Does this patient have a mole or a melanoma?

John D. Whited, James M Grichnik

Research output: Contribution to journalArticle

86 Citations (Scopus)

Abstract

Lifetime risk for malignant melanoma has increased from 1 in 1500 in the United States in 1930 to 1 in 75 projected for the year 2000. Because the tumor's thickness at excision is the primary prognostic determinant, early detection through the history and physical examination can play an important role in the patient's clinical course. Two checklists have been developed as diagnostic aids, the ABCD (A indicates asymmetry; B, border irregularity; C, irregular color; and D, diameter >6 mm) and the revised 7-point checklists. These checklists should be interpreted with some discretion, but 2 studies have found the sensitivity for the ABCD checklist to be 92% (95% confidence interval [CI], 82%-96%) and 100% (95% CI, 54%-100%); 1 study found the specificity to be 98% (95% CI, 95%-99%). The revised 7-point checklist has been reported to have a sensitivity of 79% (95% CI, 70%-85%) to 100% (95% CI, 94%-100%) and specificity of 30% (95% CI, 21%-39%) to 37% (95% CI, 28%-46%). Physicians' global assessments for detecting the presence or absence of melanoma are estimated to have a specificity of 96% to 99%, while sensitivity ranges widely from 50% to 97%. Nondermatologists' examinations appear to be less sensitive than examinations performed by dermatologists.

Original languageEnglish
Pages (from-to)696-701
Number of pages6
JournalJournal of the American Medical Association
Volume279
Issue number9
DOIs
StatePublished - Mar 4 1998
Externally publishedYes

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Melanoma
Checklist
Confidence Intervals
Physical Examination
Color
History
Physicians
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Does this patient have a mole or a melanoma? / Whited, John D.; Grichnik, James M.

In: Journal of the American Medical Association, Vol. 279, No. 9, 04.03.1998, p. 696-701.

Research output: Contribution to journalArticle

Whited, John D. ; Grichnik, James M. / Does this patient have a mole or a melanoma?. In: Journal of the American Medical Association. 1998 ; Vol. 279, No. 9. pp. 696-701.
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