Relevant studies were identified and retrieved by a search of MEDLINE for the period January 1987 to December 2000, by manual searches of the reference lists of retrieved articles, and by direct communication with experts on this topic. The terms “epiluminescence”, “dermoscopy”, “dermatoscopy”, and “incident light microscopy” were linked with a Boolean OR operator and the search yielded 157 articles. 116 articles were excluded at this stage: those that were not relevant to the topic, did
ReviewDiagnostic accuracy of dermoscopy
Section snippets
Methods
Eligible studies (see Search strategy and selection criteria) were classified, with no masking, by two readers in consensus on prospectively defined characteristics important for assessment of diagnostic tests. The following information was extracted from each report: authors' names; year of publication; description of pigmented skin lesions (melanoma prevalence, melanoma invasion thickness, frequency of non-melanocytic lesions); experience of examiners; independence of clinical and
Statistical analysis
Sensitivity and specificity were calculated according to standard formulae. When individual assessments from several observers were given in a study, the median values of the sensitivity and specificity were used in our analysis. Least-squares linear regression was used to estimate parameters for summary receiver-operating-characteristic (SROC) models. Estimates of sensitivity and specificity were obtained from each study and used to calculate their log odds ratio (logit), which measures how
Study characteristics
The main characteristics of each of the 27 eligible studies4, 5, 6, 10, 11, 12, 13, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36 are presented in Table 1. The pooled sample was 9821 pigmented skin lesions (median per study 232). The prevalence of melanoma ranged from 1·6% to 60·8% (mean 28·3%). The mean or median Breslow thickness was reported in 15 studies and ranged from 0·40 mm to 1·11 mm (median 0·70 mm).
In most of the available studies, all lesions were
Discussion
This meta-analysis of 27 studies provides evidence that dermoscopy gives better diagnostic accuracy for melanoma than clinical inspection without dermatoscopy (ie with the unaided eye). This conclusion accords with that of a previous review, which included six studies,37 and another meta-analysis, which included eight studies.38 The review did not provide a quantitative analysis and the other metaanalysis was restricted to studies that directly compared the diagnostic performance with and
Conclusion
Dermoscopy improves the diagnostic accuracy for melanoma in comparison with inspection by the unaided eye. However, dermoscopy requires sufficient training and cannot be recommended for untrained users. A consensus diagnosis involving two or more experts is recommended to yield the highest possible diagnostic accuracy.
Search strategy and selection criteria
References (41)
- et al.
Dermoscopy of pigmented skin lesions: a valuable tool for early diagnosis of melanoma
Lancet Oncol
(2001) - et al.
Reevaluation of the ABCD rule for epiluminescence microscopy
J Am Acad Dermatol
(1999) - et al.
Epiluminescence microscopy of small pigmented skin lesions: short-term formal training improves the diagnostic performance of dermatologists
J Am Acad Dermatol
(1997) - et al.
In vivo epiluminescence microscopy of pigmented skin lesions: I, pattern analysis of pigmented skin lesions
J Am Acad Dermatol
(1987) - et al.
The ABCD rule of dermatoscopy: high prospective value in the diagnosis of doubtful melanocytic skin lesions
J Am Acad Dermatol
(1994) - et al.
Morphologic changes of pigmented skin lesions: a useful extension of the ABCD rule for dermatoscopy
J Am Acad Dermatol
(1999) - et al.
Digital videomicroscopy improves diagnostic accuracy for melanoma
J Am Acad Dermatol
(1998) - et al.
In vivo epiluminescence microscopy of pigmented skin lesions: II, diagnosis of small pigmented skin lesions and early detection of malignant melanoma
J Am Acad Dermatol
(1987) - et al.
Teledermatoscopy in Switzerland: a preliminary evaluation
J Am Acad Dermatol
(2000) - et al.
Accuracy in the clinical diagnosis of malignant melanoma
Arch Dermatol
(1990)
In vivo epiluminescence microscopy: improvement of early diagnosis of melanoma
J Invest Dermatol
Epiluminescence microscopy: a useful tool for the diagnosis of pigmented skin lesions for formally trained dermatologists
Arch Dermatol
Estimating diagnostic accuracy from multiple conflicting reports: a new meta-analytic method
Med Decis Making
Combining independent studies of a diagnostic test into a summary ROC curve: data- analytic approaches and some additional considerations
Stat Med
ABCD rule of dermatoscopy: a new practical method for early recognition of melanoma
Eur J Dermatol
Epiluminescence microscopy for the diagnosis of doubtful melanocytic skin lesions: comparison of the ABCD rule of dermatoscopy and a new 7-point checklist based on pattern analysis
Arch Dermatol
Frequency and morphologic characteristics of invasive melanomas lacking specific surface microscopic features
Arch Dermatol
The morphologic criteria of the pseudopod in surface microscopy
Arch Dermatol
Reducing mortality and morbidity of cutaneous melanoma: a six year plan. B) Identifying high and low risk pigmented lesions using epiluminescence microscopy
J Dermatol
Reproducibility of a dermoscopic method (7FFM) for the diagnosis of malignant melanoma
Eur J Dermatol
Cited by (1058)
A novel Deeplabv3+ and vision-based transformer model for segmentation and classification of skin lesions
2024, Biomedical Signal Processing and ControlExpert Agreement on the Presence and Spatial Localization of Melanocytic Features in Dermoscopy
2024, Journal of Investigative DermatologyArtificial Intelligence in Skin Cancer Diagnosis: A Reality Check
2024, Journal of Investigative DermatologyEnhancing skin lesion classification with advanced deep learning ensemble models: a path towards accurate medical diagnostics
2024, Current Problems in Cancer4D spectral-spatial computational photoacoustic dermoscopy
2023, Photoacoustics