scholarly journals Diagnostic efficiency of the main dermatoscopic symptoms and algorithms for detecting skin melanoma

2021 ◽  
Vol 40 (1) ◽  
pp. 45-52
Author(s):  
Maksim V. Mamunov ◽  
Aleksandr V. Patrushev
Keyword(s):  
Diagnostic Accuracy ◽  
General Practitioners ◽  
Skin Lesions ◽  
Diagnostic Efficiency ◽  
Cross Polarization ◽  
Skin Melanoma ◽  
Venereal Diseases ◽  
Melanocytic Nevi ◽  
Medical Specialists ◽  
Diagnostic Algorithms

AIM: to assess the diagnostic accuracy of the main dermatoscopic signs and algorithms used to diagnose skin melanoma. MATERIALS AND METHODS: To assess the diagnostic effectiveness of the performed dermatoscopy in detecting skin melanoma, the main dermatoscopic signs that occur in this disease were identified: atypical pigment network, atypical globules, asymmetry of pigmentation and structure, asymmetric stripes, asymmetric zones of hyperpigmentation (spots), blue-white (white-blue) veil, graininess, scar-like foci of depigmentation, white shiny stripes, negative pigment network. The study was carried out based on the analysis of 34 archival dermatoscopic images of melanocytic skin lesions with a morphologically verified diagnosis (11 melanomas and 23 melanocytic nevi). In addition, a comparison was made of the indicators of the diagnostic efficiency of two main dermatoscopic algorithms used in the diagnosis of skin melanoma: the algorithm by 3 signs and by 7 signs. For this, 186 archived dermatoscopic images of melanocytic skin lesions were analyzed. All patients included in the study were examined and treated at the clinic for skin and venereal diseases in the period from 2015 to 2019. The study was carried out using a HEINE DELTA 20 Plus dermatoscope in immersion mode and in cross-polarization. RESULTS: The following dermatoscopic features had the highest diagnostic efficiency for the diagnosis of skin melanoma: blue-white veil (86.8%), asymmetry of pigmentation and structure (82.6%), and white shiny stripes (72.8%). The diagnostic efficiency of the 3 signs algorithm was 93.0%, the 7 signs algorithm 90.5%. CONCLUSION: Diagnostic algorithms for confirming melanoma can be successfully used by both general practitioners and medical specialists (dermatologists, oncologists). In this case, it is preferable to use the three signs algorithm at the initial admission of patients as a screening option, and the seven-signs algorithm by experienced specialists in the field of dermatoscopy to confirm the diagnosis (4 figures, 3 tables, bibliography: 11 refs).

Clinical Recognition of Melanoma in Dermatologists and Nondermatologists

2016 ◽  
Vol 20 (6) ◽  
pp. 532-535 ◽  
Author(s):  
Michal J. Martinka ◽  
Richard I. Crawford ◽  
Shannon Humphrey
Keyword(s):  
Retrospective Study ◽  
Diagnostic Accuracy ◽  
General Practitioners ◽  
Family Physicians ◽  
Skin Lesions ◽  
The Other ◽  
Training And Education ◽  
Clinical Diagnoses ◽  
Pathology Reports ◽  
Better Than

Background: The incidence of melanoma is increasing annually in Canada. Objectives: This retrospective study was designed to assess the ability of physicians of different specialties to accurately recognize melanoma. Methods: Pathology reports of biopsies submitted to Vancouver Coastal Health with clinical diagnoses of melanoma were reviewed (January to July 2013). The clinical diagnoses made by dermatologists, general practitioners and family physicians, and all other specialists were correlated with the final histopathologic diagnoses. Results: The dermatologists, general practitioners and family physicians, and all other specialists achieved diagnostic accuracies of 24.75%, 3.52%, and 12.75%, respectively. Conclusions: Although the diagnostic accuracy of dermatologists was significantly better than that the other practitioners, the majority of patients with suspicious skin lesions present to family physicians or general practitioners first. Thus, there is considerable value in providing more training and education to nondermatologists, because it can have a meaningful impact on patient care.

scholarly journals Diagnostic Accuracy of Three-dimensional Ultrasonography in Detection of Endometrial Lesions compared with Hysteroscopy in Infertile Women

2016 ◽  
Vol 10 (4) ◽  
pp. 393-397
Author(s):  
Firoozeh Ahmadi ◽  
Farnaz Akhbari ◽  
Fatemeh Niknejad ◽  
Hadieh Haghighi ◽  
Zahra Ghahremani ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Gold Standard ◽  
Three Dimensional ◽  
Assessment Method ◽  
Diagnostic Efficiency ◽  
Infertile Women ◽  
Reliable Assessment ◽  
Uterine Anomalies

ABSTRACT Introduction Two of the most frequent procedures performed on infertile women are two-dimensional ultrasound (2DUS) and three-dimensional ultrasound (3DUS). Hysteroscopy is considered as the gold standard for evaluation of acquired endometrial lesions in infertile women; however, 3DUS is used as a noninvasive, less expensive, and reliable assessment method for evaluation of the intrauterine lesions in infertile women. We aimed to compare the diagnostic efficiency between 3DUS and hysteroscopy in the detection of lesions (polyps, submucous leiomyoma, and synechiae) in infertile women. Materials and methods In this prospective observational study, infertile women (n = 155) with indication of hysteroscopy were scheduled to undergo 3DUS prior to hysteroscopy from September 2010 to 2011. Women with suspected congenital uterine anomalies were excluded. The sensitivity and specificity values of 3DUS were compared with those of hysteroscopy. Hysteroscopy was used as the gold standard for diagnosis of intrauterine lesions in infertile women. Results Of the 155 women, 50 were found to have an intracavitary abnormality, 36 had polyps, 12 had myomas, and 7 had synechiae on hysteroscopic findings. Examination with 3DUS in the diagnosis of intrauterine lesions reached an accuracy of 94%, and 92.15 and 96.9% of sensitivity and specificity respectively. Positive predictive value (PPV) was 83.9%, and a negative predictive value (NPV) was 91.3% (LR+ = 10.75, LR+ = 0.065). Conclusion According to our results, 3DUS has a reliable diagnostic accuracy for intrauterine lesions, and it may limit unnecessary hysteroscopy in patients with normal results. How to cite this article Ahmadi F, Haghighi H, Ghahremani Z, Niknejad F, Akhbari F, Ramezanali F, Chehrazi M. Diagnostic Accuracy of Three-dimensional Ultrasonography in Detection of Endometrial Lesions compared with Hysteroscopy in Infertile Women. Donald School J Ultrasound Obstet Gynecol 2016;10(4):393-397.

scholarly journals Interest of a Joint Use of Two Diagnostic Tools of Burnout: Comparison between the Oldenburg Burnout Inventory and the Early Detection Tool of Burnout Completed by Physicians

2021 ◽  
Vol 18 (19) ◽  
pp. 10544
Author(s):  
Céline Leclercq ◽  
Lutgart Braeckman ◽  
Pierre Firket ◽  
Audrey Babic ◽  
Isabelle Hansez
Keyword(s):  
Early Detection ◽  
Diagnostic Accuracy ◽  
General Practitioners ◽  
The Self ◽  
Added Value ◽  
Diagnostic Tools ◽  
Occupational Physicians ◽  
Detection Tool ◽  
Interview Guide ◽  
Oldenburg Burnout Inventory

Most research on burnout is based on self-reported questionnaires. Nevertheless, as far as the clinical judgement is concerned, a lack of consensus about burnout diagnosis constitutes a risk of misdiagnosis. Hence, this study aims to assess the added value of a joint use of two tools and compare their diagnostic accuracy: (1) the early detection tool of burnout, a structured interview guide, and (2) the Oldenburg burnout inventory, a self-reported questionnaire. The interview guide was tested in 2019 by general practitioners and occupational physicians among 123 Belgian patients, who also completed the self-reported questionnaire. A receiver operating characteristic curve analysis allowed the identification of a cut-off score for the self-reported questionnaire. Diagnostic accuracy was then contrasted by a McNemar chi-squared test. The interview guide has a significantly higher sensitivity (0.76) than the self-reported questionnaire (0.70), even by comparing the self-reported questionnaires with the interviews of general practitioners and occupational physicians separately. However, both tools have a similar specificity (respectively, 0.60–0.67), except for the occupational physicians’ interviews, where the specificity (0.68) was significantly lower than the self-reported questionnaire (0.70). In conclusion, the early detection tool of burnout is more sensitive than the Oldenburg burnout inventory, but seems less specific. However, by crossing diagnoses reported by patients and by physicians, they both seem useful to support burnout diagnosis.

scholarly journals Diagnostic Accuracy of Clinical and Microbiological Signs in Patients With Skin Lesions Resembling Buruli Ulcer in an Endemic Region

2018 ◽  
Vol 67 (6) ◽  
pp. 827-834 ◽  
Author(s):  
Miriam Eddyani ◽  
Ghislain E Sopoh ◽  
Gilbert Ayelo ◽  
Luc V C Brun ◽  
Jean-Jacques Roux ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Buruli Ulcer ◽  
Skin Lesions ◽  
Endemic Region

COMPUTED TOMOGRAPHY (CT) IMAGE IN REPAIRING TENDON INJURY IN ATHLETES

2021 ◽  
Vol 27 (7) ◽  
pp. 699-702
Author(s):  
Hongliang Li
Keyword(s):  
Computed Tomography ◽  
Diagnostic Accuracy ◽  
Tendon Injury ◽  
Fracture Dislocation ◽  
Ct Image ◽  
Diagnostic Efficiency ◽  
Level Of Evidence ◽  
Anatomical Basis ◽  
Hands And Feet ◽  
Ct And Mri

ABSTRACT Introduction: endon injury can usually be divided into the following types: fracture, dislocation, compression, bone insert, tendon injury, among which dislocation and compression are more common. Objective: To evaluate the application value of Computed Tomography (CT) image in tendon display. Methods: CT scan of the hands and feet was performed in our hospital for suspected tendon lesions. The CT and MRI data of 61 patients with tendon injury were retrospectively analyzed, and the diagnostic efficiency of CT and MRI were compared and analyzed. Results: The diagnostic accuracy of 61 patients was 89.71% (61/68). Except for chronic tendon injury (12/19), the diagnostic accuracy of other lesions was 100%. The sensitivity of CT and MRI in the diagnosis of hand tendon injury was 94.7% and 90.7%, the specificity was 99.3% and 98.6%, and the coincidence rate was 97.7% and 96.3%. Conclusions: CT images are accurate in localization and characterization of tendon injury, with high sensitivity and specificity, and can provide accurate anatomical basis for surgery. Level of evidence II; Therapeutic studies - investigation of treatment results.

scholarly journals Introducing teledermoscopy of possible skin cancers in general practice in Southern Denmark

2020 ◽  
Vol 37 (4) ◽  
pp. 513-518
Author(s):  
Tine Vestergaard ◽  
Sumangali C Prasad ◽  
Annette Schuster ◽  
Rasa Laurinaviciene ◽  
Anette Bygum ◽  
...  
Keyword(s):  
General Practice ◽  
Diagnostic Accuracy ◽  
Health Care Systems ◽  
Final Diagnosis ◽  
Skin Lesions ◽  
University Hospital ◽  
Predictive Values ◽  
Face To Face ◽  
Skin Cancers ◽  
Care Systems

Abstract Background The increasing incidence of skin cancers poses a burden to health care systems. General practitioners (GPs) play an important role in triaging these diseases and referring relevant patients to specialists. It is challenging to distinguish benign from malignant skin lesions, and GPs may benefit from diagnostic support from teledermoscopy (TD). Objectives To assess whether the introduction of TD in general practice was feasible and might reduce the number of unnecessary referrals to specialists and to assess the diagnostic accuracy and confidence of participating GPs. Methods Fifty general practices in Southern Denmark participated. Adult patients presenting to their GP with suspected skin cancer could be included. Images including dermoscopy were taken by the GP and sent for evaluation by specialized dermatologists at a university hospital. Patients were simultaneously referred for a face-to-face evaluation at the university hospital. Diagnoses proposed by the GPs and by TD were compared to the final diagnoses obtained by histopathology or, if not available, face-to-face evaluation. Results Five hundred and nineteen patients with 600 suspected skin cancers were included. The final diagnosis was benign in 72.3%. The photo quality was good or fair in 90.5%. GPs reported uncertainty about their diagnoses in 41.5% of cases. The GPs’ positive predictive values for any malignancy and for malignant melanoma were 49.5% and 26.3%, respectively. On evaluation by TD, 31.5% of lesions did not need further in-person assessment. Conclusion Useful images of suspicious skin lesions were obtained from general practice, and GPs could benefit from TD to improve their diagnostic accuracy and confidence.

scholarly journals Profile of patients with Baggio-Yoshinari Syndrome admitted at "Instituto de Infectologia Emilio Ribas"

2010 ◽  
Vol 52 (6) ◽  
pp. 297-303 ◽  
Author(s):  
Emy Akiyama Gouveia ◽  
Mayra Fernanda Alves ◽  
Elenice Mantovani ◽  
Luiza Keiko Oyafuso ◽  
Virgínia Lucia Nazario Bonoldi ◽  
...  
Keyword(s):  
Skin Lesions ◽  
Disease Stage ◽  
Borrelia Burgdorferi Sensu Lato ◽  
Reference Laboratory ◽  
Positive Serology ◽  
High Frequencies ◽  
Medical Specialists ◽  
New Knowledge ◽  
Tick Borne Disease ◽  
Almost All

The aim of this study was to evaluate the epidemiological, clinical and laboratorial profile of patients with Baggio-Yoshinari Syndrome (BYS), who underwent internment at the Instituto de Infectologia Emilio Ribas in São Paulo, Brazil, during the period from July 1990 to July 2006. BYS is a new Brazilian tick-borne disease caused by Borrelia burgdorferi sensu lato microorganisms that resembles features of Lyme disease (LD), except for its epidemiological, clinical and laboratorial particularities. From 60 patients' records with positive serology to B. burgdorferi done by ELISA and Western-blotting methods, 19 cases were diagnosed as having BYS, according to criteria adopted at LIM-17 HCFMUSP, the Brazilian Reference Laboratory for the research of BYS. The other 41 remaining patients displayed miscellaneous infections or auto-immune processes. The beginning of symptoms in BYS group varied from one day to six years, from the onset of the disease. Four of 19 patients were included in acute disease stage, and 15 in latent. General unspecific symptoms were identified in almost all cases, with high frequencies of fever (78.9%) and lymphadenomegaly (36.8%). Six patients had skin lesions (31.5%); six arthralgia or arthritis (31.5%) and eight neurological symptoms (42%). Interestingly, two patients showed antibodies directed to B. burgdorferi exclusively in cerebrospinal fluid. Since BYS is a new emergent Brazilian zoonosis and its diagnosis is sometimes complex, all the new knowledge about BYS must be scattered to Brazilian Medical specialists, aiming to teach them how to diagnose this amazing tick-borne disease and to avoid its progression to chronic irreversible sequels

Distinctive Dermatoscopic Features of Acral Lentiginous Melanoma in Situ from Plantar Melanocytic Nevi and Their Histopathologic Correlation

1998 ◽  
Vol 2 (4) ◽  
pp. 199-204 ◽  
Author(s):  
Yasuhiro Kawabata ◽  
Kunihiko Tamaki
Keyword(s):  
Skin Lesions ◽  
Melanocytic Nevus ◽  
Entire Surface ◽  
Acral Lentiginous Melanoma ◽  
Melanocytic Nevi ◽  
Melanoma In Situ ◽  
Technical Advances ◽  
Surface Profiles ◽  
Histopathologic Findings

Background: An acral lentiginous melanoma in situ on the sole is often difficult to differentiate with the naked eye from an acquired plantar melanocytic nevus. Recent technical advances in epiluminescence microscopy have contributed to the differentiation of these two pigmented skin lesions. Objective: In this study, the correlation between dermatoscopic and histopathologic findings of acral lentiginous melanoma in situ on the sole are compared to those of acquired plantar melanocytic nevi. Methods: Three acral lentiginous melanomas in situ on the sole, and two cases of acral lentiginous melanoma were compared with 50 acquired plantar melanocytic nevi by means of dermatoscopy and histopathology. Results: The dermatoscopic surface profiles of acquired melanocytic nevi were composed of linear pigmentation accentuated mainly on the sulcus superficialis. Histologically, some areas of the sulcus superficialis corresponded to rete ridges of the epidermis, and nests of nevus cells were also often located there. In contrast, the acral lentiginous melanomas in situ showed diffuse, irregularly shaped pigmentation distributed in a disorderly fashion over the entire surface. Histologically, isolated areas of proliferation and small nest formations of atypical melanocytes were irregularly distributed in the epidermis. Conclusion: A distinctive dermatoscopic feature of acral lentiginous melanoma in situ is diffuse and irregular pigmentation over the entire surface of the lesion. This feature is helpful for differentiating acral lentiginous melanoma in situ from acquired plantar melanocytic nevi.

scholarly journals Implementing coordinated ambulatory cardiology care in southern Germany: a mixed-methods study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Patrick Hennrich ◽  
Regine Bölter ◽  
Michel Wensing
Keyword(s):  
Medical Care ◽  
General Practitioners ◽  
Contextual Factors ◽  
Control Mechanisms ◽  
Observation Study ◽  
Medical Specialists ◽  
Avoidable Hospitalizations ◽  
Medical Guideline ◽  
Access To Medical Care ◽  
Primary Care Practices

Abstract Background In 2009 health insurers AOK and Bosch BKK introduced the “FacharztProgramm Kardiologie” - a program for coordinated ambulatory cardiology care in the German state of Baden-Württemberg. It aims for efficient, medical guideline-oriented cardiology care to reduce avoidable hospitalizations as well as costs of care. A high number of cardiologists participate and the program has served as blueprint for programs in other medical fields. With many prerequisites and conditions involved, its implementation cannot be expected to be self-directed. Still, only little data on the actual implementation exists. We aimed to determine to what extent medical specialists and cooperating general practitioners implemented the program, which components they adapted, and which contextual factors they deemed relevant. Methods We collected data from primary care practices of medical specialists and general practitioners within Baden-Württemberg. Qualitative data was obtained through structured telephone interviews with participating and non-participating medical specialists as well as general practitioners cooperating with the program and general practitioners not cooperating. Interviews were analyzed through content-structuring qualitative content analyses via MAXQDA. Quantitative data was obtained using anonymous written questionnaires completed by participating and non-participating medical specialists as well as general practitioners cooperating with the program. Analyses were performed using SPSS Statistics, mainly with regard to differences within and between groups of physicians. Results Most components of the program regarding medical care were well implemented. However, access to medical care was not completely as intended due to high numbers of patients participating in the program and prioritization by physicians. Procedures for communication and cooperation between medical specialists and general practitioners were only partially adhered to and standardized communication was not implemented. A range of regional and practice-related contextual factors influenced implementation and outcomes. Conclusions Implementation of this program was mixed. Contextual factors posed individual challenges to participating physicians which can’t be captured by an encompassing program. Both control mechanisms and tailoring of the program to medical care seem needed. Trial registration Though not a clinical study, we deemed registration appropriate to ensure transparency. The study has been registered as a non-interventional observation study at the German Clinical Trials Register under ID: DRKS00013070.

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