Integrating Electrical Impedance Spectroscopy into Clinical Decisions for Pigmented Skin Lesions Improves Diagnostic Accuracy: A Multitiered Study
Main Article Content
Keywords
Electrical Impedance Spectroscopy, Melanoma, Melanoma Diagnosis, Number-Needed-To-Biopsy
Abstract
Introduction: The number-needed-to-biopsy (NNB) metric measures the efficiency of a clinician’s ability to accurately diagnose and recommend pigmented skin lesions (PSLs) for biopsy for suspected melanomas. Electrical impedance spectroscopy (EIS) is a non-invasive technique that measures differences in resistance between healthy and cancerous skin cells, intended as an aid to enhance diagnostic accuracy.
Methods: Dermatology clinicians of three distinct groups (residents, physician assistants/nurse practitioners, and practicing dermatologists) were evaluated on their ability to accurately recommend suspect PSLs for biopsy before and after the integration of EIS data.
Results: All three groups had a reduction in NNB after the inclusion of EIS. Instances of missed biopsies for malignant melanoma were significantly reduced with simultaneous significant reductions in unnecessary biopsies for benign lesions. There was a material improvement of biopsy selection for PSLs having clinically challenging features. EIS also greatly improved the diagnostic acumen of clinicians whose assessments were less accurate than their peers prior to EIS incorporation.
Conclusions: The integration of EIS technology into the PSL biopsy decision was demonstrated to be effective in significantly enhancing clinician NNB and more accurate PSL biopsy selection.
References
2. U.S. Cancer Statistics Working Group. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Cancer Institute, Nov. 2018, www.cdc.gov/cancer/dataviz.
3. Guy GP Jr, Ekwueme DU, Tangka FK, Richardson LC. Melanoma treatment costs: a systematic review of the literature, 1990-2011. American Journal of Preventative Medicine. 2012;43(5):537-545. doi: 10.1016/j.amepre.2012.07.031.
4. Arnold JD, Yoon S, Kirkorian AY. The national burden of inpatient dermatology in adults. Journal of the American Academy of Dermatology. 2019;80(2):425-432.
5. Anderson AM, Matsumoto M, Saul MI, Secrest AM, Ferris LK. Accuracy of Skin Cancer Diagnosis by Physician Assistants Compared With Dermatologists in a Large Health Care System [published correction appears in JAMA Dermatol. 2018 Jun 1;154(6):739]. JAMA Dermatol. 2018;154(5):569‐573. doi:10.1001/jamadermatol.2018.0212
6. Krensel M, Schäfer I, Augustin M. Cost-of-illness of melanoma in Europe – a systematic review of the published literature. Journal of the European Academy of Dermatology and Venereology. 2019;33(3):504-510.
7. Privalle A, Havighurst T, Kim K, Bennett DD, Xu YG. Number of skin biopsies needed per malignancy: Comparing the use of skin biopsies among dermatologists and nondermatologist clinicians. Journal of the American Academy of Dermatology. 2020;81(1):110-116.
8. Malvehy J, Hauschild A, Curiel-Lewandrowski C, et al. Clinical performance of the Nevisense system in cutaneous melanoma detection: an international, multicentre, prospective and blinded clinical trial on efficacy and safety. The British Journal of Dermatology. 2014;171(5):1099-1107.
9. Rocha L, Menzies SW, Lo S, et al.Analysis of an electrical impedance spectroscopy system in short-term digital dermoscopy imaging of melanocytic lesions. The British Journal of Dermatology. 2017;177(5):1432-1438.
10. Ferris LK, Rigel DS, Siegel DM, Skelsey MK, et al. Impact on clinical practice of a non-invasive gene expression melanoma rule-out test: 12-month follow-up of negative test results and utility data from a large US registry study. Dermatology Online Journal. 2019;25(5). pii: 13030/qt61w6h7mn.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons Attribution (CC BY): lets others distribute and copy the article, to create extracts, abstracts, and other revised versions, adaptations or derivative works of or from an article (such as a translation), to include in a collective work (such as an anthology), to text or data mine the article, even for commercial purposes, as long as they credit the author(s), do not represent the author as endorsing their adaptation of the article, and do not modify the article in such a way as to damage the author's honor or reputation.
Authors retain copyright in their work and license the publisher to publish the content. The publisher is the National Society for Cutaneous Medicine, with production and publishing support provided by OJS, Open Journal Systems,see https://pkp.sfu.
Prior to January 2022, authors transferred copyright to the National Society for Cutaneous Medicine. However, all articles are freely available to anyone in the world. There are no subscription fees, page charges, or article processing charges.