A beneficial effect of a short-term formal training course in epiluminescence microscopy on the diagnostic performance of dermatologists about cutaneous malignant melanoma

Background: Epiluminescence microscopy (ELM) is a useful tool, which, in the hands of experienced dermatologists successfully helps in the diagnosis of early cutaneous malignant melanoma (CMM). As all imaging diagnostic methods, ELM also requires preliminary training of the physicians. Objective: The aim of the study was to evaluate a possible beneficial effect of a short-term formal training course in ELM on the diagnostic performance of dermatologists about CMM. Methods: The test group consisted of 32 dermatologists. Tests were performed in the beginning and in the end of the teaching course. Every time a total 50 histologically proven pigmented skin lesions (PSLs) photographed without oil immersion-Surface microscopy (SM) and with oil immersion-ELM was presented by slide projection. To assess the effect on the diagnostic performance before and after short-term training the data concerning diagnoses were analysed for the following: sensitivity, specificity, positive predictive value, and negative predictive value, index of suspicion and diagnostic accuracy. Results: Before the training course the implementation of ELM leads to relative increasing of all studied indicators of ELM diagnosis towards SM diagnosis, but differences are not statistically significant (P>0.05). After the course there is an improvement of diagnostic performance of dermatologists by ELM, manifested by enhancement of all indicators. The changes of the sensitivity, negative predictive value and diagnostic accuracy of ELM diagnosis was statistically significant (P<0.05). Conclusion: The short-term formal course in ELM has a beneficial effect on the diagnostic performance of dermatologists about CMM. The improvement of early detection of CMM requires dermatologists enhanced training and higher qualification in the field of dermoscopy.