-dermatologists.

摘要

引言

近几十年来,黑色素瘤的发病率显著上升,这是一个重大的公共卫生问题。我们旨在评估非专科医生对皮肤病变进行初步筛查以识别可疑黑色素瘤病变的能力。

材料与方法

一名医学生和一名皮肤科专家对50名患者进行了全身扫描。

结果

在临床意义评估方面,专家与非专科医生的一致性为87.75%(κ = 0.65)。对两位观察者均评定为具有临床意义的129处病变评估了ABCD法则的四个参数。在79.9%(κ = 0.59)的病例中对不对称性进行了类似评估,在74.4%(κ = 0.50)的病例中对边界不规则性进行了评估,在81.4%(κ = 0.57)的病例中对颜色进行了评估,在89.9%(κ = 0.77)的病例中对直径进行了评估。在检测丑小鸭征方面,两组的一致性为96.9%(κ = 0.83)。

结论

尽管全科医生的参与是全球常规医疗的一部分,但强调对医学生和全科医生进行教育的重要性至关重要,因为许多欧洲国家缺乏针对非皮肤科医生的结构化黑色素瘤筛查培训项目。

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