Harrison Kathryn
Dr. Harrison is with Forefront Dermatology in Englewood, Colorado, and is a Diplomat Fellow of the SDPA; she was with the Doctor of Medical Science Program, AT Still University in Mesa, Arizona at the time of writing.
J Clin Aesthet Dermatol. 2024 Sep-Oct;17(9-10 Suppl 1):S18-S27.
The goal is to determine if the implementation of dermoscopy improves the accuracy, specificity, and sensitivity rates of skin cancer detection among dermatology clinicians and identify the optimal training method for dermatology clinicians to become proficient in dermoscopy.
A comprehensive search through the A.T. Still Memorial Library, including the electronic health databases PubMed, Scopus, UpToDate, and CINAHL, was performed. Google Scholar search results were sorted by relevance, and the first 30 pages were included within the search due to the large quantity of results. The search keywords included "skin cancer diagnosis," "accuracy," "detection," "dermoscopy," and "dermatologists." The search was performed in July 2023. The date limitations used within the search parameters ranged from 2017 to 2023 to review the past seven years of publications. The search evaluated reference lists and encompassed those that met the inclusion and exclusion criteria. Dermatologists, dermatology physician assistants, dermatology nurse practitioners, and primary care practitioners were eligible for inclusion. The search included literature from any country. The English language was the only language permitted within the search. Gray literature was included in the search using news, press release, and MedRxiv.
A total of 28 articles met the inclusion criteria. All of the articles included were from peer-reviewed sources and in the English language. The articles came from 10 different countries of origin and were published from 2017 to 2023. The main results of the scoping review discovered that the use of dermoscopy improves the accuracy of skin cancer diagnosis. The results also demonstrated that dermoscopy training is highly variable; multiple different types of diagnostic algorithms are used in the professional medical education systems of the 10 countries included within the scoping review. The dermoscopy training algorithms recommended include pattern analysis, 7-point checklist, Menzies method, Triage Amalgamated Dermoscopy Algorithm, Australasian College of Dermatology Dermoscopy Course, 3-point checklist, ABCD rule, Skin Imaging College of China, and no particular algorithm. Of these, the three most commonly recommended included the 7-point checklist, Menzies method, and pattern analysis.
The results demonstrated that dermoscopy improves the accuracy of skin cancer diagnosis for dermatology clinicians and primary care providers. Key implications of these findings for practice include earlier skin cancer detection, which can lead to reduced rates of morbidity and mortality, reduced overall healthcare costs, reduced number of benign lesions biopsied, and improved patient outcomes.
确定皮肤镜检查的实施是否能提高皮肤科临床医生检测皮肤癌的准确性、特异性和敏感性，并确定皮肤科临床医生熟练掌握皮肤镜检查的最佳培训方法。
通过A.T. Still纪念图书馆进行全面检索，包括电子健康数据库PubMed、Scopus、UpToDate和CINAHL。谷歌学术搜索结果按相关性排序，由于结果数量众多，前30页被纳入检索范围。检索关键词包括“皮肤癌诊断”“准确性”“检测”“皮肤镜检查”和“皮肤科医生”。检索于2023年7月进行。检索参数中使用的日期限制为2017年至2023年，以回顾过去七年的出版物。检索评估了参考文献列表，并涵盖符合纳入和排除标准的文献。皮肤科医生、皮肤科医师助理、皮肤科执业护士和初级保健从业者均符合纳入条件。检索包括来自任何国家的文献。检索只允许使用英语。灰色文献通过新闻、新闻稿和MedRxiv纳入检索。
共有28篇文章符合纳入标准。所有纳入的文章均来自同行评审来源且为英文。这些文章来自10个不同的国家，发表时间为2017年至2023年。范围综述的主要结果发现，使用皮肤镜检查可提高皮肤癌诊断的准确性。结果还表明，皮肤镜检查培训差异很大；纳入范围综述的10个国家的专业医学教育系统中使用了多种不同类型的诊断算法。推荐的皮肤镜检查培训算法包括模式分析、7分检查表、门齐斯方法、综合分诊皮肤镜算法、澳大利亚皮肤科医学院皮肤镜课程、3分检查表、ABCD规则、中国皮肤影像学院，以及无特定算法。其中，最常推荐的三种算法包括7分检查表、门齐斯方法和模式分析。
结果表明，皮肤镜检查提高了皮肤科临床医生和初级保健提供者诊断皮肤癌的准确性。这些发现对实践的关键影响包括更早地检测皮肤癌，这可导致发病率和死亡率降低、总体医疗成本降低、良性病变活检数量减少以及患者预后改善。
