LAUSR

BACKGROUND Early detection of melanoma is crucial to improving the detection of thin curable melanomas. Non-invasive, computer-assisted methods have been developed to use at the bedside to aid in diagnoses but have not been compared directly in a clinical setting. OBJECTIVE We conducted a prospective diagnostic accuracy study comparing a dermatologist's clinical examination at the bedside, teledermatology, and non-invasive imaging techniques (FotoFinder®, Melafind®, Verisante AuraTM). METHODS 184 patients were recruited prospectively from an outpatient dermatology clinic, with lesions imaged, assessed and excised. Skin specimens were assessed by 2 blinded pathologists, providing the gold standard comparison. RESULTS 59 lesions from 56 patients had a histopathological diagnosis of melanoma, while 150 lesions from 128 patients were diagnosed as benign. Sensitivities and specificities were, respectively: MelaFind® (82.5%, 52.4%), Verisante AuraTM (21.4%, 86.2%), FotoFinder® Moleanalyzer Pro (88.1%, 78.8%). The sensitivity and specificity of the teledermoscopist (84.5%, 82.6%) and local dermatologist (96.6%, 32.2%) were also compared. LIMITATIONS There are inherent limitations in using pathology as the gold standard to compare sensitivities and specificities. CONCLUSION This study demonstrates that the highest sensitivity and specificity of the instruments was established with the FotoFinder® Moleanalyzer Pro, which could be a valuable tool to assist with, but not replace clinical decision making.