A dermoscopy training program for Victorian GPs to improve skin cancer prevention and detection

Jones, Shannon; Walker, Heather; Maitland, Clover

doi:10.17061/phrp3212207

Cited by 3 publications

(6 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several ST courses in dermoscopy have already shown to improve diagnostic accuracy for skin tumours in inexperienced users. 36,[38][39][40][41][42] However, the present study is the first to compare the skills acquired after a short dermoscopy training program and after a long training program. Hence, ST was shown to provide acceptable short-and medium-term competence in skin tumour triage with significant benefits.…”

Section: Discussionmentioning

confidence: 88%

Evaluation of primary care physicians' competence in selective skin tumour triage after short versus long dermoscopy training: a randomized non‐inferiority trial

Harkemanne

Legrand²,

Sawadogo

et al. 2023

Acad Dermatol Venereol

View full text Add to dashboard Cite

Background Although primary care physicians (PCPs) play a key role in skin cancer screening, their skills in detecting malignant tumours is suboptimal. Objectives To determine whether a short dermoscopy e‐learning course (4 h) in skin tumour diagnosis for PCPs is non‐inferior to a long course (12 h) in selective triage of skin lesions. Secondly, to evaluate whether regular refresher training sessions are necessary to maintain the PCPs' skills in the medium term. Methods A randomized 2 × 2 factorial non‐inferiority trial was conducted online over an 8‐month period among 233 PCPs including 126 certified general practitioners, 94 PCPs in training, and 13 occupational physicians, all without prior advanced dermoscopy training. Participants were randomized 1:1:1:1 to receive short training and mandatory refreshers (n = 58), short training and optional refreshers (n = 59), long training and mandatory refreshers (n = 58), or long training and optional refreshers (n = 58). PCPs' skills were evaluated before training (T0), immediately after training (T1) to test the non‐inferiority, and after 5 months (T2) to evaluate the impact of the refreshers. The primary endpoint was the difference in the change of score after short and long training. The non‐inferiority margin was set at −28%. Results Among the 233 randomized participants, 216 (93%) completed T1 and 197 (84.5%) completed T2. For short versus long training, the primary endpoint was 1.392 (95% CI: 0.138; 2.645) in the per‐protocol population (p < 0.001) and 1.016 (95% CI: −0.224; 2.256) in the modified intention‐to‐treat population (p < 0.001). After training, the type of refresher showed no impact on the score (p = 0.840). However, PCPs who completed all refreshers showed the best mean overall score at T2 (p < 0.001). Conclusions These findings confirm that short dermoscopy e‐learning is non‐inferior in training PCPs to triage skin lesions compared to long training. After training, regular refreshers are important to maintain the PCPs' acquired skills over time.

show abstract

Section: Discussionmentioning

confidence: 88%

Evaluation of primary care physicians' competence in selective skin tumour triage after short versus long dermoscopy training: a randomized non‐inferiority trial

Harkemanne

Legrand²,

Sawadogo

et al. 2023

Acad Dermatol Venereol

View full text Add to dashboard Cite

show abstract

“…16 When discussing education, there is clear evidence in the literature that demonstrates the role of dermoscopy training in increasing the diagnostic accuracy of GPs in both the short and long terms. [17][18][19] Considering that dermoscopy and detection of melanoma recurrences were the two skill sets that respondents reported lower levels of confidence with (Table 1, Q11 and Q12), this defines an area for future GP education and upskilling. It is noted in the literature that dermoscopy use and training during registrar years were inconsistent and this could explain why the fellowship status of study respondents lacked statistically significant differences.…”

Section: Discussionmentioning

confidence: 99%

“…These include education supported by peak training and governing bodies as well as the development and implementation of rapid access referral pathways for patients who develop lesions of concern. 17,20,25,36 These efforts will not only continue to have a positive impact on the implementation of shared care models but also directly improve patient access to dermatologists for non-skin cancer-related presentations across South Australia.…”

Section: Discussionmentioning

confidence: 99%

“…When discussing education, there is clear evidence in the literature that demonstrates the role of dermoscopy training in increasing the diagnostic accuracy of GPs in both the short and long terms 17–19 . Considering that dermoscopy and detection of melanoma recurrences were the two skill sets that respondents reported lower levels of confidence with (Table 1, Q11 and Q12), this defines an area for future GP education and upskilling.…”

Section: Discussionmentioning

confidence: 99%

“…As the risk of melanoma recurrence and second primary melanomas differ due to a variety of patient factors, the use of risk stratification calculators can be used by specialists to appropriately select patients suitable for shared care 30 Finally, ongoing efforts to support the engagement of GPs in shared care should be considered. These include education supported by peak training and governing bodies as well as the development and implementation of rapid access referral pathways for patients who develop lesions of concern 17,20,25,36 . These efforts will not only continue to have a positive impact on the implementation of shared care models but also directly improve patient access to dermatologists for non‐skin cancer‐related presentations across South Australia 37 …”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Stage IA melanoma follow‐up: Exploring the level of confidence of South Australian general practitioners in undertaking surveillance skin checks including considerations for shared care

2023

View full text Add to dashboard Cite

Background The literature highlights the role of Australian general practitioners (GP) in the management of skin cancers. With melanoma incidences on the rise, there have been discussions into whether lower‐risk stage IA patients could safely be followed up by their GPs for annual surveillance full skin examinations (FSE). This study explores the level of confidence of South Australian (SA) GPs in undertaking FSEs including factors that could support discussions around shared care between GPs and dermatology units for lower‐risk patients. Methods An online survey was designed and distributed to SA GPs via email, newsletters and social media between 5 December 2021 and 30 January 2022. Descriptive statistics were used to describe survey responses. Pearson's Chi‐squared analysis was used to investigate associations between key variables of interest and explanatory variables. Logistic regression analysis was used to model odds ratios for associations between the dependent variable and independent variables. Results A total of 135 responses were obtained. Forty‐four per cent of GPs were comfortable undertaking annual FSEs, 41% were uncomfortable and 15% were unsure. Scope of work, >20 years experience and additional training had statistically significant relationships (p < 0.05). Dermoscopy and detecting melanoma recurrences were reported to be skills with lower levels of confidence. With regards to shared care, 77% indicated that they would feel supported undertaking FSEs if rapid access referral pathways were allocated for patients who developed suspicious lesions. Preferred upskilling modalities included, face‐to‐face sessions in a dermatology unit (39%), dermatologist run webinars (25%) and certificate courses (20%). Conclusions At present, there is a subset of SA GPs who are comfortable undertaking FSEs and therefore could be engaged in shared care with specialists. Further considerations have to be made in the areas of upskilling and supporting the workforce to enhance engagement in shared care.

show abstract

Comparison of Ophthalmologists versus Dermatologists for the Diagnosis and Management of Periorbital Atypical Pigmented Skin Lesions

Rubegni,

Zeppieri,

Tognetti

et al. 2024

JCM

View full text Add to dashboard Cite

Background/Objectives: Lentigo maligna (LM) and lentigo maligna melanoma (LMM) are significant subtypes of melanoma, with an annual incidence of 1.37 per 100,000 people in the U.S. These skin tumors, often found in photo-exposed areas such as the face, are frequently misdiagnosed, leading to delayed treatment or unnecessary excisions, especially in the elderly. Facial melanocytic skin tumors (lentigo maligna—LM/lentigo maligna melanoma—LMM) and their simulators (solar lentigo, pigmented actinic keratosis, seborrheic keratosis and lichen planus-like keratosis) often affect the periocular region. Thus, their diagnosis and management can involve different medical figures, mainly dermatologists and ophthalmologists. This study aimed to evaluate the ability of ophthalmologists to diagnose and manage pigmented skin lesions of the periorbital area. Methods: A multicentric, retrospective, cross-sectional study on a dataset of 79 periorbital pigmented skin lesions with both clinical and dermoscopic images was selected. The images were reviewed by six ophthalmologists and two dermatologists. Descriptive statistics were carried out, and the accuracy, sensitivity, and specificity, with their 95% confidence interval (95% CI), were estimated. Results: Ophthalmologists achieved a diagnostic accuracy of 63.50% (95% CI: 58.99–67.85%), while dermatologists achieved 66.50% (95% CI: 58.5–73.8). The sensitivity was lower for ophthalmologists in respect to dermatologists, 33.3% vs. 46.9%, respectively. Concerning the case difficulty rating, ophthalmologists rated as “difficult” 84% of cases, while for dermatologists, it was about 30%. Management was also consistently different, with a “biopsy” decision being suggested in 25.5% of malignant lesions by ophthalmologists compared with 50% of dermatologists. Conclusions: Ophthalmologists revealed a good diagnostic potential in the identification of periorbital LMs/LMMs. Given progressive population ageing and the parallel increase in facial/periorbital skin tumors, the opportunity to train new generations of ophthalmologists in the early diagnosis of these neoformations should be considered in the next future, also taking into account the surgical difficulty/complexity of this peculiar facial area.

show abstract

A dermoscopy training program for Victorian GPs to improve skin cancer prevention and detection

Abstract: Peer review and provenanceExternally peer reviewed, invited.

Cited by 3 publications

References 6 publications

Evaluation of primary care physicians' competence in selective skin tumour triage after short versus long dermoscopy training: a randomized non‐inferiority trial

Evaluation of primary care physicians' competence in selective skin tumour triage after short versus long dermoscopy training: a randomized non‐inferiority trial

Stage IA melanoma follow‐up: Exploring the level of confidence of South Australian general practitioners in undertaking surveillance skin checks including considerations for shared care

Comparison of Ophthalmologists versus Dermatologists for the Diagnosis and Management of Periorbital Atypical Pigmented Skin Lesions

Contact Info

Product

Resources

About