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Influence of time on dermoscopic diagnosis and management
Author(s) -
Jaimes Natalia,
Dusza Stephen W.,
Quigley Elizabeth A.,
Braun Ralph P.,
Puig Susana,
Malvehy Josep,
Kittler Harald,
Rabinovitz Harold S.,
Oliviero Margaret C.,
Soyer H. Peter,
Grichnik James M.,
Korzenko Adam,
Cabo Horacio,
CarlosOrtega Blanca,
AhlgrimmSiess Verena,
Kopf Alfred W.,
Marghoob Ashfaq A.
Publication year - 2013
Publication title -
australasian journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.67
H-Index - 53
eISSN - 1440-0960
pISSN - 0004-8380
DOI - 10.1111/ajd.12001
Subject(s) - medicine , context (archaeology) , medical diagnosis , biopsy , lesion , dermatology , medical physics , radiology , surgery , paleontology , biology
Background/Objectives Dermoscopy aids in clinical decision‐making. However, time pressure is a common reason precluding its use. We evaluated the effect of time on lesion recognition and management decisions utilising clinical and dermoscopic images. Method In all, 100 dermoscopic images were presented to 15 dermatologists with experience in dermoscopy and seven non‐experts (dermatology residents). Each lesion was displayed thrice in succession. The dermoscopic image was initially presented for 1 s (t1). The same dermoscopic image was shown again without time constraints (t2) and then a final time with additional images of the clinical context (t3). Participants provided a diagnosis, their level of confidence and biopsy predilection after evaluating each image. Results For benign lesions, both groups rarely changed their diagnosis. However, an improvement in the number of correct benign diagnoses was observed when the lesion was shown in a clinical context. For malignant lesions, both groups improved when more time and clinical context was given; nevertheless, non‐experts were more likely to change the diagnosis towards the correct one as more time was given and tended to perform more biopsies, in particular of benign lesions. Limitations were a small number of participants and an artificial study setting. Conclusion Dermoscopy uses analytical and non‐analytical reasoning approaches. We suggest that non‐analytical reasoning is employed when rapid clinical decisions need to be made, especially during the evaluation of benign lesions. We conclude that dermoscopy is relatively rapid and non–time‐consuming technique that adds relevant information and guides clinicians towards appropriate management decisions.