Conflict of interest
To excise or not: impact of MelaFind on German dermatologists’ decisions to biopsy atypical lesions
Article first published online: 18 JUN 2014
© 2014 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.
JDDG: Journal der Deutschen Dermatologischen Gesellschaft
Volume 12, Issue 7, pages 606–614, July 2014
How to Cite
Hauschild, A., Chen, S. C., Weichenthal, M., Blum, A., King, H. C., Goldsmith, J., Scharfstein, D. and Gutkowicz-Krusin, D. (2014), To excise or not: impact of MelaFind on German dermatologists’ decisions to biopsy atypical lesions. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 12: 606–614. doi: 10.1111/ddg.12362
Axel Hauschild has consultancy contracts with MELA Sciences, Inc. (USA) and SciBase (Schweden).
- Issue published online: 1 JUL 2014
- Article first published online: 18 JUN 2014
- Manuscript Accepted: 17 MAR 2014
- Manuscript Received: 6 JAN 2014
To determine the biopsy sensitivity to melanoma of dermatologists in Germany and the impact of MelaFind® on their decisions to biopsy melanomas.
Randomized two-armed online reader study presenting case information, clinical/dermatoscopic images of pigmented skin lesions and MelaFind results (Arm 2).
Each participant was asked to review 130 pigmented skin lesions. Biopsy decisions of dermatologists without MelaFind versus MelaFind and dermatologists without MelaFind versus dermatologists with MelaFind were compared.
Dermatologists without MelaFind had average sensitivity to melanoma of 69.5 % and average specificity of 55.9 %. MelaFind had greater sensitivity than dermatologists alone (96.9 % vs. 69.5 %, one-sided p < 0.00001) and lower specificity (9.2 % vs. 55.9 %, one-sided p < 0.00001). Dermatologists with MelaFind had higher sensitivity than those without MelaFind (78 % vs. 69.5 %, one-sided p < 0.00001) and a lower specificity (45.8 % vs. 55.9 %, one-sided p < 0.00001). The number of dermatologists detecting over 90 % of melanomas increased from 3 of 101 without MelaFind to 22 of 101 with MelaFind (p = 0.00006) while specificity remained relatively equivalent (23 % vs. 21 %, p = 0.99).
The MelaFind information, when incorporated into the final biopsy decision, can improve biopsy sensitivity with modest effect on biopsy specificity.