Practitioner characteristics, diagnostic accuracy metrics and discovering-individual with respect to 637 melanomas documented by 27 general practitioners on the Skin Cancer Audit Research Database.

Autor: Coetzer-Botha M; General Practice Clinical Unit, Medical School, The University of Queensland, St Lucia, Queensland, Australia., Jimenez Balcells C; 4D Skin Cancer Clinic, Belmont North, New South Wales, Australia.; Universitat de Autonoma de Barcelona (UAB), Catalunya, Spain., Hay J; Upper Hutt Skin Clinic, Upper Hutt, Wellington, New Zealand., Keir J; General Practice Clinical Unit, Medical School, The University of Queensland, St Lucia, Queensland, Australia., Rosendahl N; Faculty of Medicine, The University of Queensland, St Lucia, Queensland, Australia., Wilson T; SCARD, Eight Mile Plains, Queensland, Australia., Clark S; Faculty of Medicine, The University of Queensland, St Lucia, Queensland, Australia.; Tehran University of Medical Sciences, Tehran, Iran., Baade A; Gladstone GP Superclinic, Gladstone, Queensland, Australia., Becker C; Wairarapa Skin Clinic, Masterton, New Zealand.; Wairarapa Hospital, Lansdowne, Masterton, New Zealand., Bookallil L; The University of New England, Armidale, New South Wales, Australia., Clifopoulos C; General Practice Clinical Unit, Medical School, The University of Queensland, St Lucia, Queensland, Australia., Dicker T; General Practice Clinical Unit, Medical School, The University of Queensland, St Lucia, Queensland, Australia., Denby MP; Silverdale Medical, Silverdale, Auckland, New Zealand., Duthie D; Darwin Skin Cancer Clinic, Parap, Northern Territory, Australia., Elliott C; Solarderm Skin Cancer Practice, Caboolture, Queensland, Australia., Fishburn P; General Practice Clinical Unit, Medical School, The University of Queensland, St Lucia, Queensland, Australia., Foley M; The Skin Clinic, Marlborough, Blenheim, New Zealand., Franck M; MoleSafe Skin Cancer Clinic, Windsor, Victoria, Australia., Giam I; Skin2 Clinic, Deakin, Australian Capital Territory, Australia., Gordillo P; Cairns Skin Cancer Clinic, Cairns, Queensland, Australia., Lilleyman A; Newcastle Skin Check, Charlestown, New South Wales, Australia., Macauley R; Bateau Bay Medical Centre, Bateau Bay, New South Wales, Australia., Maher J; Skin Cancer Ballarat, Alfredton, Victoria, Australia., McPhee E; Emerald Medical Group, Emerald, Queensland, Australia., Reid M; Nelson Bay Skin Cancer Clinic, Nelson Bay, New South Wales, Australia., Shirlaw B; Lakeside Medical, Springfield Lakes, Queensland, Australia., Siggs G; Regency Medical Clinic, Sefton Park, South Australia, Australia., Spark R; Toukley Family Practice, Toukley, New South Wales, Australia., Stretch J; Bond University, Robina, Queensland, Australia., van Den Heever K; CQ Skin Cancer Clinic, Bucasia, Queensland, Australia., van Rensburg T; Kippax Ochre Medical Centre, Holt, Australian Capital Territory, Australia., Watson C; Brisbane City Doctors, Brisbane, Queensland, Australia., Kittler H; Vienna Dermatologic Imaging Research Group, Department of Dermatology, Medical University of Vienna, Vienna, Austria., Rosendahl C; General Practice Clinical Unit, Medical School, The University of Queensland, St Lucia, Queensland, Australia.; Tehran University of Medical Sciences, Tehran, Iran.
Jazyk: angličtina
Zdroj: The Australasian journal of dermatology [Australas J Dermatol] 2023 Aug; Vol. 64 (3), pp. 378-388. Date of Electronic Publication: 2023 Apr 24.
DOI: 10.1111/ajd.14061
Abstrakt: Background and Objective: Knowledge of accuracy for melanoma diagnosis and melanoma discovering-individual in primary care is limited. We describe general practitioner (GP) characteristics and analyse defined diagnostic accuracy metrics for GPs in the current study comparing this with a previous study for GPs common to both, and we analyse the individual first discovering each melanoma as a lesion of concern.
Methods: The characteristics and diagnostic accuracy of 27 Australasian GPs documenting 637 melanomas on the Skin Cancer Audit Research Database (SCARD) in 2013 were described and analysed. The number needed to treat (NNT) and percentage of melanomas that were in situ (percentage in situ) were analysed as surrogates for specificity and sensitivity, respectively. The discovering-individual was analysed according to patient age and sex and lesion Breslow thickness.
Results: The average NNT and percentage in situ were 5.73% and 65.07%, respectively. For 21 GPs in both a 2008-2010 study and the current study, the NNT was 10.78 and 5.56, respectively (p = 0.0037). A consistent trend of decreasing NNT and increasing percentage in situ through increasingly subspecialised GP categories did not reach statistical significance. NNT trended high at ages and sites for which melanoma was rare. While the patient or family member was more likely to discover thick melanomas and melanomas in patients under 40 years, GPs discovered 73.9% of the melanomas as lesions of concern.
Conclusions: GPs were the discovering-individuals for the majority of melanomas in the current study and their accuracy metrics compared favourably with published figures for dermatologists and GPs.
(© 2023 The Authors. Australasian Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Australasian College of Dermatologists.)
Databáze: MEDLINE
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