Diagnostic inaccuracy of smartphone applications for melanoma detection
- PMID: 23325302
- PMCID: PMC4019431
- DOI: 10.1001/jamadermatol.2013.2382
Diagnostic inaccuracy of smartphone applications for melanoma detection
Abstract
Objective: To measure the performance of smartphone applications that evaluate photographs of skin lesions and provide the user with feedback about the likelihood of malignancy.
Design: Case-control diagnostic accuracy study.
Setting: Academic dermatology department. PARTICIPANTS AND MATERIALS: Digital clinical images of pigmented cutaneous lesions (60 melanoma and 128 benign control lesions) with a histologic diagnosis rendered by a board-certified dermatopathologist, obtained before biopsy from patients undergoing lesion removal as a part of routine care.
Main outcome measures: Sensitivity, specificity, and positive and negative predictive values of 4 smartphone applications designed to aid nonclinician users in determining whether their skin lesion is benign or malignant.
Results: Sensitivity of the 4 tested applications ranged from 6.8% to 98.1%; specificity, 30.4% to 93.7%; positive predictive value, 33.3% to 42.1%; and negative predictive value, 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; the lowest, for applications that use automated algorithms to analyze images.
Conclusions: The performance of smartphone applications in assessing melanoma risk is highly variable, and 3 of 4 smartphone 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 can delay the diagnosis of melanoma and harm users.
Comment in
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Diagnostic inaccuracy of smartphone applications for melanoma detection: representative lesion sets and the role for adjunctive technologies.JAMA Dermatol. 2013 Jul;149(7):884. doi: 10.1001/jamadermatol.2013.4334. JAMA Dermatol. 2013. PMID: 23864094 No abstract available.
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Diagnostic inaccuracy of smartphone applications for melanoma detection--reply.JAMA Dermatol. 2013 Jul;149(7):885. doi: 10.1001/jamadermatol.2013.4337. JAMA Dermatol. 2013. PMID: 23864095 No abstract available.
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References
-
- Brady MS, Oliveria SA, Christos PJ, et al. Patterns of detection in patients with cutaneous melanoma. Cancer. 2000 Jul 15;89(2):342–347. - PubMed
-
- Epstein DS, Lange JR, Gruber SB, Mofid M, Koch SE. Is physician detection associated with thinner melanomas? JAMA. 1999 Feb 17;281(7):640–643. - PubMed
-
- Kantor J, Kantor DE. Routine dermatologist-performed full-body skin examination and early melanoma detection. Arch Dermatol. 2009 Aug;145(8):873–876. - PubMed
-
- McGuire ST, Secrest AM, Andrulonis R, Ferris LK. Surveillance of patients for early detection of melanoma: patterns in dermatologist vs patient discovery. Arch Dermatol. Jun;147(6):673–678. - PubMed
-
- Morris DP. Health-care apps for smartphones pit FDA against tech industry. The Washington Post. 2012 Jun 22;
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