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Clinical Trial
. 2007 Oct 11:2007:191-5.

Applying a decision support system in clinical practice: results from melanoma diagnosis

Stephan Dreiseitl  1 , Michael Binder, Staal Vinterbo, Harald Kittler
Affiliations
Clinical Trial

Applying a decision support system in clinical practice: results from melanoma diagnosis

Stephan Dreiseitl et al. AMIA Annu Symp Proc. .

Abstract

The work reported in this paper investigates the use of a decision-support tool for the diagnosis of pigmented skin lesions in a real-world clinical trial with 511 patients and 3827 lesion evaluations. We analyzed a number of outcomes of the trial, such as direct comparison of system performance in laboratory and clinical setting, the performance of physicians using the system compared to a control dermatologist without the system, and repeatability of system recommendations. The results show that system performance was significantly less in the real-world setting compared to the laboratory setting (c-index of 0.87 vs. 0.94, p = 0.01). Dermatologists using the system achieved a combined sensitivity of 85% and combined specificity of 95%. We also show that the process of acquiring lesion images using digital dermoscopy devices needs to be standardized before sufficiently high repeatability of measurements can be assured.

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Figures

Figure 1
Figure 1
Scatterplot of the decision-support system output for two examinations of the same lesion, for a total of 768 lesions.
See this image and copyright information in PMC

References

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