Analysis: Dermoscopy Raises Diagnostic Odds for Melanoma Accuracy

Key Takeaways

• Dermoscopy improves diagnostic accuracy, and experienced dermatologists achieved up to 13.3-fold higher odds of melanoma detection compared to PCPs.
• Sensitivity and specificity for keratinocytic carcinomas and melanoma were higher among experienced dermatologists versus other groups.

Experienced dermatologists achieve significantly higher diagnostic accuracy for skin cancer than primary care physicians (PCPs), particularly when using dermoscopy, according to a new meta-analysis of 100 studies.

The review, published in JAMA Dermatology, focused on diagnostic accuracy for keratinocytic carcinomas and melanomas based on physician specialty, experience, and examination method. Among experienced dermatologists, the sensitivity and specificity for diagnosing keratinocytic carcinomas using dermoscopy and dermoscopic images were 83.7% and 87.4%, respectively. By contrast, PCPs achieved sensitivity and specificity of 81.4% and 80.1%, respectively. Experienced dermatologists had 2.5-fold higher odds of accurate diagnosis using dermoscopy compared to standard clinical examination.

Experienced dermatologists using dermoscopy for melanoma detection had a sensitivity of 85.7% and a specificity of 81.3%, compared to 49.5% sensitivity and 91.3% specificity among PCPs. Experienced dermatologists were 13.3 times more likely to make an accurate melanoma diagnosis using dermoscopic images vs. PCPs.

"The findings of this systematic review and meta-analysis indicate that there are significant differences in diagnostic accuracy for skin cancer when comparing physician specialty and experience, and examination methods," the authors concluded. "These summary metrics of clinician diagnostic accuracy could be useful benchmarks for clinical trials, practitioner training, and the performance of emerging technologies."

Source: Chen J, et al. JAMA Dermatology. 2024. Doi:10.1001/jamadermatol.2024.4382