A worthwhile tool in evaluating worrisome lesions

Shayan Owji, Chibuzo Aguwa, Joseph Han, Daniel Yassky, Yen Luu, Margaret Glausser, Nicholas Gulati, Benjamin Ungar, Daniel Napolitano, Jonathan Ungar

Research output: Contribution to journalArticlepeer-review

Abstract

► Background: We sought to examine whether electrical impedance spectroscopy (EIS), a diagnostic tool approved by the US Food and Drug Administration for the evaluation of pigmented skin lesions (PSLs), is beneficial to primary care providers (PCPs) by comparing the accuracy of PCPs’ management decisions for PSLs based on visual examination alone with those based on concurrent visual and EIS evaluation. ► Methods: Physicians and nurse practitioners (NPs) participated in an anonymous online survey in which they viewed clinical images of PSLs and were asked to make 2 clinical decisions before and after being provided an EIS score that indicated the likelihood that the lesion was a melanoma. They were asked (1) if they would biopsy the lesion/refer the patient out and (2) what they expected the pathology results would show. ► Results: Forty-four physicians and 17 NPs participated, making clinical decisions for 1354 presented lesions. Overall, with the addition of EIS to visual inspection of clinical images, the sensitivity of biopsy/referral decisions for melanomas and severely dysplastic nevi (SDN) increased from 69.2% to 90.0% (P < .001), while specificity increased from 44.0% to 72.6% (P < .001). Physicians and NPs, regardless of years of experience, each saw significant improvements in sensitivity, specificity, and diagnostic accuracy with the addition of EIS scores. ► Conclusions: The incorporation of EIS data into clinical decision-making by PCPs significantly increased the sensitivity and specificity of biopsy/referral decisions for melanomas and SDN and overall diagnostic accuracy compared with visual inspection alone. The results of this study suggest that diagnostic accuracy for PSLs by PCPs may be improved with adjunctive use of EIS with visual inspection.

Original languageEnglish
Pages (from-to)E1-E6
JournalJournal of Family Practice
Volume72
Issue number7
DOIs
StatePublished - 2023

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