Impact of Dermoscopy Training on Diagnostic Accuracy, and Its Association With Biopsy and Referral Patterns Among Primary Care Providers: A Retrospective and Prospective Educational Intervention Study.

Autor:	Middleton HT; M Health Fairview, St. Paul, MN, USA.; Mayo Clinic Rochester, Rochester, MN, USA., Swanson DL; Mayo Clinic Arizona, Scottsdale, AZ, USA., Sartori-Valinotti JC; Mayo Clinic Rochester, Rochester, MN, USA., O'Laughlin DJ; Mayo Clinic Rochester, Rochester, MN, USA., Young PA; Stanford University, Redwood City, CA, USA., Merry SP; Mayo Clinic Rochester, Rochester, MN, USA., Nelson K; Anderson Cancer Center, The University of Texas, Houston, TX, USA., Fischer K; Department of Quantitative Health Sciences, Mayo Clinic Rochester, Rochester, MN, USA., Weatherly RM; Mayo Clinic Rochester, Rochester, MN, USA., Boswell CL; Mayo Clinic Rochester, Rochester, MN, USA.
Jazyk:	angličtina
Zdroj:	Journal of primary care & community health [J Prim Care Community Health] 2024 Jan-Dec; Vol. 15, pp. 21501319241296625.
DOI:	10.1177/21501319241296625
Abstrakt:	Background: 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). Objective: To assess the success of concise dermoscopy training among primary care providers. Design: 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. Results: 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. Conclusion: 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. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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