The effect of a dermoscopy training programme on diagnostic accuracy and management decisions regarding pigmented skin lesions: a comparison between dermal therapists and general practitioners

Clinical and Experimental Dermatology, vol. 49, pp. 591–598

Abstract

BACKGROUND: Dermoscopy is known to increase the diagnostic accuracy of pigmented skin lesions (PSLs) when used by trained professionals. The effect of dermoscopy training on the diagnostic ability of dermal therapists (DTs) has not been studied so far. OBJECTIVES: This study aimed to investigate whether DTs, in comparison with general practitioners (GPs), benefited from a training programme including dermoscopy, in both their ability to differentiate between different forms of PSL and to assign the correct therapeutic strategy. METHODS: In total, 24 DTs and 96 GPs attended a training programme on PSLs. Diagnostic skills as well as therapeutic strategy were assessed, prior to the training (pretest) and after the training (post-test) using clinical images alone, as well as after the addition of dermatoscopic images (integrated post-test). Bayesian hypothesis testing was used to determine statistical significance of differences between pretest, post-test and integrated post-test scores. RESULTS: Both the DTs and the GPs demonstrated benefit from the training: at the integrated post-test, the median proportion of correctly diagnosed PSLs was 73% (range 30-90) for GPs and 63% (range 27-80) for DTs. A statistically significant difference between pretest results and integrated test results was seen, with a Bayes factor > 100. At 12 percentage points higher, the GPs outperformed DTs in the accuracy of detecting PSLs. CONCLUSIONS: The study shows that a training programme focusing on PSLs while including dermoscopy positively impacts detection of PSLs by DTs and GPs. This training programme could form an integral part of the training of DTs in screening procedures, although additional research is needed.

Authors 5

1. Amber H J Barten corresponding

   The Hague University of Applied Sciences

   Affiliation as printed

   Oncological Care Research Group

   Research group Oncological Care, The Hague University of Applied Sciences, Johanna Westerdijkplein 75, The Hague, The Netherlands

2. Cornelis P Beyers

   Avans University of Applied Sciences · The Hague University of Applied Sciences

   Affiliation as printed

   Data Science Research Group, The Hague University of Applied Sciences , The Hague , the Netherlands

   The Centre of Expertise Wellbeing Economy and New Entrepreneurship, Avans University of Applied Sciences , Breda , the Netherlands

   Research group Data Science, The Hague University of Applied Sciences, Johanna Westerdijkplein 75, The Hague, The Netherlands

3. Mark F. R. Vondenhoff

   The Hague University of Applied Sciences

   Affiliation as printed

   Data Science Research Group, The Hague University of Applied Sciences , The Hague , the Netherlands

   Oncological Care Research Group

   Research group Oncological Care, The Hague University of Applied Sciences, Johanna Westerdijkplein 75, The Hague, The Netherlands

4. Lampros K. Stergioulas

   The Hague University of Applied Sciences

   Affiliation as printed

   Data Science Research Group, The Hague University of Applied Sciences , The Hague , the Netherlands

   Research group Data Science, The Hague University of Applied Sciences, Johanna Westerdijkplein 75, The Hague, The Netherlands

5. Nicole A. Kukutsch Aachen Department of Dermatology, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Department of Dermatology, Leiden University Medical Center , Leiden , the Netherlands

   Department of Dermatology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands