Learning a novel technique to identify possible melanomas: are Australian general practitioners better than their U.K. colleagues?

Abstract

Background: Spectrophotometric intracutaneous analysis (SIAscopy) is a multispectral imaging technique that is used to identify 'suspicious' (i.e. potentially malignant) pigmented skin lesions for further investigation. The MoleMate system is a hand-held scanner that captures SIAscopy images that are then classified by the clinician using a computerized diagnostic algorithm designed for the primary health care setting. The objectives of this study were to test the effectiveness of a computer program designed to train health care workers to identify the diagnostic features of SIAscopy images and compare the results of a group of Australian and a group of English general practitioners (GPs).

Methods: Thirty GPs recruited from the Perth (Western Australia) metropolitan area completed the training program at a workshop held in March 2008. The accuracy and speed of their pre- and post-test scores were then compared with those of a group of 18 GPs (including 10 GP registrars) who completed a similar program at two workshops held in Cambridge (U.K.) in March and April, 2007.

Results: The median test score of the Australian GPs improved from 79.5% to 86.5% (median increase 5.5%; p < 0.001) while the median test score of the English GPs improved from 74.5% to 86.5% (median increase 9.5%; p < 0.001). The Australian GPs had significantly higher pre-test scores but there were no significant differences in post-test scores between the Australian and English GPs or between the GPs and GP registrars. There was no significant difference in scores between GPs with previous dermoscopy experience or dermatology training.

Conclusion: Most of the SIAscopy features can be learnt to a reasonable degree of accuracy with this brief computer training program. Although the Australian GPs scored higher in the pre-test, both groups had similar levels of accuracy and speed in interpreting the SIAscopy features after completing the program. Scores were not affected by previous dermoscopy experience or dermatology training, which suggests that the MoleMate system is relatively easy to learn.

Figure 1

Overview of MoleMate™ training program showing 'Views'.

Figure 2

Feedback section of MoleMate™ training program.

Figure 3

Pre-test vs Post-test scores by MoleMate™ feature: Perth vs Cambridge GPs.