NNB was used to assess differences in the ratio of biopsies that had nevi versus melanoma outcomes over time. A total of 1,236 biopsies were in the preintervention group and 1,042 biopsies were in the postintervention group. In this analysis, only biopsy results that revealed nevi or melanoma were included.
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We manually reviewed pathology reports, and we entered results into Research Electronic Data Capture software (REDCap).
We conducted a retrospective chart review of the biopsy data.
#BIBLATEX WITH JABREF SKIN#
Using the current procedural terminology codes, we extracted all skin biopsies performed in our health system by PCPs between Novemand Novemfrom our electronic medical record. 11 Our research aims to test if meaningful reductions in NNB are possible in the primary care setting as well. 10 While it is known that the use of dermoscopy reduces the number needed to biopsy (NNB) to detect melanoma, most of this literature is in the dermatology setting. 9,10 TADA training equips learners with the skills needed to differentiate benign from malignant dermoscopic images with high sensitivity and specificity. 3 The Triage Amalgamated Dermoscopic Algorithm (TADA) was developed to aid novice dermoscopists in the evaluation of skin growths. 8 Despite the benefits of dermoscopy, fewer than 15% of PCPs are trained to use a dermoscope. In trained hands, dermoscopy improves the user’s ability to differentiate benign melanocytic nevi from melanoma. 7ĭermoscopy is a noninvasive tool that allows for visualization of colors and structures in the epidermis and dermis at 10x magnification. 3-5 To address this need, we offered a dermatology training intervention targeted for PCPs that included a 90-minute Triage Amalgamated Dermoscopic Algorithm (TADA) workshop, subsequent monthly telementoring sessions via the Extension of Community Health Outcomes project (ECHO) 6, and equipping participating clinics with dermatoscopes. 2 Studies have shown that PCPs desire more training in dermatology and the evaluation of cutaneous lesions. 1 This, in combination with a national shortage of dermatologists, means that primary care practitioners (PCPs) must play a pivotal role in early skin cancer detection. The incidence of melanoma is rising across the United States, with Maine having the tenth highest incidence in the nation.
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