Three-point checklist of dermoscopy: A new screening method for early detection of melanoma

Soyer, H. Peter, Argenziano, Giuseppe, Zalaudek, Iris, Corona, Rosamaria, Sera, Francesco, Talamini, Renato, Barbato, Filomena, Baroni, Adone, Cicale, Lorenza, Di Stefani, Alessandro, Farro, Pietro, Rossiello, Luigi, Ruocco, Eleonora and Chimenti, Sergio (2004) Three-point checklist of dermoscopy: A new screening method for early detection of melanoma. Dermatology, 208 1: 27-31. doi:10.1159/000075042


Author Soyer, H. Peter
Argenziano, Giuseppe
Zalaudek, Iris
Corona, Rosamaria
Sera, Francesco
Talamini, Renato
Barbato, Filomena
Baroni, Adone
Cicale, Lorenza
Di Stefani, Alessandro
Farro, Pietro
Rossiello, Luigi
Ruocco, Eleonora
Chimenti, Sergio
Title Three-point checklist of dermoscopy: A new screening method for early detection of melanoma
Journal name Dermatology   Check publisher's open access policy
ISSN 1018-8665
1421-9832
Publication date 2004-01-01
Year available 2004
Sub-type Article (original research)
DOI 10.1159/000075042
Open Access Status DOI
Volume 208
Issue 1
Start page 27
End page 31
Total pages 5
Place of publication Basel, Switzerland
Publisher S. Karger AG
Language eng
Subject 110304 Dermatology
1103 Clinical Sciences
Abstract Background: Dermoscopy used by experts has been demonstrated to improve the diagnostic accuracy for melanoma. However, little is known about the diagnostic validity of dermoscopy when used by nonexperts. Objective: To evaluate the diagnostic performance of nonexperts using a new 3-point checklist based on a simplified dermoscopic pattern analysis. Methods: Clinical and dermoscopic images of 231 clinically equivocal and histopathologically proven pigmented skin lesions were examined by 6 nonexperts and 1 expert in dermoscopy. For each lesion the nonexperts assessed 3 dermoscopic criteria (asymmetry, atypical network and blue-white structures) constituting the 3-point method. In addition, all examiners made an overall diagnosis by using standard pattern analysis of dermoscopy. Results: Asymmetry, atypical network and blue-white structures were shown to be reproducible dermoscopic criteria, with a kappa value ranging from 0.52 to 0.55. When making the overall diagnosis, the expert had 89.6% sensitivity for malignant lesions (tested on 68 melanomas and 9 pigmented basal cell carcinomas), compared to 69.7% sensitivity achieved by the nonexperts. Remarkably, the sensitivity of the nonexperts using the 3-point checklist reached 96.3%. The specificity of the expert using overall diagnosis was 94.2% compared to 82.8 and 32.8% achieved by the nonexperts using overall diagnosis and 3-point checklist, respectively. Conclusion: The 3-point checklist is a valid and reproducible dermoscopic algorithm with high sensitivity for the diagnosis of melanoma in the hands of non-experts. Thus it may be applied as a screening procedure for the early detection of melanoma. Copyright (C) 2004 S. Karger AG, Basel.
Formatted abstract
Background: Dermoscopy used by experts has been demonstrated to improve the diagnostic accuracy for melanoma. However, little is known about the diagnostic validity of dermoscopy when used by nonexperts.
Objective: To evaluate the diagnostic performance of nonexperts using a new 3-point checklist based on a simplified dermoscopic pattern analysis.
Methods: Clinical and dermoscopic images of 231 clinically equivocal and histopathologically proven pigmented skin lesions were examined by 6 nonexperts and 1 expert in dermoscopy. For each lesion the nonexperts assessed 3 dermoscopic criteria (asymmetry, atypical network and blue-white structures) constituting the 3-point method. In addition, all examiners made an overall diagnosis by using standard pattern analysis of dermoscopy.
Results: Asymmetry, atypical network and blue-white structures were shown to be reproducible dermoscopic criteria, with a kappa value ranging from 0.52 to 0.55. When making the overall diagnosis, the expert had 89.6% sensitivity for malignant lesions (tested on 68 melanomas and 9 pigmented basal cell carcinomas), compared to 69.7% sensitivity achieved by the nonexperts. Remarkably, the sensitivity of the nonexperts using the 3-point checklist reached 96.3%. The specificity of the expert using overall diagnosis was 94.2% compared to 82.8 and 32.8% achieved by the nonexperts using overall diagnosis and 3-point checklist, respectively.
Conclusion: The 3-point checklist is a valid and reproducible dermoscopic algorithm with high sensitivity for the diagnosis of melanoma in the hands of non-experts. Thus it may be applied as a screening procedure for the early detection of melanoma.
Keyword Dermoscopy
Melanoma
Pigmented skin lesions
Q-Index Code C1
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Thu, 19 Mar 2009, 18:47:51 EST by Ms Karen Naughton on behalf of School of Medicine