Diagnostic inaccuracy of smartphone applications for melanoma detection.
Diagnostic inaccuracy of smartphone applications for melanoma detection.
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DOI：
10.1001/jamadermatol.2013.2382
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发表时间：
2013-04
期刊：
影响因子：
10.9
通讯作者：
Ferris, Laura K.
中科院分区：
文献类型：
--
作者：
Wolf, Joel A.;Moreau, Jacqueline F.;Akilov, Oleg;Patton, Timothy;English, Joseph C., III;Ho, Jonhan;Ferris, Laura K.
测量智能手机应用程序的性能，这些应用程序可以评估皮肤病变的照片，并向用户提供有关其恶性肿瘤可能性的反馈。病例-对照诊断准确性研究学术皮肤学部门色素皮肤病变的数字临床图像（60例黑色素瘤病例和128例良性病变对照），所有患者的组织学诊断均由委员会认证的皮肤病理学家提供，在接受病变切除作为常规护理的一部分的患者活检之前获得。四种智能手机应用程序的敏感性、特异性和阳性和阴性预测值，旨在帮助非临床医生用户确定他们的皮肤病变是良性还是恶性。四种测试应用的灵敏度从6.8%到98.1%不等。特异性从30.4%到93.7%不等。阳性预测值为33.3% ~ 42.1%，阴性预测值为65.4% ~ 97.0%。对黑色素瘤诊断的敏感度最高的应用程序是直接将图像发送给委员会认证的皮肤科医生进行分析，而对使用自动算法分析图像的应用程序的敏感度最低。智能手机应用程序在评估黑色素瘤风险方面的表现变化很大，四分之三的智能手机应用程序错误地将30%或更多的黑色素瘤分类为无关紧要。依赖这些不受监管监督的应用程序来代替医疗咨询，有可能延迟黑色素瘤的诊断并伤害用户。
To measure the performance of smart phone applications which evaluate photographs of skin lesions and provide the user feedback as to their likelihood of malignancy. Case-control diagnostic accuracy study Academic dermatology department Digital clinical images of pigmented cutaneous lesions (60 melanoma cases and 128 benign lesion controls), all with histologic diagnosis rendered by a board-certified dermatopathologist, obtained prior to biopsy in patients undergoing lesion removal as part of routine care. Sensitivity, specificity, and positive and negative predictive values of four smart phone applications designed to aid non-clinician users in determining if their skin lesion is benign or malignant. Sensitivity of the four tested applications ranged from 6.8% to 98.1%. Specificity ranged from 30.4% to 93.7%. Positive predictive value ranged from 33.3% to 42.1%, and negative predictive value ranged from 65.4% to 97.0%. The highest sensitivity for melanoma diagnosis was observed for an application that sends the image directly to a board-certified dermatologist for analysis and the lowest sensitivity was observed for applications that use automated algorithms to analyze images. The performance of smart phone applications in assessing melanoma risk is highly variable, and 3 out of 4 smart phone applications incorrectly classified 30% or more of melanomas as unconcerning. Reliance on these applications, which are not subject to regulatory oversight, in lieu of medical consultation, has the potential to delay the diagnosis of melanoma and to harm users.
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