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The effect of a dermato‐oncological training programme on the diagnostic skills and quality of referrals for suspicious skin lesions by general practitioners *
Author(s) -
Marra E.,
van Rijsingen M.C.J.,
Alkemade J.A.C.,
Groenewoud J.M.M.,
Hueskes K.F.,
Nij Bijvank C.H.M.,
van de Laar F.A.,
Lubeek S.F.K.
Publication year - 2021
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.19214
Subject(s) - medicine , referral , cohort , incidence (geometry) , cohort study , emergency medicine , pediatrics , family medicine , physical therapy , physics , optics
Summary Background The rising incidence rates of skin cancer ( SC ) lead to an enormous burden on healthcare systems. General practitioners ( GP s) might play an important part in SC care, but research has shown poor clinical recognition of SC , leading to a high rate of potentially unnecessary referrals. Objectives The aim of this study was to evaluate if a dermato‐oncological training programme ( DOTP ) for GP s improved their diagnostic skills and quality of referrals. Methods Out of 194 GP s in the Nijmegen area, 83 (42·8%) followed a DOTP on SC . Referrals from both a trained cohort ( TC ) and two cohorts of untrained GP s [untrained present cohort ( UPC ) and untrained historical cohort ( UHC )] were included. Data on diagnostic skills, quality of referrals and the number of potentially unnecessary referrals were evaluated. Results A total number of 1662 referrals were analysed. The referral diagnosis was correct more often in the TC (70·3%) compared with the UPC (56·2%; P < 0·001) and the UHC (51·6%; P < 0·001). Furthermore, the TC also provided a better lesion description, mentioned a diagnosis more often in their referral letters and more often performed diagnostics before referral. In addition, fewer potentially unnecessary referrals were identified in the TC compared with the UPC (62·7% vs. 73·7%; P < 0·001) and the UHC (75·2%; P < 0·001). Conclusions GP s who followed a DOTP had better diagnostic skills and quality of referrals than untrained GP s, leading to fewer potentially unnecessary referrals. This might enhance a more efficient use of the limited capacity in secondary dermatological care and consequently lead to lower healthcare costs.