M Health Fairview, St. Paul, MN, USA.
Mayo Clinic Rochester, Rochester, MN, USA.
J Prim Care Community Health. 2024 Jan-Dec;15:21501319241296625. doi: 10.1177/21501319241296625.
Proper diagnosis in primary care is crucial due to the large number of skin cancer diagnoses each year and its associated growing economic burden. Understanding how primary care providers can be best trained in dermoscopy is instrumental in helping primary care providers differentiate benign and malignant cutaneous lesions so that appropriate action can be taken (eg, biopsy/referral to dermatology or reassurance).
To assess the success of concise dermoscopy training among primary care providers.
A cohort study was conducted in primary care at Mayo Clinic, Rochester, including primary care physicians, nurse practitioners, and physician assistants in internal medicine and family medicine. Diagnostic accuracy was measured on standardized testing through image-based recognition and in clinical practice through observation of referral and biopsy patterns both before and after dermoscopy education, focused on the TADA plus method.
Forty-three primary care providers completed the image-based recognition tests, with significant improvement in mean score measured after dermoscopy training workshop (20%). Among the thirteen primary care providers who continued to use dermoscopy in clinical practice, a significant improvement (31%) in mean clinical diagnostic accuracy was observed comparing 1 year of practice data before versus after dermoscopy training.
Improvement in diagnostic accuracy with utilization of the TADA plus method translates into clinical practice. Therefore, training primary care providers in dermoscopy may improve the dermatologic care patients receive in primary care, especially in rural or medically underserved areas where access to dermatology is limited.
由于每年诊断出的皮肤癌数量众多，且相关的经济负担不断增加，因此初级保健中的正确诊断至关重要。了解初级保健提供者如何接受最佳的皮肤镜检查培训，有助于初级保健提供者区分良性和恶性皮肤病变，以便采取适当的行动（例如，活检/转诊至皮肤科或给予安心）。
评估对初级保健提供者进行简明皮肤镜检查培训的效果。
在梅奥诊所罗切斯特院区的初级保健中进行了一项队列研究，包括内科和家庭医学的初级保健医生、护士从业者和医师助理。通过基于图像的识别和临床实践中的转诊和活检模式观察，在皮肤镜检查教育前后，评估标准化测试中的诊断准确性，重点关注 TADA plus 方法。
43 名初级保健提供者完成了基于图像的识别测试，在皮肤镜检查培训研讨会后，平均得分显著提高（20%）。在继续在临床实践中使用皮肤镜检查的 13 名初级保健提供者中，与皮肤镜检查培训前 1 年的实践数据相比，观察到平均临床诊断准确性显著提高（31%）。
利用 TADA plus 方法提高诊断准确性可转化为临床实践。因此，对初级保健提供者进行皮肤镜检查培训可能会改善患者在初级保健中接受的皮肤科护理，尤其是在获得皮肤科治疗机会有限的农村或医疗资源不足地区。
