Dermoscopy compared with naked eye examination for the diagnosis of primary melanoma: a meta-analysis of studies performed in a clinical setting

Summary Background  Dermoscopy is a noninvasive technique that enables the clinician to perform direct microscopic examination of diagnostic features, not seen by the naked eye, in pigmented skin lesions. Diagnostic accuracy of dermoscopy has previously been assessed in meta‐analyses including studi...

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Veröffentlicht in:British journal of dermatology (1951) 2008-09, Vol.159 (3), p.669-676
Hauptverfasser: Vestergaard, M.E., Macaskill, P., Holt, P.E., Menzies, S.W.
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container_issue 3
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container_title British journal of dermatology (1951)
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creator Vestergaard, M.E.
Macaskill, P.
Holt, P.E.
Menzies, S.W.
description Summary Background  Dermoscopy is a noninvasive technique that enables the clinician to perform direct microscopic examination of diagnostic features, not seen by the naked eye, in pigmented skin lesions. Diagnostic accuracy of dermoscopy has previously been assessed in meta‐analyses including studies performed in experimental and clinical settings. Objectives  To assess the diagnostic accuracy of dermoscopy for the diagnosis of melanoma compared with naked eye examination by performing a meta‐analysis exclusively on studies performed in a clinical setting. Methods  We searched for publications from 1987 to January 2008 and found nine eligible studies. The selected studies compare diagnostic accuracy of dermoscopy with naked eye examination using a valid reference test on consecutive patients with a defined clinical presentation, performed in a clinical setting. Hierarchical summary receiver operator curve analysis was used to estimate the relative diagnostic accuracy for clinical examination with, and without, the use of dermoscopy. Results  We found the relative diagnostic odds ratio for melanoma, for dermoscopy compared with naked eye examination, to be 15·6 [95% confidence interval (CI) 2·9–83·7, P = 0·016]; removal of two outlier studies changed this to 9·0 (95% CI 1·5–54·6, P = 0·03). Conclusions  Dermoscopy is more accurate than naked eye examination for the diagnosis of cutaneous melanoma in suspicious skin lesions when performed in the clinical setting.
doi_str_mv 10.1111/j.1365-2133.2008.08713.x
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Diagnostic accuracy of dermoscopy has previously been assessed in meta‐analyses including studies performed in experimental and clinical settings. Objectives  To assess the diagnostic accuracy of dermoscopy for the diagnosis of melanoma compared with naked eye examination by performing a meta‐analysis exclusively on studies performed in a clinical setting. Methods  We searched for publications from 1987 to January 2008 and found nine eligible studies. The selected studies compare diagnostic accuracy of dermoscopy with naked eye examination using a valid reference test on consecutive patients with a defined clinical presentation, performed in a clinical setting. Hierarchical summary receiver operator curve analysis was used to estimate the relative diagnostic accuracy for clinical examination with, and without, the use of dermoscopy. Results  We found the relative diagnostic odds ratio for melanoma, for dermoscopy compared with naked eye examination, to be 15·6 [95% confidence interval (CI) 2·9–83·7, P = 0·016]; removal of two outlier studies changed this to 9·0 (95% CI 1·5–54·6, P = 0·03). Conclusions  Dermoscopy is more accurate than naked eye examination for the diagnosis of cutaneous melanoma in suspicious skin lesions when performed in the clinical setting.</description><identifier>ISSN: 0007-0963</identifier><identifier>EISSN: 1365-2133</identifier><identifier>DOI: 10.1111/j.1365-2133.2008.08713.x</identifier><identifier>PMID: 18616769</identifier><identifier>CODEN: BJDEAZ</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Biological and medical sciences ; Clinical Trials as Topic ; Dermatology ; dermatoscopy ; dermoscopy ; Dermoscopy - methods ; Dermoscopy - standards ; diagnosis ; Humans ; Medical sciences ; melanoma ; Melanoma - diagnosis ; meta-analysis ; Nevus, Pigmented - diagnosis ; Physical Examination ; Pigmentary diseases of the skin ; pigmented skin lesions ; ROC Curve ; Sensitivity and Specificity ; Skin Neoplasms - diagnosis ; Tumors of the skin and soft tissue. 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Diagnostic accuracy of dermoscopy has previously been assessed in meta‐analyses including studies performed in experimental and clinical settings. Objectives  To assess the diagnostic accuracy of dermoscopy for the diagnosis of melanoma compared with naked eye examination by performing a meta‐analysis exclusively on studies performed in a clinical setting. Methods  We searched for publications from 1987 to January 2008 and found nine eligible studies. The selected studies compare diagnostic accuracy of dermoscopy with naked eye examination using a valid reference test on consecutive patients with a defined clinical presentation, performed in a clinical setting. Hierarchical summary receiver operator curve analysis was used to estimate the relative diagnostic accuracy for clinical examination with, and without, the use of dermoscopy. Results  We found the relative diagnostic odds ratio for melanoma, for dermoscopy compared with naked eye examination, to be 15·6 [95% confidence interval (CI) 2·9–83·7, P = 0·016]; removal of two outlier studies changed this to 9·0 (95% CI 1·5–54·6, P = 0·03). Conclusions  Dermoscopy is more accurate than naked eye examination for the diagnosis of cutaneous melanoma in suspicious skin lesions when performed in the clinical setting.</description><subject>Biological and medical sciences</subject><subject>Clinical Trials as Topic</subject><subject>Dermatology</subject><subject>dermatoscopy</subject><subject>dermoscopy</subject><subject>Dermoscopy - methods</subject><subject>Dermoscopy - standards</subject><subject>diagnosis</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>melanoma</subject><subject>Melanoma - diagnosis</subject><subject>meta-analysis</subject><subject>Nevus, Pigmented - diagnosis</subject><subject>Physical Examination</subject><subject>Pigmentary diseases of the skin</subject><subject>pigmented skin lesions</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><subject>Skin Neoplasms - diagnosis</subject><subject>Tumors of the skin and soft tissue. 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Premalignant lesions</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vestergaard, M.E.</creatorcontrib><creatorcontrib>Macaskill, P.</creatorcontrib><creatorcontrib>Holt, P.E.</creatorcontrib><creatorcontrib>Menzies, S.W.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of dermatology (1951)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vestergaard, M.E.</au><au>Macaskill, P.</au><au>Holt, P.E.</au><au>Menzies, S.W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dermoscopy compared with naked eye examination for the diagnosis of primary melanoma: a meta-analysis of studies performed in a clinical setting</atitle><jtitle>British journal of dermatology (1951)</jtitle><addtitle>Br J Dermatol</addtitle><date>2008-09</date><risdate>2008</risdate><volume>159</volume><issue>3</issue><spage>669</spage><epage>676</epage><pages>669-676</pages><issn>0007-0963</issn><eissn>1365-2133</eissn><coden>BJDEAZ</coden><abstract>Summary Background  Dermoscopy is a noninvasive technique that enables the clinician to perform direct microscopic examination of diagnostic features, not seen by the naked eye, in pigmented skin lesions. Diagnostic accuracy of dermoscopy has previously been assessed in meta‐analyses including studies performed in experimental and clinical settings. Objectives  To assess the diagnostic accuracy of dermoscopy for the diagnosis of melanoma compared with naked eye examination by performing a meta‐analysis exclusively on studies performed in a clinical setting. Methods  We searched for publications from 1987 to January 2008 and found nine eligible studies. The selected studies compare diagnostic accuracy of dermoscopy with naked eye examination using a valid reference test on consecutive patients with a defined clinical presentation, performed in a clinical setting. Hierarchical summary receiver operator curve analysis was used to estimate the relative diagnostic accuracy for clinical examination with, and without, the use of dermoscopy. 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source MEDLINE; Access via Wiley Online Library; Oxford University Press Journals All Titles (1996-Current)
subjects Biological and medical sciences
Clinical Trials as Topic
Dermatology
dermatoscopy
dermoscopy
Dermoscopy - methods
Dermoscopy - standards
diagnosis
Humans
Medical sciences
melanoma
Melanoma - diagnosis
meta-analysis
Nevus, Pigmented - diagnosis
Physical Examination
Pigmentary diseases of the skin
pigmented skin lesions
ROC Curve
Sensitivity and Specificity
Skin Neoplasms - diagnosis
Tumors of the skin and soft tissue. Premalignant lesions
title Dermoscopy compared with naked eye examination for the diagnosis of primary melanoma: a meta-analysis of studies performed in a clinical setting
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