Blink of an Eye: Evaluating Dermatologist's Speed Versus Accuracy for Melanoma Diagnosis

Abstract

BACKGROUND Detection of melanoma at an early stage is critical to optimize surgical removal outcomes. The time to accurately visually diagnose melanoma has not been studied. OBJECTIVE To evaluate dermatologists' speed versus accuracy of melanoma diagnosis. METHODS A cross-sectional study with a 20-question quiz was conducted at a national dermatology conference. Questions were asked to identify either melanoma or benign lesion. The first 10 lesions were shown for 4 seconds each, and the next 10 were shown for 0.25 seconds each. Participants included dermatologists and dermatology residents and fellows. RESULTS Three hundred fifteen participants completed the quiz. Overall, 79.6% of cases were correctly diagnosed. Melanoma was correctly diagnosed in 78.2% and benign lesions in 81.0% of cases (p < .001). There was a significantly greater diagnostic accuracy found for 0.25 seconds versus 4 seconds (80.6% vs 78.6%, p = .007). Dermatologists practicing for 1 to 10 years had a higher percentage of correct answers and number of correct answers for 0.25 seconds compared with residency/fellowship. CONCLUSION Dermatologists have high diagnosis accuracy for melanoma, irrespective of time of lesion observation. Diagnostic accuracy for 0.25 seconds was consistent with findings in the typical clinical setting. Greater length of practice was associated with higher accuracy, but this did not persist after 10 years.