Comparing Improvements in Biopsy Decision Making with Electrical Impedance Spectroscopy Between US and German Dermatologists

Electrical impedance spectroscopy (EIS) is a noninvasive tool that measures the electrophysical properties of pigmented lesions, generating a score to aid in the differentiation of benign and malignant lesions. This research letter compares two studies, conducted in the United States (US) and Germany, evaluating the impact of EIS on biopsy decision-making among dermatologists. Both studies used the same set of clinical and dermoscopic images along with EIS scores for 49 lesions. Findings revealed that American dermatologists had a higher rate of correct biopsy decisions for malignant melanomas (MMs) and severe dysplastic nevi (SDNs) compared to their German counterparts. However, German dermatologists showed greater accuracy in avoiding unnecessary biopsies of benign pigmented skin lesions (PSLs). The addition of both dermoscopy and EIS significantly improved biopsy decision accuracy for MMs and SDNs in both groups, with EIS further mitigating initial reductions in correct biopsy choices for benign lesions. Differences in practice patterns, training, and malpractice concerns may explain the observed variations between US and German dermatologists. These results underscore the utility of EIS as a complementary tool to dermoscopy, enhancing the accuracy of biopsy decisions and improving patient outcomes.