Validity and Reliability of Dermoscopic Criteria Used to Differentiate Nevi From Melanoma

Carrera, Cristina; Marchetti, Michael A.; Dusza, Stephen W.; Argenziano, Giuseppe; Braun, Ralph P.; Halpern, Allan C.; Jaimes, Natalia; Kittler, Harald; Malvehy, Josep; Menzies, Scott W.; Pellacani, Giovanni; Puig, Susana; Rabinovitz, Harold; Scope, Alon; Soyer, H. Peter; Stolz, Wilhelm; Hofmann‐Wellenhof, Rainer; Zalaudek, Iris; Marghoob, Ashfaq A.

doi:10.1001/jamadermatol.2016.0624

Cited by 114 publications

(116 citation statements)

References 15 publications

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“…13,[17][18][19][20][21][22] Less than 1.0% of lesions with atypia and positive margins that undergo excision are diagnostically upgraded to melanoma. 12,13 This notion that the current pathway has a significant number of unnecessary surgical procedures is also supported by other investigators, [13][14][15][16][17]21,23 who recently found that more than 90% of skin biopsies to rule out melanoma were attributed to benign and low-risk lesions. Approximately 3.0 million surgical biopsies and 780 000 excisions are performed in the United States annually to find approximately 150 000 in situ and invasive melanomas as part of the current diagnostic pathway for atypical pigmented lesions.…”

Section: -14mentioning

confidence: 99%

Economic Analysis of a Noninvasive Molecular Pathologic Assay for Pigmented Skin Lesions

Hornberger

Siegel

2018

JAMA Dermatol

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IMPORTANCEA recently described noninvasive gene expression test (the pigmented lesion assay [PLA]) with adhesive patch-based sampling has the potential to rule out melanoma and the need for surgical biopsy of pigmented lesions suggestive of melanoma with a negative predictive value of 99% compared with 83% for the histopathologic standard of care. The cost implications of using this molecular test vs visual assessment followed by biopsy and histopathologic assessment (VAH) have not been evaluated. OBJECTIVE To determine potential cost savings of PLA use vs the VAH pathway. DESIGN, SETTING, AND PARTICIPANTSThis health economic analysis performed from a US payer perspective was based on consensus treatment guidelines and fee schedules from the Centers for Medicare & Medicaid Services. Data for model input were derived from routine use of the test in US dermatology practices and literature. Participants included patients with primary cutaneous pigmented lesions suggestive of melanoma. Data were analyzed from February 8 to December 1, 2017. MAIN OUTCOMES AND MEASURESThe primary analysis consisted of the relative reduction in costs of diagnostic surgical procedures for PLA vs VAH management. Additional analyses included stage-related treatment costs associated with delays in diagnosis. RESULTSIn the cost analysis for this economic model, the relative reduction in surgical procedure costs (biopsy and subsequent excision

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Section: -14mentioning

confidence: 99%

Economic Analysis of a Noninvasive Molecular Pathologic Assay for Pigmented Skin Lesions

Hornberger

Siegel

2018

JAMA Dermatol

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“…38 Numerous algorithms have been developed to help new users approach the second step of diagnosing melanoma with high sensitivity and specificity. 43 Some of these algorithms include the ABCD Rule, the 7-point checklist, the Menzies’ Method, the CASH algorithm, and the “Chaos and Clues” algorithm. 7,44–47 The latter emphasizes the importance of a disorganized distribution of dermoscopic structures in malignant lesions.…”

Section: Dermoscopy Algorithmsmentioning

confidence: 99%

“…A study led by the International Dermoscopy Society found architectural disorder, with an OR of 6.6, the most powerful discriminator of melanoma. 43 Furthermore, the subjective interpretation of architectural disorder had the highest interobserver agreement among participants (intraclass correlation coefficient (ICC) of 0.43, where an ICC of 0 is an agreement by chance and an ICC of 1 is perfect agreement). 43 The additional criteria included in TADA (starburst pattern, blue-black or gray color, shiny white structures, negative network, ulcer/erosion, and/or vessels) are needed to identify organized-appearing malignancies, such as spitzoid, nodular, and amelanotic melanoma.…”

Section: Dermoscopy Algorithmsmentioning

confidence: 99%

Enhancing Skin Cancer Diagnosis with Dermoscopy

Wolner

Yélamos

Liopyris

et al. 2017

Dermatologic Clinics

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Synopsis Dermoscopy increases the sensitivity for skin cancer detection, decreases the number of benign lesions biopsied for each malignant diagnosis, and enables the diagnosis of thinner melanomas compared to naked eye examination. Three meta-analyses have all identified that dermoscopy improved diagnostic accuracy for melanoma when compared to naked eye exam. In addition, studies have established that dermoscopy can aid in the detection of keratinocyte carcinomas. Dermoscopy triage algorithms have been developed to help novices decide when a biopsy or a referral is most appropriate. In this chapter we illustrate the dermoscopic features that assist in identifying melanoma and keratinocyte carcinomas.

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“…Accordingly, the scoring system with the highest sensitivity was Menzies scoring system, while the 3-point checklist scoring had the lowest sensitivity. Regarding the specificity, ABCD had the highest specificity as compared to "Chaos and Clues" having the lowest specificity (23). In conclusion, although 3-point checklist scoring and automated screening systems appear to be important diagnostic tools, they also have significant disadvantages.…”

Section: Discussionmentioning

confidence: 86%

Assessment of Melanoma Risk in Acquired Melanocytic Nevi Using Digital Dermoscopic and 3-Point Checklist Score

Yavuz¹,

Akdeniz²,

Yavuz³

et al. 2017

Eastern J Med

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Validity and Reliability of Dermoscopic Criteria Used to Differentiate Nevi From Melanoma

Cited by 114 publications

References 15 publications

Economic Analysis of a Noninvasive Molecular Pathologic Assay for Pigmented Skin Lesions

Economic Analysis of a Noninvasive Molecular Pathologic Assay for Pigmented Skin Lesions

Enhancing Skin Cancer Diagnosis with Dermoscopy

Assessment of Melanoma Risk in Acquired Melanocytic Nevi Using Digital Dermoscopic and 3-Point Checklist Score

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