TY  - JOUR
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
PY  - 2023
DA  - 2023/8/9
TI  - Improving Skin Cancer Diagnostics Through a Mobile App With a Large Interactive Image Repository: Randomized Controlled Trial
JO  - JMIR Dermatol
SP  - e48357
VL  - 6
KW  - dermoscopy
KW  - nevi
KW  - skin neoplasms
KW  - benign skin tumors
KW  - melanoma
KW  - skin cancer
KW  - medical education
KW  - eLearning
KW  - digital learning
KW  - diagnostic test
KW  - mHealth
KW  - mobile app
KW  - recognition training
KW  - skin lesions
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. Trial Registration: ClinicalTrials.gov NCT05661370; https://classic.clinicaltrials.gov/ct2/show/NCT05661370 
SN  - 2562-0959
UR  - https://derma.jmir.org/2023/1/e48357
UR  - https://doi.org/10.2196/48357
UR  - http://www.ncbi.nlm.nih.gov/pubmed/37624707
DO  - 10.2196/48357
ID  - info:doi/10.2196/48357
ER  -