Three-point checklist of dermoscopy: an open internet study

Area of Science:

• Dermatology
• Oncology
• Medical Diagnostics

Background:

• A pilot study indicated the three-point checklist of dermoscopy is a valid and reproducible tool for skin cancer diagnosis.
• High sensitivity was observed in a small group of nonexpert users.

Purpose of the Study:

• To re-evaluate preliminary findings on the three-point checklist in a large, diverse group of observers.
• To assess the tool's performance independently of participants' profession and dermoscopy expertise.

Main Methods:

• An internet-based study provided worldwide access to participants.
• 150 participants evaluated 150 dermoscopic images of skin lesions after a brief tutorial.
• Performance was assessed using criteria like asymmetry, atypical network, and blue-white structures, with statistical analysis of kappa values, odds ratios, sensitivity, and specificity.

Main Results:

• The three-point checklist demonstrated good interobserver reproducibility (kappa: 0.53).
• Overall sensitivity for skin cancer was 91.0%, with minimal influence from observer profession.
• Untrained novices showed high sensitivity (86.7%), while specificity was 71.9%, influenced by profession with dermatologists performing best.

Conclusions:

• The three-point checklist is a feasible, simple, accurate, and reproducible tool for skin cancer screening.
• The study validates its effectiveness across a broad range of users, including those with limited experience.