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Research ArticleOriginal Research

Teaching Benign Skin Lesions as a Strategy to Improve the Triage Amalgamated Dermoscopic Algorithm (TADA)

Elizabeth V. Seiverling, Hadjh T. Ahrns, Amrit Greene, Melissa Butt, Oriol Yélamos, Stephen W. Dusza and Ashfaq A. Marghoob
The Journal of the American Board of Family Medicine January 2019, 32 (1) 96-102; DOI: https://doi.org/10.3122/jabfm.2019.01.180049
Elizabeth V. Seiverling
From Maine Medical Center, Division of Dermatology, Portland, ME (EVS); Department of Family & Community Medicine (HTA) and Department of Dermatology (AG, MB), Penn State Milton S. Hershey Medical Center, Hershey, PA; Dermatology Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain (OY); Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY (OY, SWD, AAM).
MD
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Hadjh T. Ahrns
From Maine Medical Center, Division of Dermatology, Portland, ME (EVS); Department of Family & Community Medicine (HTA) and Department of Dermatology (AG, MB), Penn State Milton S. Hershey Medical Center, Hershey, PA; Dermatology Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain (OY); Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY (OY, SWD, AAM).
MD
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Amrit Greene
From Maine Medical Center, Division of Dermatology, Portland, ME (EVS); Department of Family & Community Medicine (HTA) and Department of Dermatology (AG, MB), Penn State Milton S. Hershey Medical Center, Hershey, PA; Dermatology Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain (OY); Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY (OY, SWD, AAM).
MD
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Melissa Butt
From Maine Medical Center, Division of Dermatology, Portland, ME (EVS); Department of Family & Community Medicine (HTA) and Department of Dermatology (AG, MB), Penn State Milton S. Hershey Medical Center, Hershey, PA; Dermatology Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain (OY); Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY (OY, SWD, AAM).
MPH
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Oriol Yélamos
From Maine Medical Center, Division of Dermatology, Portland, ME (EVS); Department of Family & Community Medicine (HTA) and Department of Dermatology (AG, MB), Penn State Milton S. Hershey Medical Center, Hershey, PA; Dermatology Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain (OY); Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY (OY, SWD, AAM).
MD
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Stephen W. Dusza
From Maine Medical Center, Division of Dermatology, Portland, ME (EVS); Department of Family & Community Medicine (HTA) and Department of Dermatology (AG, MB), Penn State Milton S. Hershey Medical Center, Hershey, PA; Dermatology Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain (OY); Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY (OY, SWD, AAM).
DrPH
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Ashfaq A. Marghoob
From Maine Medical Center, Division of Dermatology, Portland, ME (EVS); Department of Family & Community Medicine (HTA) and Department of Dermatology (AG, MB), Penn State Milton S. Hershey Medical Center, Hershey, PA; Dermatology Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain (OY); Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY (OY, SWD, AAM).
MD
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Figures

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    Figure 1.

    Study design. Three arms, each with a different educational modality for benign growths, namely dermatofibroma (DF), angioma, and seborrheic keratosis (SK).

  • Figure 2.
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    Figure 2.

    Common benign skin growths.

  • Figure 3.
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    Figure 3.

    Dermoscopic findings in malignant skin growths by using the Triage Amalgamated Dermoscopic Algorithm TADA.

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    Figure 4.

    Boxplot of preintervention and postintervention scores.

  • Figure 5.
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    Figure 5.

    Sensitivity preintervention and postintervention for common benign skin growths and skin cancer. DF, dermatofibroma; SK, seborrheic keratosis.

Tables

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    Table 1.

    Population Characteristics

    VariableCodingHershey Medical Center (didactic + interactive), N (%)Mt. Nittany Medical Center (didactic + heuristic), N (%)St. Joseph's Medical Center (didactic), N (%)
    Number of participants37 (100)15 (100)7 (100)
    SexMale24 (64.9)8 (5.7)3 (42.9)
    Female13 (35.1)7 (5.2)4 (57.1)
    Age≤200 (0)0 (0)0 (0)
    21 to 304 (10.8)0 (0)0 (0)
    31 to 4013 (35.1)3 (21.4)2 (28.6)
    41 to 507 (18.9)4 (28.6)2 (28.6)
    51 to 606 (16.2)4 (28.6)1 (14.3)
    61 to 707 (18.9)3 (21.4)2 (28.6)
    71+0 (0)0 (0)0 (0)
    Practitioner typePhysician assistant2 (5.4)2 (13.3)0 (0)
    Nurse practitioner2 (5.4)4 (26.7)2 (28.6)
    MD/DO33 (89.2)9 (60.0)5 (71.4)
    Any formal training in dermoscopy?Yes11 (29.7)5 (33.3)0 (0)
    No26 (70.3)10 (66.7)7 (100.0)
    Do you have access to a dermatoscope?Yes29 (78.4)15 (100.0)5 (71.4)
    No8 (21.6)0 (0)2 (28.6)
    How many years have you been evaluating skin lesions?≤1018 (48.7)6 (40.0)1 (14.3)
    >1019 (51.3)9 (60.0)9 (60.0)
    • MD, medical doctor; DO, doctor of osteopathic medicine.

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The Journal of the American Board of Family   Medicine: 32 (1)
The Journal of the American Board of Family Medicine
Vol. 32, Issue 1
January-February 2019
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Teaching Benign Skin Lesions as a Strategy to Improve the Triage Amalgamated Dermoscopic Algorithm (TADA)
Elizabeth V. Seiverling, Hadjh T. Ahrns, Amrit Greene, Melissa Butt, Oriol Yélamos, Stephen W. Dusza, Ashfaq A. Marghoob
The Journal of the American Board of Family Medicine Jan 2019, 32 (1) 96-102; DOI: 10.3122/jabfm.2019.01.180049

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Teaching Benign Skin Lesions as a Strategy to Improve the Triage Amalgamated Dermoscopic Algorithm (TADA)
Elizabeth V. Seiverling, Hadjh T. Ahrns, Amrit Greene, Melissa Butt, Oriol Yélamos, Stephen W. Dusza, Ashfaq A. Marghoob
The Journal of the American Board of Family Medicine Jan 2019, 32 (1) 96-102; DOI: 10.3122/jabfm.2019.01.180049
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Keywords

  • Cross-Sectional Studies
  • Dermatofibroma
  • Dermoscopy
  • Family Physicians
  • Seborrheic Keratosis
  • Skin Cancer

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