Online training improves diagnosis of skin cancer in primary care

21 November 2013

Primary care doctors who took an online training course on diagnosing skin cancer significantly improved their skill to properly diagnose and manage benign and malignant lesions, according to a national study from Henry Ford Hospital in Detroit.

The training also resulted in a reduction in unnecessary referrals to dermatology specialists.

The INFORMED study is believed to be the first of its kind to track physician practice patterns as an outcome of a skin cancer detection training course.

There are more new cases of skin cancer in the US than breast, prostate, lung and colon cancers combined, according to the Skin Cancer Foundation. Treatment of nonmelanoma skin cancers increased by nearly 77% between 1992 and 2006. Meanwhile, incidence rates of melanoma — the most serious form of skin cancer — have been increasing for at least 30 years. It is estimated that one in 50 Americans will develop melanoma by 2015.

Researchers sought to evaluate whether primary care physicians (PCP) could diagnose skin cancer if provided targeted, specific education. PCPs, after all, see more patients than any other physician group. Fewer than 30% of primary care residents receive training for performing a skin examination during their medical training.

The training produced positive results in a number measures:

  • scores for diagnosing and managing all skin cancer lesions increased 10%.
  • scores for diagnosing benign lesions increased 14%.
  • patient referrals for suspicious lesions or new visits to a dermatology specialist declined as the result of improved detection by primary care physicians.
  • physicians still retained their improved skill level six months later.

“We all know the demands on a physician’s time. But this online course shows that we can empower primary care physicians to know when they themselves can take care of some of these patients and have the confidence in doing so, and not drive up the cost of utilization with unnecessary referrals to a dermatologist,” says Melody Eide MD, a Henry Ford dermatologist and the study’s lead author.

“Improving PCPs skills at diagnosing and managing skin lesions is an important way to improve patient care because patients frequently bring skin complaints to their family doctor,” Dr Eide says.

The web-based course covered the three most common skin cancers: basal cell carcinoma, squamous cell carcinoma and melanoma, and featured 450 clinical images of lesions.

The participants chose from two web options: traditional textbook format and case-based format, which took about two to three hours to complete. The case-based format featured nine case studies with interactive self-assessment tests and immediate feedback.

Before taking the course in 2011, participants took a pretest of 25 images of skin lesions in which they had to choose a diagnosis and course of action – reassure or refer. Participants were assessed a post-test immediately after completing the course, then repeated six months later.

Further information

The findings are published online in the November/December issue of the Journal of the American Board of Family Medicine at http://www.jabfm.org/content/26/6/648.full 

The course is at:  www.skinsight.com/info/for_professionals/skin-cancer-detection-informed/skin-cancer-education

 

To top