Examining the factors associated with past and present dermoscopy use among family physicians

Morris, Jeffrey B.; Alfonso, Sarah V.; Hernández, Nilda; Fernández, M. Isabel

doi:10.5826/dpc.0704a13

Cited by 20 publications

(34 citation statements)

References 3 publications

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“…Recent reviews of dermoscopy use for melanoma diagnosis point to an increase in diagnostic accuracy for benign lesions and melanoma when dermoscopy is used by trained GPs, and it can lead to a reduction in unnecessary referrals and excisions. There is also international evidence that GPs are receptive to incorporating dermoscopy into their routine practice …”

Section: Discussionmentioning

confidence: 99%

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Dermoscopy use in UK primary care: a survey of GPs with a special interest in dermatology

Jones

Jurascheck

Utukuri

et al. 2019

Acad Dermatol Venereol

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Background Melanoma accounts for 90% of skin cancer mortality and typically presents in primary care, where it can be challenging to distinguish from benign lesions. Dermoscopy is a tool for skin visualization that is routinely used for melanoma diagnosis in secondary care. However, the role of dermoscopy in primary care remains unclear. Objectives To determine views on, and use of, dermoscopy by dermatology‐interested general practitioners (GPs). Methods An online questionnaire was emailed to the UK Primary Care Dermatology Society members in February 2018, and responses collected over the following 4 weeks. Results A total of 205 responses were analysed. Most respondents were GPs (94%), aged over 50 (53%), had a postgraduate dermatological qualification (67%) and used dermoscopy regularly when reviewing pigmented skin lesions (97%). Dermoscopy use was commoner amongst GPs who had worked longer in primary care and had experience of secondary care dermatology. Most had undertaken training in dermoscopy (91%), although one‐fifth (20%) had not updated their training in over 5 years. Most of those who had received only 1 day of face‐to‐face training reported feeling confident using a dermatoscope. Few respondents (11%) reported access to teledermatology or teledermoscopy for urgent or routine referrals. Conclusions UK GPs with a special interest in dermatology are routinely using dermoscopy in the primary care setting. More research is needed to establish optimal approaches to training and updating GP dermoscopy skills. When dermoscopy has been shown to be safe, effective, acceptable and cost‐effective in this setting, more GPs may also be able to gain and maintain the skills to implement dermoscopy into routine primary care. Technological advances, including incorporation of artificial intelligence (AI) and algorithms to guide GPs, could also contribute to widening use of dermoscopy among GPs.

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Section: Discussionmentioning

confidence: 99%

“…There is also international evidence that GPs are receptive to incorporating dermoscopy into their routine practice. 24,[36][37][38] Diagnostic accuracy for dermoscopy users appears to depend on sufficient training. 11,21,23 However, there is little evidence to confirm the optimal training modality and duration.…”

Section: Comparisons With Existing Literaturementioning

confidence: 99%

Dermoscopy use in UK primary care: a survey of GPs with a special interest in dermatology

Jones

Jurascheck

Utukuri

et al. 2019

Acad Dermatol Venereol

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“…1 In addition, mastery-learning courses in dermoscopy can improve diagnostic accuracy and increase physician confidence. As only 8% of PCPs in the United States use dermoscopy, 2 there is opportunity to increase and promote its practice. However, before embarking on dermoscopy training initiatives, it is important to understand the views of PCPs in learning and implementing this tool.…”

Section: Introductionmentioning

confidence: 99%

Perspectives on Dermoscopy in the Primary Care Setting

et al. 2020

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Introduction: Dermoscopy is a noninvasive, in vivo imaging technique that allows for the visualization of subsurface skin structures. In recent years, several education interventions have incorporated dermoscopy in the primary care setting to improve skin cancer detection. We aim to describe the perspectives, attitudes, and interest of primary care physicians (PCPs) regarding dermoscopy. Methods: PCPs associated with academic institutions completed an anonymous survey emailed to faculty and resident listservs. The survey consisted of 23 questions related to dermoscopy. Results: A total of 156 PCPs completed the questionnaire. Few PCPs reported having access to a dermatoscope (16%), using it regularly (9%), or having received training (15%). The most common reasons for not using a dermatoscope were the lack of access to the device (85%), followed by the lack of training (76%). However, the majority view dermoscopy as a valuable tool in primary care and are interested in receiving training (87%), particularly with a hands-on approach. Conclusion: Our sample of PCPs in the United States showed that although few use dermoscopy, most perceive it as a useful tool, particularly family medicine physicians. The main reported barriers preventing its use included the lack of training and poor access to dermatoscopes. The vast majority of PCPs in our sample want to be trained in dermoscopy, thereby providing an opportunity for educational initiatives that take into account the barriers and preferred learning strategies.

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“…It may be that current programs are not meeting the training needs of participants in order to facilitate on-going use of dermoscopy in independent practice, and it is notable that only one study set a pass standard for participants [17]. However, it must also be acknowledged that training is not the only barrier to dermoscopy use, and others such as equipment costs must also be considered and addressed [7,8].…”

Section: Principal Findingsmentioning

confidence: 99%

“…Dermoscopy has been shown to be an effective tool for the detection of melanoma and the triage of other pigmented skin lesions in primary care [ 3 – 5 ]. However, these improvements in diagnosis are only achieved after training [ 6 ], and lack of training has been cited by PCPs in observational studies as a key barrier to the use of dermoscopy [ 7 , 8 ]. Given the potential of dermoscopy to improve skin cancer detection in primary care, it is crucial to understand how to train PCPs in dermoscopy, and to highlight where the evidence base is currently insufficient, in order to direct future research.…”

Section: Introductionmentioning

confidence: 99%

Training Primary Care Physicians in Dermoscopy for Skin Cancer Detection: a Scoping Review

et al. 2019

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In many countries, patients with concerning skin lesions will first consult a primary care physician (PCP). Dermoscopy has an evidence base supporting its use in primary care for skin cancer detection, but need for training has been cited as a key barrier to its use. How PCPs train to use dermoscopy is unclear. A scoping literature review was carried out to examine what is known from the published literature about PCP training in dermoscopy. The methodological steps taken in this review followed those described by Arksey and O'Malley, as revised by Levac et al. Four electronic databases were searched for evidence published up to June 2018. Sixteen articles were identified for analysis, all published since 2000. Ten training programs were identified all of which addressed dermoscopy of pigmented skin lesions, among other topics. Ten articles reported on a range of outcomes measured after training and showed generally positive results in terms of improved diagnostic performance, although no metaanalysis was conducted. However, it was unclear whether trained PCPs continued to use dermoscopy after training. Observational questionnaire data revealed that many PCPs use dermoscopy in practice without any formal training. The literature generally supports the use of dermoscopy by PCPs, but it is unclear whether current training leads to long-term change in PCPs' use of dermoscopy in clinical practice. Understanding this problem, as well as exploring PCPs' training needs, is essential to develop training programs that will facilitate the uptake and use of dermoscopy in primary care.

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Examining the factors associated with past and present dermoscopy use among family physicians

Cited by 20 publications

References 3 publications

Dermoscopy use in UK primary care: a survey of GPs with a special interest in dermatology

Dermoscopy use in UK primary care: a survey of GPs with a special interest in dermatology

Perspectives on Dermoscopy in the Primary Care Setting

Training Primary Care Physicians in Dermoscopy for Skin Cancer Detection: a Scoping Review

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