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A Systematic Review of Training to Improve Melanoma Diagnostic Skills in General Practitioners

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Abstract

Australia has the highest incidence of melanoma in the world. General practitioners encounter melanoma in 9.9 per 10,000 clinical encounters and play a key role in diagnosis. A systematic review was conducted to study the efficacy of training methods to improve general practitioners’ diagnostic skills in melanoma. Article abstracts (1307) were screened, from a Medline search. Four trials met our criteria and were highly variable in their intervention methods and outcome measures. The Cochrane risk of bias tool was used to assess study quality with only one good, one poor, and two of questionable quality. Our results showed limited evidence via one study that training of general practitioners in surface microscopy improved melanoma diagnosis, from a clinical (naked eye) pre-intervention score of 54.6 % to a post-intervention surface microscopy score of 75.9 % in 74 general practitioners. Future work should explore the barriers to implementing this strategy in clinical practice.

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References

  1. Britt H, Miller GC (eds) (2009) General practice in Australia, health priorities and policy 1998 to 2008. AIHW, Canberra

  2. Bafounta ML, Beauchet A, Aegerter P, Saiag P (2001) Is dermoscopy (epiluminescence microscopy) useful for the diagnosis of melanoma? Results of a meta-analysis using techniques adapted to the evaluation of diagnostic tests. Arch Dermatol 137(10):1343–1350

    Article  CAS  PubMed  Google Scholar 

  3. AIHW (Australian Institute of Health and Welfare), AACR (Australasian Association of Registries) (2008) Cancer in Australia: an overview, 2008. AIHW, Canberra

  4. Australian Institute of Health and Welfare (AIHW), Australasian Association of Registries (AACR) (2004) Cancer in Australia 2001. AIHW, Canberra

  5. National Health and Hospitals Reform Commission (2009) A healthier future for all Australians – final report of the National Health and Hospitals Reform Commission – June 2009. Commonwealth of Australia, Australia

  6. Duckett SJ (2007) The Australian health care system, 3rd edn. Oxford University Press, South Melbourne, Victoria

    Google Scholar 

  7. English DR, Burton RC, del Mar CB, Donovan RJ, Ireland PD, Emery G (2003) Evaluation of aid to diagnosis of pigmented skin lesions in general practice: controlled trial randomised by practice. BMJ 327(7411):375. doi:10.1136/bmj.327.7411.375

    Article  PubMed  PubMed Central  Google Scholar 

  8. Gerbert B, Bronstone A, Wolff M, Maurer T, Berger T, Pantilat S, McPhee SJ (1998) Improving primary care residents’ proficiency in the diagnosis of skin cancer. J Gen Intern Med 13(2):91–97

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Girgis A, Sanson-Fisher RW (1996) Skin cancer prevention, early detection, and management: current beliefs and practices of Australian family physicians. Cancer Detect Prev 20(4):316–324

    CAS  PubMed  Google Scholar 

  10. Girgis A, Sanson-Fisher RW, Howe C, Raffan B (1995) A skin cancer training programme: evaluation of a postgraduate training for family doctors. Med Educ 29(5):364–371

    Article  CAS  PubMed  Google Scholar 

  11. Higgins JPT, Green S (eds) (2009). Cochrane handbook for systematic reviews of interventions. The Cochrane Collaboration, UK

  12. Kittler H, Pehamberger H, Wolff K, Binder M (2002) Diagnostic accuracy of dermoscopy. Lancet Oncol 3(3):159–165

    Article  CAS  PubMed  Google Scholar 

  13. Marks R (1996) Prevention and control of melanoma: the public health approach. CA Cancer J Clin 46(4):199–216

    Article  CAS  PubMed  Google Scholar 

  14. Australian Cancer Network Melanoma Guidelines Revision Working Party (2008) Clinical practice guidelines for the management of melanoma in Australia and New Zealand. Cancer Council Australia and Australian Cancer Network, Sydney and New Zealand Guidelines Group, Wellington

    Google Scholar 

  15. Royal Australian College of General Practitioners (2009) Guidelines for preventive activities in general practice (7th edition). The Royal Australian College of General Practitioners, Melbourne

  16. Tran H, Chen K, Lim AC, Jabbour J, Shumack S (2005) Assessing diagnostic skill in dermatology: a comparison between general practitioners and dermatologists. Australas J Dermatol 46(4):230–234. doi:10.1111/j.1440-0960.2005.00189.x

    Article  PubMed  Google Scholar 

  17. Vestergaard ME, Macaskill P, Holt PE, Menzies SW (2008) Dermoscopy compared with naked eye examination for the diagnosis of primary melanoma: a meta-analysis of studies performed in a clinical setting. Br J Dermatol 159(3):669–676. doi:10.1111/j.1365-2133.2008.08713.x

    CAS  PubMed  Google Scholar 

  18. Westerhoff K, McCarthy WH, Menzies SW (2000) Increase in the sensitivity for melanoma diagnosis by primary care physicians using skin surface microscopy. Br J Dermatol 143(5):1016–1020

    Article  CAS  PubMed  Google Scholar 

  19. Youl PH, Baade PD, Janda M, Del Mar CB, Whiteman DC, Aitken JF (2007) Diagnosing skin cancer in primary care: how do mainstream general practitioners compare with primary care skin cancer clinic doctors? Med J Aust 187(4):215–220

    PubMed  Google Scholar 

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Correspondence to Alvin Chia.

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Chia, A., Trevena, L. A Systematic Review of Training to Improve Melanoma Diagnostic Skills in General Practitioners. J Canc Educ 31, 730–735 (2016). https://doi.org/10.1007/s13187-015-0864-6

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  • DOI: https://doi.org/10.1007/s13187-015-0864-6

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