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Practitioner Characteristics, Diagnostic Accuracy Metrics and Discovering-Individual With Respect to 637 Melanomas Documented by 27 General Practitioners on the Skin Cancer Audit Research Database Publisher Pubmed



Coetzerbotha M1 ; Jimenezbalcells C2, 3 ; Hay J4 ; Keir J1 ; Rosendahl N5 ; Wilson T6 ; Clark S5, 7 ; Baade A8 ; Becker C9, 10 ; Bookallil L11 ; Clifopoulos C1 ; Dicker T1 ; Denby MP12 ; Duthie D13 Show All Authors
Authors
  1. Coetzerbotha M1
  2. Jimenezbalcells C2, 3
  3. Hay J4
  4. Keir J1
  5. Rosendahl N5
  6. Wilson T6
  7. Clark S5, 7
  8. Baade A8
  9. Becker C9, 10
  10. Bookallil L11
  11. Clifopoulos C1
  12. Dicker T1
  13. Denby MP12
  14. Duthie D13
  15. Elliott C14
  16. Fishburn P1
  17. Foley M15
  18. Franck M16
  19. Giam I17
  20. Gordillo P18
  21. Lilleyman A19
  22. Macauley R20
  23. Maher J21
  24. Mcphee E22
  25. Reid M23
  26. Shirlaw B24
  27. Siggs G25
  28. Spark R26
  29. Stretch J27
  30. Van Den Heever K28
  31. Van Rensburg T29
  32. Watson C30
  33. Kittler H31
  34. Rosendahl C1, 7
Show Affiliations
Authors Affiliations
  1. 1. General Practice Clinical Unit, Medical School, The University of Queensland, St Lucia, QLD, Australia
  2. 2. 4D Skin Cancer Clinic, Belmont North, NSW, Australia
  3. 3. Universitat de Autonoma de Barcelona (UAB), Catalunya, Spain
  4. 4. Upper Hutt Skin Clinic, Upper Hutt, Wellington, New Zealand
  5. 5. Faculty of Medicine, The University of Queensland, St Lucia, QLD, Australia
  6. 6. SCARD, Eight Mile Plains, QLD, Australia
  7. 7. Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Gladstone GP Superclinic, Gladstone, QLD, Australia
  9. 9. Wairarapa Skin Clinic, Masterton, New Zealand
  10. 10. Wairarapa Hospital, Lansdowne, Masterton, New Zealand
  11. 11. The University of New England, Armidale, NSW, Australia
  12. 12. Silverdale Medical, Silverdale, Auckland, New Zealand
  13. 13. Darwin Skin Cancer Clinic, Parap, NT, Australia
  14. 14. Solarderm Skin Cancer Practice, Caboolture, QLD, Australia
  15. 15. The Skin Clinic, Marlborough, Blenheim, New Zealand
  16. 16. MoleSafe Skin Cancer Clinic, Windsor, VIC, Australia
  17. 17. Skin2 Clinic, Deakin, ACT, Australia
  18. 18. Cairns Skin Cancer Clinic, Cairns, QLD, Australia
  19. 19. Newcastle Skin Check, Charlestown, NSW, Australia
  20. 20. Bateau Bay Medical Centre, Bateau Bay, NSW, Australia
  21. 21. Skin Cancer Ballarat, Alfredton, VIC, Australia
  22. 22. Emerald Medical Group, Emerald, QLD, Australia
  23. 23. Nelson Bay Skin Cancer Clinic, Nelson Bay, NSW, Australia
  24. 24. Lakeside Medical, Springfield Lakes, QLD, Australia
  25. 25. Regency Medical Clinic, Sefton Park, SA, Australia
  26. 26. Toukley Family Practice, Toukley, NSW, Australia
  27. 27. Bond University, Robina, QLD, Australia
  28. 28. CQ Skin Cancer Clinic, Bucasia, QLD, Australia
  29. 29. Kippax Ochre Medical Centre, Holt, ACT, Australia
  30. 30. Brisbane City Doctors, Brisbane, QLD, Australia
  31. 31. Vienna Dermatologic Imaging Research Group, Department of Dermatology, Medical University of Vienna, Vienna, Austria

Source: Australasian Journal of Dermatology Published:2023


Abstract

Background and Objective: Knowledge of accuracy for melanoma diagnosis and melanoma discovering-individual in primary care is limited. We describe general practitioner (GP) characteristics and analyse defined diagnostic accuracy metrics for GPs in the current study comparing this with a previous study for GPs common to both, and we analyse the individual first discovering each melanoma as a lesion of concern. Methods: The characteristics and diagnostic accuracy of 27 Australasian GPs documenting 637 melanomas on the Skin Cancer Audit Research Database (SCARD) in 2013 were described and analysed. The number needed to treat (NNT) and percentage of melanomas that were in situ (percentage in situ) were analysed as surrogates for specificity and sensitivity, respectively. The discovering-individual was analysed according to patient age and sex and lesion Breslow thickness. Results: The average NNT and percentage in situ were 5.73% and 65.07%, respectively. For 21 GPs in both a 2008–2010 study and the current study, the NNT was 10.78 and 5.56, respectively (p = 0.0037). A consistent trend of decreasing NNT and increasing percentage in situ through increasingly subspecialised GP categories did not reach statistical significance. NNT trended high at ages and sites for which melanoma was rare. While the patient or family member was more likely to discover thick melanomas and melanomas in patients under 40 years, GPs discovered 73.9% of the melanomas as lesions of concern. Conclusions: GPs were the discovering-individuals for the majority of melanomas in the current study and their accuracy metrics compared favourably with published figures for dermatologists and GPs. © 2023 The Authors. Australasian Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Australasian College of Dermatologists.
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