accuracy of siascopy for pigmented skin lesions encountered in primary care development and validation of a new diagnostic algorithmsiascopy精度对色素的皮肤病变在初级护理遇到一种新的诊断算法的开发和验证.pdfVIP

Emery et al. BMC Dermatology 2010, 10:9 /1471-5945/10/9 RESEARCH ARTICLE Open Access Accuracy of SIAscopy for pigmented skin lesions encountered in primary care: development and validation of a new diagnostic algorithm 1,5* 2,3 2 1 4 5,1 Jon D Emery , Judith Hunter , Per N Hall , Anthony J Watson , Marc Moncrieff , Fiona M Walter Abstract Background: Diagnosing pigmented skin lesions in general practice is challenging. SIAscopy has been shown to increase diagnostic accuracy for melanoma in referred populations. We aimed to develop and validate a scoring system for SIAscopic diagnosis of pigmented lesions in primary care. Methods: This study was conducted in two consecutive settings in the UK and Australia, and occurred in three stages: 1) Development of the primary care scoring algorithm (PCSA) on a sub-set of lesions from the UK sample; 2) Validation of the PCSA on a different sub-set of lesions from the same UK sample; 3) Validation of the PCSA on a new set of lesions from an Australian primary care population. Patients presenting with a pigmented lesion were recruited from 6 general practices in the UK and 2 primary care skin cancer clinics in Australia. The following data were obtained for each lesion: clinical history; SIAscan; digital photograph; and digital dermoscopy. SIAscans were interpreted by an expert and validated against histopathology where possible, or expert clinical review of all available data for each lesion. Results: A total of 858 patients with 1,211 lesions were recruited. Most lesions were benign naevi (64.8%) or seborrhoeic keratoses (22.1%); 1.2% were melanoma. The original SIAscopic diagnostic algorithm did not perform well because of the higher prevalence of seborrhoe