Assessing diagnostic skill in dermatology: A comparison between general practitioners and dermatologists

Abstract

This retrospective study was conducted to assess and compare the diagnostic accuracy between referring general practitioners and dermatologists with regard to skin conditions. Six hundred and fifty-six consecutive general practitioner referrals to a private dermatology practice and a dermatology outpatient department were assessed. The concordance rate in diagnoses from a wide spectrum of dermatological diseases was compared between general practitioners and dermatologists. Referring general practitioners agreed with dermatologists' clinical diagnosis and histology (when available) in 42% of cases. The concordance between general practitioners and dermatologists in the setting of non-biopsied cases is 45%. One hundred and fifty-one of 656 (23%) conditions had histological confirmation. Overall, general practitioners agreed with the histological diagnosis in 24% of cases and dermatologists agreed with the histological diagnosis in 77% of cases.

Clinical study of noninvasivein vivomelanoma and nonmelanoma skin cancers using multimodal spectral diagnosis

“…When compared with histopathology, general practitioners' diagnostic accuracy was reported to be between 24% and 44%, while dermatologists' diagnostic accuracy was 77%. 4,5 The common stance to err on the side of caution has led to performing an increased number of biopsies, where histopathology may be found to be negative for tumors. This increases both the patient's and health care financial burdens, with associated patient discomfort undergoing these additional surgical procedures.…”

Evaluation of Clinical Diagnostic Tests in Dermatology

“…Diagnoses made by dermatologists, did not match the histology mostly in skin tumors and skin condtions where clinical diagnosis was not always possible or reliable. This extremely low level of agreement suggests a need for improving general practicioners' skills for recognizing dermatological conditions, especially in diagnosing skin cancer, through both undregraduate and postgraduate education (9). However, it is not determined whether further general practitioners' education will reduce the health-care costs.…”

A Systematic Review of Training to Improve Melanoma Diagnostic Skills in General Practitioners

“…In a study by Youl et al, GP diagnosis had 29 % sensitivity and 18 % positive predictive value for melanoma [19]. In another study by Tran et al, GPs had a sensitivity of 33 % for melanoma [16]. These studies had highlighted melanoma as a key area of diagnostic weakness and recommended assistance to improve GP skills in diagnosing skin cancer.…”

“…Considering the different factors explained above, it comes as no surprise that the provision of assistance to GPs in regards to melanoma training, with the aim of improving their diagnostic skills, had been advocated [16]. However, in order to channel our resources judiciously, we need to know the types of training or education that have been shown to improve melanoma diagnostic ability.…”