Using the 7-point checklist as a diagnostic aid for pigmented skin lesions in general practice: a diagnostic validation study

Walter, Fiona M; Prevost, A. Toby; Vasconcelos, Joana; Hall, Per; Burrows, Nigel; Morris, Helen; Kinmonth, Ann Louise; Emery, Jon

doi:10.3399/bjgp13x667213

Cited by 65 publications

(53 citation statements)

References 23 publications

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“…A recent validation study in English primary care 135 suggests that a cutoff score of four performs best at identifi cation of clinically suspicious pigmented skin lesions.…”

Section: The Lancet Oncology Commissionmentioning

confidence: 99%

The expanding role of primary care in cancer control

Rubin

Berendsen

Crawford

et al. 2015

The Lancet Oncology

437

450

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The nature of cancer control is changing, with an increasing emphasis, fuelled by public and political demand, on prevention, early diagnosis, and patient experience during and after treatment. At the same time, primary care is increasingly promoted, by governments and health funders worldwide, as the preferred setting for most health care for reasons of increasing need, to stabilise health-care costs, and to accommodate patient preference for care close to home. It is timely, then, to consider how this expanding role for primary care can work for cancer control, which has long been dominated by highly technical interventions centred on treatment, and in which the contribution of primary care has been largely perceived as marginal. In this Commission, expert opinion from primary care and public health professionals with academic and clinical cancer expertise-from epidemiologists, psychologists, policy makers, and cancer specialists-has contributed to a detailed consideration of the evidence for cancer control provided in primary care and community care settings. Ranging from primary prevention to end-of-life care, the scope for new models of care is explored, and the actions needed to eff ect change are outlined. The strengths of primary care-its continuous, coordinated, and comprehensive care for individuals and families-are particularly evident in prevention and diagnosis, in shared follow-up and survivorship care, and in end-of-life care. A strong theme of integration of care runs throughout, and its elements (clinical, vertical, and functional) and the tools needed for integrated working are described in detail. All of this change, as it evolves, will need to be underpinned by new research and by continuing and shared multiprofessional development.

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“…A recent validation study in English primary care 135 suggests that a cutoff score of four performs best at identifi cation of clinically suspicious pigmented skin lesions.…”

Section: The Lancet Oncology Commissionmentioning

confidence: 99%

The expanding role of primary care in cancer control

Rubin

Berendsen

Crawford

et al. 2015

The Lancet Oncology

437

450

View full text Add to dashboard Cite

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“…28 Future apps could consider incorporating and validating the 7-point checklist for melanoma detection, particularly for use in the U.K. population where it was developed and recently validated in a primary care population. 29 Two apps were not included in the review as they were marketed for doctor's use only. iDoc24 Pro was the 'professional' version of iDoc24, aiming to 'help clinicians assess whether to refer a patient to a dermatologist', and Melanoma Risk Assessment Tool (Apple; last updated 2011) used the patient's personal and medical history and the result of a back and shoulders examination to calculate an estimate of a patient's absolute melanoma risk.…”

Section: Discussionmentioning

confidence: 99%

Smartphone applications for melanoma detection by community, patient and generalist clinician users: a review

et al. 2015

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Smartphone health applications ('apps') are widely available but experts remain cautious about their utility and safety. We reviewed currently available apps for the detection of melanoma (July 2014), aimed at general community, patient and gen-eralist clinician users. A proforma was used to extract and assess each app that met the inclusion criteria, and we undertook content analysis to evaluate their content and the evidence applied in their development. Thirty-nine apps were identified with the majority available only for Apple users. Over half (n = 22) provided information or education about melanoma, ultraviolet radiation exposure prevention advice, and skin self-examination strategies, mainly using the ABCDE (A, Asymmetry ; B, Border; C, Colour; D, Diameter; E, Evolving) method. Half (n = 19) helped users take and store images of their skin lesions either for review by a dermatologist or for self-monitoring to identify change, an important predictor of melanoma; a similar number (n = 18) used reminders to help users monitor their skin lesions. A few (n = 9) offered expert review of images. Four apps provided a risk assessment to patients about the probability that a lesion was malignant or benign, and one app calculated users' future risk of melanoma. None of the apps appeared to have been validated for diagnostic accuracy or utility using established research methods. Smartphone apps for detecting melanoma by nonspecialist users have a range of functions including information, education, classification, risk assessment and monitoring change. Despite their potential usefulness, and while clinicians may choose to use apps that provide information to educate their patients, apps for melanoma detection require further validation of their utility and safety. What's already known about this topic? • Earlier detection of melanoma would allow timely treatment and could improve outcomes. • Although smartphone applications ('apps') are recognized as having potentially wide use in dermatology and oncology, experts have expressed caution concerning their diagnostic utility and safety. What does this study add? • We identified almost 40 smartphone apps available to detect or prevent melanoma by nonspecialist users including previously unaffected individuals, patients previously diagnosed with skin cancer, and generalist clinicians. • Most apps gave advice or education about melanoma, ultraviolet radiation exposure preventive advice, and skin self-examination strategies; half of the apps enabled patients to capture and store images of their skin lesions either for review by a dermatologist or for self-monitoring to identify change, an important predictor of melanoma; only four apps provided a risk assessment about a skin lesion.

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“…Such an analysis provides the opportunity to enlarge the standard ABCD rule [4] or 7-point checklist [5] and involve additional criteria in suspicious skin tissues inspection. For example, dermatoscopy analysis may include monitoring of more specifically related tumor features like atypical pigmentation and vascular networks as well as so-called blue-whitish veil, which represents a gray-white pattern with well perceptible blue tone [6].…”

Section: Introductionmentioning

confidence: 99%

In vivo hyperspectral imaging of skin malignant and benign tumors in visible spectrum

Bratchenko

Sherendak

Myakinin

et al. 2018

JBPE

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Abstract. The paper presents analysis of hyperspectral images for human skin cancer pathologies diagnostics. Hyperspectral images data contained backscattered spectra of normal skin and tumors. Analysis of hyperspectral images provided information about hemoglobin and melanin content for the differentiation of malignant and benign skin neoplasms based on tissues optical density calculation. It was shown that the accuracy of cancerous tissues classification reaches 88% for proposed algorithm of hyperspectral images analysis. The proposed approach may be a rapid and reliable tool for skin oncological diseases screening. © 2018 Journal of Biomedical Photonics & Engineering.Keywords: hyperspectral imaging; backscattering spectroscopy; oncodermatology; oncological diagnostics; melanoma; nevi; carcinoma; melanin; hemoglobin content.

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Using the 7-point checklist as a diagnostic aid for pigmented skin lesions in general practice: a diagnostic validation study

Cited by 65 publications

References 23 publications

The expanding role of primary care in cancer control

The expanding role of primary care in cancer control

Smartphone applications for melanoma detection by community, patient and generalist clinician users: a review

In vivo hyperspectral imaging of skin malignant and benign tumors in visible spectrum

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