Evaluation of the Number-Needed-to-Biopsy Metric for the Diagnosis of Cutaneous Melanoma

Nelson, Kelly C.; Swetter, Susan M.; Saboda, Kathylynn; Chen, Shuo; Curiel‐Lewandrowski, Clara

doi:10.1001/jamadermatol.2019.1514

Cited by 48 publications

(45 citation statements)

References 47 publications

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“…Thus, NNE, melanoma thickness, and cumulative melanoma incidence are reasonable surrogate outcomes, and to assess efficacy of a particular intervention, studies should report between‐group differences in these metrics. In a systematic review of 46 studies, NNE ranged from 2.2 to 287, highlighting the need for standardization of NNE and its reporting, which may require structured clinical impression and pathologic diagnostic data collection (Nelson, Swetter, Saboda, Chen, & Curiel‐Lewandrowski, 2019). Furthermore, to facilitate comparisons across studies and devices, adhering to standards in dermatologic imaging is imperative, such as those proposed by the International Skin Imaging Collaborative (ISIC) (Marghoob, 2015).…”

Section: Resultsmentioning

confidence: 99%

The role of technology in melanoma screening and diagnosis

Young

Vora

Cortez

et al. 2020

Pigment Cell Melanoma Res

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Melanoma presents challenges for timely and accurate diagnosis. Expert panels have issued risk‐based screening guidelines, with recommended screening by visual inspection. To assess how recent technology can impact the risk/benefit considerations for melanoma screening, we comprehensively reviewed non‐invasive visual‐based technologies. Dermoscopy increases lesional diagnostic accuracy for both dermatologists and primary care providers; total body photography and sequential digital dermoscopic imaging also increase diagnostic accuracy, are supported by automated lesion detection and tracking, and may be best suited to use by dermatologists for longitudinal follow‐up. Specialized imaging modalities using non‐visible light technology have unproven benefit over dermoscopy and can be limited by cost, access, and training requirements. Mobile apps facilitate image capture and lesion tracking. Teledermatology has good concordance with face‐to‐face consultation and increases access, with increased accuracy using dermoscopy. Deep learning models can surpass dermatologist accuracy, but their clinical utility has yet to be demonstrated. Technology‐aided diagnosis may change the calculus of screening; however, well‐designed prospective trials are needed to assess the efficacy of these different technologies, alone and in combination to support refinement of guidelines for melanoma screening.

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Section: Resultsmentioning

confidence: 99%

The role of technology in melanoma screening and diagnosis

Young

Vora

Cortez

et al. 2020

Pigment Cell Melanoma Res

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“…In a study by Nault et al [ 9 ], numbers needed to biopsy (NNB) for all skin cancers and melanoma were reported to be 3.4 and 21.4, respectively. In another recent meta-analysis by Nelson et al, NNB for melanoma was estimated from studies published between 2000 and 2018 which was 15.6 worldwide [ 10 ]. In the present study, NNB was 3.29 and 27.24 for diagnosis of all skin malignancies and melanoma, respectively.…”

Section: Discussionmentioning

confidence: 99%

Clinical Diagnosis has a High Negative Predictive Value in Evaluation of Malignant Skin Lesions

Ahadi

Firooz

Rahimi

et al. 2021

Dermatology Research and Practice

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Background. The increasing incidence of skin cancers in fair-skinned population and its relatively good response to treatment make its accurate diagnosis of great importance. We evaluated the accuracy of clinical diagnosis of malignant skin lesions by comparing the clinical diagnosis with histological diagnosis as the gold standard. Materials and Methods. In this retrospective study, we assessed all the pathology reports from specimens sent to a university hospital laboratory in 3 consecutive years from March 2008 to March 2010. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and positive and negative likelihood ratios were calculated for clinical diagnosis of malignant skin lesions stratified by their histological subtype. Results. A total 4,123 specimen were evaluated. The sensitivity and specificity for clinical diagnosis of malignancy were 90.48% and 82.85%, respectively, whereas the negative predictive value was shown to be 99.06%. The positive and negative likelihood ratios were 5.23 and 0.11, respectively. Conclusion. Pathological assessment of skin lesions remains the cornerstone of skin cancer diagnosis. The high NPV and the relatively low PPV indicate that clinical diagnosis is more efficient in ruling out malignancies rather than diagnosing them.

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“…melanoma. This ranges from ∼2 for some dermatologists to ∼30 for primary care physicians (31). Thus, according to current clinical practices, any lesions with prior odds lower than 1/2-1/30 of being malignant are less likely to be biopsied.…”

Section: Toward Enhancing Pigmented Lesion Screening With Biomarkersmentioning

confidence: 99%

Molecular Biomarkers for Melanoma Screening, Diagnosis and Prognosis: Current State and Future Prospects

2021

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Despite significant progress in the development of treatment options, melanoma remains a leading cause of death due to skin cancer. Advances in our understanding of the genetic, transcriptomic, and morphologic spectrum of benign and malignant melanocytic neoplasia have enabled the field to propose biomarkers with potential diagnostic, prognostic, and predictive value. While these proposed biomarkers have the potential to improve clinical decision making at multiple critical intervention points, most remain unvalidated. Clinical validation of even the most commonly assessed biomarkers will require substantial resources, including limited clinical specimens. It is therefore important to consider the properties that constitute a relevant and clinically-useful biomarker-based test prior to engaging in large validation studies. In this review article we adapt an established framework for determining minimally-useful biomarker test characteristics, and apply this framework to a discussion of currently used and proposed biomarkers designed to aid melanoma detection, staging, prognosis, and choice of treatment.

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Evaluation of the Number-Needed-to-Biopsy Metric for the Diagnosis of Cutaneous Melanoma

Cited by 48 publications

References 47 publications

The role of technology in melanoma screening and diagnosis

The role of technology in melanoma screening and diagnosis

Clinical Diagnosis has a High Negative Predictive Value in Evaluation of Malignant Skin Lesions

Molecular Biomarkers for Melanoma Screening, Diagnosis and Prognosis: Current State and Future Prospects

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