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Factors for not performing total body skin examinations in primary care in association with teledermoscopy

Ingvar, Jonas LU ; Nielsen, Kari LU orcid and Ingvar, Åsa LU orcid (2023) In BMC Primary Care 24(1).
Abstract

PURPOSE: To investigate factors related to omitted total body skin examination (TBSE) in skin cancer diagnostics while managing patients using teledermoscopy (TDS) in Swedish primary care.

METHODS: 4,987 TDS referrals from primary care centers were analyzed to identify factors associated with failing to perform TBSE. Data collected included age, gender of patient and physician, and reason for a visit. Logistic regression was used to test the association between the variables and risk of failing to complete a TBSE.

RESULTS: The risk for omitted TBSE is higher in older patients, females, patients whose primary reason for seeking care was not specifically for a complete skin check, and with female physician. Patients > 80... (More)

PURPOSE: To investigate factors related to omitted total body skin examination (TBSE) in skin cancer diagnostics while managing patients using teledermoscopy (TDS) in Swedish primary care.

METHODS: 4,987 TDS referrals from primary care centers were analyzed to identify factors associated with failing to perform TBSE. Data collected included age, gender of patient and physician, and reason for a visit. Logistic regression was used to test the association between the variables and risk of failing to complete a TBSE.

RESULTS: The risk for omitted TBSE is higher in older patients, females, patients whose primary reason for seeking care was not specifically for a complete skin check, and with female physician. Patients > 80 years had more than four times increased risk of not undergoing TBSE compared to the youngest (< 30 y). The strongest correlation to omitting TBSE was with other reasons for primary care visits than "skin check". Male gender of the patient and being examined by male physicians decreased the risk of omitted TBSE by 20% and 30%, respectively. There was no evidence of interaction between the gender of the patient and the physician.

CONCLUSION: Since TDS reduces the opportunities to have a TBSE by dermatologists, the standard management of patients with suspicious skin lesions in primary care must be revised and evidence-based. TBSE is strongly recommended for patients with increased risk of skin cancer, for example old persons with fair skin and a history of skin cancer, when managing them with TDS.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, Male, Female, Aged, Skin Neoplasms/diagnosis, Physical Examination, Skin Diseases/diagnosis, Physicians, Primary Health Care
in
BMC Primary Care
volume
24
issue
1
article number
76
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85150897932
  • pmid:36944927
ISSN
2731-4553
DOI
10.1186/s12875-023-02034-4
project
Teledermoscopy and artificial intelligence: implementation in clinical practice
language
English
LU publication?
yes
additional info
© 2023. The Author(s).
id
c721f4d0-35e0-4575-8698-963cb7f67096
date added to LUP
2023-04-06 08:39:55
date last changed
2024-06-14 19:40:52
@article{c721f4d0-35e0-4575-8698-963cb7f67096,
  abstract     = {{<p>PURPOSE: To investigate factors related to omitted total body skin examination (TBSE) in skin cancer diagnostics while managing patients using teledermoscopy (TDS) in Swedish primary care.</p><p>METHODS: 4,987 TDS referrals from primary care centers were analyzed to identify factors associated with failing to perform TBSE. Data collected included age, gender of patient and physician, and reason for a visit. Logistic regression was used to test the association between the variables and risk of failing to complete a TBSE.</p><p>RESULTS: The risk for omitted TBSE is higher in older patients, females, patients whose primary reason for seeking care was not specifically for a complete skin check, and with female physician. Patients &gt; 80 years had more than four times increased risk of not undergoing TBSE compared to the youngest (&lt; 30 y). The strongest correlation to omitting TBSE was with other reasons for primary care visits than "skin check". Male gender of the patient and being examined by male physicians decreased the risk of omitted TBSE by 20% and 30%, respectively. There was no evidence of interaction between the gender of the patient and the physician.</p><p>CONCLUSION: Since TDS reduces the opportunities to have a TBSE by dermatologists, the standard management of patients with suspicious skin lesions in primary care must be revised and evidence-based. TBSE is strongly recommended for patients with increased risk of skin cancer, for example old persons with fair skin and a history of skin cancer, when managing them with TDS.</p>}},
  author       = {{Ingvar, Jonas and Nielsen, Kari and Ingvar, Åsa}},
  issn         = {{2731-4553}},
  keywords     = {{Humans; Male; Female; Aged; Skin Neoplasms/diagnosis; Physical Examination; Skin Diseases/diagnosis; Physicians; Primary Health Care}},
  language     = {{eng}},
  month        = {{03}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Primary Care}},
  title        = {{Factors for not performing total body skin examinations in primary care in association with teledermoscopy}},
  url          = {{http://dx.doi.org/10.1186/s12875-023-02034-4}},
  doi          = {{10.1186/s12875-023-02034-4}},
  volume       = {{24}},
  year         = {{2023}},
}