Utility of non-rule-based visual matching as a strategy to allow novices to achieve skin lesion diagnosis

Acta Derm Venereol. 2011 May;91(3):279-83. doi: 10.2340/00015555-1049.

Abstract

Non-analytical reasoning is thought to play a key role in dermatology diagnosis. Considering its potential importance, surprisingly little work has been done to research whether similar identification processes can be supported in non-experts. We describe here a prototype diagnostic support software, which we have used to examine the ability of medical students (at the beginning and end of a dermatology attachment) and lay volunteers, to diagnose 12 images of common skin lesions. Overall, the non-experts using the software had a diagnostic accuracy of 98% (923/936) compared with 33% for the control group (215/648) (Wilcoxon p < 0.0001). We have demonstrated, within the constraints of a simplified clinical model, that novices' diagnostic scores are significantly increased by the use of a structured image database coupled with matching of index and referent images. The novices achieve this high degree of accuracy without any use of explicit definitions of likeness or rule-based strategies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Case-Control Studies
  • Clinical Competence
  • Databases, Factual
  • Decision Support Techniques*
  • Dermatology / education*
  • Diagnosis, Computer-Assisted*
  • Diagnosis, Differential
  • Education, Medical, Undergraduate*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pattern Recognition, Visual*
  • Predictive Value of Tests
  • Problem Solving
  • Scotland
  • Severity of Illness Index
  • Skin / pathology*
  • Skin Diseases / diagnosis*
  • Skin Diseases / pathology
  • Software
  • Young Adult