Improving Skin Cancer Diagnostics Through a Mobile App With a Large Interactive Image Repository: Randomized Controlled Trial
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Improving Skin Cancer Diagnostics Through a Mobile App With a Large Interactive Image Repository : Randomized Controlled Trial. / Nervil, Gustav Gede; Ternov, Niels Kvorning; Vestergaard, Tine; Sølvsten, Henrik; Chakera, Annette Hougaard; Tolsgaard, Martin Grønnebæk; Hölmich, Lisbet Rosenkrantz.
I: JMIR Dermatology, Bind 6, e48357, 2023.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Improving Skin Cancer Diagnostics Through a Mobile App With a Large Interactive Image Repository
T2 - Randomized Controlled Trial
AU - Nervil, Gustav Gede
AU - Ternov, Niels Kvorning
AU - Vestergaard, Tine
AU - Sølvsten, Henrik
AU - Chakera, Annette Hougaard
AU - Tolsgaard, Martin Grønnebæk
AU - Hölmich, Lisbet Rosenkrantz
N1 - Publisher Copyright: ©Gustav Gede Nervil, Niels Kvorning Ternov, Tine Vestergaard, Henrik Sølvsten, Annette Hougaard Chakera, Martin Grønnebæk Tolsgaard, Lisbet Rosenkrantz Hölmich.
PY - 2023
Y1 - 2023
N2 - Background: Skin cancer diagnostics is challenging, and mastery requires extended periods of dedicated practice. Objective: The aim of the study was to determine if self-paced pattern recognition training in skin cancer diagnostics with clinical and dermoscopic images of skin lesions using a large-scale interactive image repository (LIIR) with patient cases improves primary care physicians’ (PCPs’) diagnostic skills and confidence. Methods: A total of 115 PCPs were randomized (allocation ratio 3:1) to receive or not receive self-paced pattern recognition training in skin cancer diagnostics using an LIIR with patient cases through a quiz-based smartphone app during an 8-day period. The participants’ ability to diagnose skin cancer was evaluated using a 12-item multiple-choice questionnaire prior to and 8 days after the educational intervention period. Their thoughts on the use of dermoscopy were assessed using a study-specific questionnaire. A learning curve was calculated through the analysis of data from the mobile app. Results: On average, participants in the intervention group spent 2 hours 26 minutes quizzing digital patient cases and 41 minutes reading the educational material. They had an average preintervention multiple choice questionnaire score of 52.0% of correct answers, which increased to 66.4% on the postintervention test; a statistically significant improvement of 14.3 percentage points (P<.001; 95% CI 9.8-18.9) with intention-to-treat analysis. Analysis of participants who received the intervention as per protocol (500 patient cases in 8 days) showed an average increase of 16.7 percentage points (P<.001; 95% CI 11.3-22.0) from 53.9% to 70.5%. Their overall ability to correctly recognize malignant lesions in the LIIR patient cases improved over the intervention period by 6.6 percentage points from 67.1% (95% CI 65.2-69.3) to 73.7% (95% CI 72.5-75.0) and their ability to set the correct diagnosis improved by 10.5 percentage points from 42.5% (95% CI 40.2%-44.8%) to 53.0% (95% CI 51.3-54.9). The diagnostic confidence of participants in the intervention group increased on a scale from 1 to 4 by 32.9% from 1.6 to 2.1 (P<.001). Participants in the control group did not increase their postintervention score or their diagnostic confidence during the same period. Conclusions: Self-paced pattern recognition training in skin cancer diagnostics through the use of a digital LIIR with patient cases delivered by a quiz-based mobile app improves the diagnostic accuracy of PCPs.
AB - Background: Skin cancer diagnostics is challenging, and mastery requires extended periods of dedicated practice. Objective: The aim of the study was to determine if self-paced pattern recognition training in skin cancer diagnostics with clinical and dermoscopic images of skin lesions using a large-scale interactive image repository (LIIR) with patient cases improves primary care physicians’ (PCPs’) diagnostic skills and confidence. Methods: A total of 115 PCPs were randomized (allocation ratio 3:1) to receive or not receive self-paced pattern recognition training in skin cancer diagnostics using an LIIR with patient cases through a quiz-based smartphone app during an 8-day period. The participants’ ability to diagnose skin cancer was evaluated using a 12-item multiple-choice questionnaire prior to and 8 days after the educational intervention period. Their thoughts on the use of dermoscopy were assessed using a study-specific questionnaire. A learning curve was calculated through the analysis of data from the mobile app. Results: On average, participants in the intervention group spent 2 hours 26 minutes quizzing digital patient cases and 41 minutes reading the educational material. They had an average preintervention multiple choice questionnaire score of 52.0% of correct answers, which increased to 66.4% on the postintervention test; a statistically significant improvement of 14.3 percentage points (P<.001; 95% CI 9.8-18.9) with intention-to-treat analysis. Analysis of participants who received the intervention as per protocol (500 patient cases in 8 days) showed an average increase of 16.7 percentage points (P<.001; 95% CI 11.3-22.0) from 53.9% to 70.5%. Their overall ability to correctly recognize malignant lesions in the LIIR patient cases improved over the intervention period by 6.6 percentage points from 67.1% (95% CI 65.2-69.3) to 73.7% (95% CI 72.5-75.0) and their ability to set the correct diagnosis improved by 10.5 percentage points from 42.5% (95% CI 40.2%-44.8%) to 53.0% (95% CI 51.3-54.9). The diagnostic confidence of participants in the intervention group increased on a scale from 1 to 4 by 32.9% from 1.6 to 2.1 (P<.001). Participants in the control group did not increase their postintervention score or their diagnostic confidence during the same period. Conclusions: Self-paced pattern recognition training in skin cancer diagnostics through the use of a digital LIIR with patient cases delivered by a quiz-based mobile app improves the diagnostic accuracy of PCPs.
KW - benign skin tumors
KW - dermoscopy
KW - diagnostic test
KW - digital learning
KW - eLearning
KW - medical education
KW - melanoma
KW - mHealth
KW - mobile app
KW - nevi
KW - recognition training
KW - skin cancer
KW - skin lesions
KW - skin neoplasms
U2 - 10.2196/48357
DO - 10.2196/48357
M3 - Journal article
C2 - 37624707
AN - SCOPUS:85169008263
VL - 6
JO - JMIR Dermatology
JF - JMIR Dermatology
SN - 2562-0959
M1 - e48357
ER -
ID: 387737854