PT  - JOURNAL ARTICLE
AU  - Elizabeth V. Seiverling
AU  - Hadjh T. Ahrns
AU  - Amrit Greene
AU  - Melissa Butt
AU  - Oriol Yélamos
AU  - Stephen W. Dusza
AU  - Ashfaq A. Marghoob
TI  - Teaching Benign Skin Lesions as a Strategy to Improve the Triage Amalgamated Dermoscopic Algorithm (TADA)
AID  - 10.3122/jabfm.2019.01.180049
DP  - 2019 Jan 01
TA  - The Journal of the American Board of Family
                Medicine
PG  - 96--102
VI  - 32
IP  - 1
4099  - http://www.jabfm.org/content/32/1/96.short
4100  - http://www.jabfm.org/content/32/1/96.full
SO  - J Am Board Fam Med2019 Jan 01; 32
AB  - Introduction: Dermoscopy aids family physicians (FPs) in skin cancer detection. The triage amalgamated dermoscopic algorithm (TADA) was created to simplify the dermoscopic evaluation of a skin growth. The purpose of this image-based study was to evaluate the effect of teaching the clinical and dermoscopic features of benign skin lesions on the diagnostic accuracy of skin cancer identification using TADA. We also sought to determine the best method to teach benign neoplasms.Methods: In this cross-sectional study of an educational intervention, FPs participated in dermoscopy training. Participants were divided into 3 groups for teaching of common benign neoplasms (dermatofibroma, angioma, and seborrheic keratosis/lentigo): didactic + interactive, didactic + heuristic, and didactic. For each group, the benign teaching was followed by skin cancer identification training with TADA. All participants took a 30 image pre-test and 30 image post-test.Results: Fifty-nine participants completed the study. The mean preintervention score (out of 30 correct responses) was 17.9 (SD, 4.5) and increased to 23.5 (SD, 3.0) on the postintervention evaluation (P < .001). Sensitivity for skin cancer increased from 62.5% to 88.1% following the intervention. Postintervention specificity for skin cancer was 87.8%. Sensitivity and specificity increased following the intervention for all 3 types of benign neoplasms. Diagnostic accuracy was not impacted by the method of benign teaching.Conclusion: Short dermoscopy training sessions with dedicated time for benign growths followed by TADA training for malignant growths are an effective means of teaching FPs dermoscopy and result in a high sensitivity and specificity for the identification of benign and malignant skin neoplasms.