Reisch Lisa M, Shucard Hannah, Radick Andrea C, Eguchi Megan M, Elder David E, Barnhill Raymond L, Piepkorn Michael W, Knezevich Stevan R, Kerr Kathleen F, Elmore Joann G
Department of Biostatistics, University of Washington, Seattle, Washington.
Department of Medicine, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California.
JAAD Int. 2023 Mar 12;11:211-219. doi: 10.1016/j.jdin.2023.01.025. eCollection 2023 Jun.
A standardized pathology management tool for melanocytic skin lesions may improve patient care by simplifying interpretation and categorization of the diverse terminology currently extant.
To assess an online educational intervention that teaches dermatopathologists to use the Melanocytic Pathology Assessment Tool and Hierarchy for Diagnosis (MPATH-Dx), a schema collapsing multiple diagnostic terms into 5 classes ranging from benign to invasive melanoma.
Practicing dermatopathologists ( 149) from 40 US states participated in a 2-year educational intervention study (71% response rate). The intervention involved a brief tutorial followed by practice on 28 melanocytic lesions, with the goal of teaching pathologists how to correctly use the MPATH-Dx schema; competence using the MPATH-Dx tool 12-24 months postintervention was assessed. Participants' self-reported confidence using the MPATH-Dx tool was assessed preintervention and postintervention.
At preintervention, confidence using the MPATH-Dx tool was already high, despite 68% lacking prior familiarity with it, and confidence increased postintervention ( .0003). During the intervention, participants used the MPATH-Dx tool correctly for 90% of their interpretations; postintervention, participants used the MPATH-Dx tool correctly for 88% of their interpretations.
Future research should examine implementing a standardized pathology assessment schema in actual clinical practice.
Dermatopathologists can be taught to confidently and competently use the MPATH-Dx schema with a simple educational tutorial followed by practice.
用于黑素细胞性皮肤病变的标准化病理管理工具可能通过简化当前现存的各种术语的解释和分类来改善患者护理。
评估一项在线教育干预措施，该措施教导皮肤病理学家使用黑素细胞病理评估工具和诊断分级系统（MPATH-Dx），这是一种将多个诊断术语合并为从良性到侵袭性黑素瘤的5个类别的模式。
来自美国40个州的149名执业皮肤病理学家参与了一项为期2年的教育干预研究（应答率为71%）。干预包括一个简短的教程，然后是对28个黑素细胞性病变的实践，目的是教导病理学家如何正确使用MPATH-Dx模式；在干预后12至24个月评估使用MPATH-Dx工具的能力。在干预前和干预后评估参与者自我报告的使用MPATH-Dx工具的信心。
在干预前，尽管68%的人之前不熟悉MPATH-Dx工具，但使用该工具的信心已经很高，并且在干预后信心有所增加（P<0.0003）。在干预期间，参与者在90%的解读中正确使用了MPATH-Dx工具；干预后，参与者在88%的解读中正确使用了MPATH-Dx工具。
未来的研究应检查在实际临床实践中实施标准化病理评估模式的情况。
通过简单的教育教程及随后的实践，可以教导皮肤病理学家自信且熟练地使用MPATH-Dx模式。
