Assessment of Imaging Diagnosis Ability of Skin Tumors in Chinese Dermatologists
Skin tumors, which originate from normal skin cells, have the potential to transform and reproduce in an uncontrolled manner. These tumors are increasingly common worldwide, posing a significant burden on healthcare systems due to rising incidence rates and associated costs. The diagnosis of skin tumors typically involves clinical screening, radiological imaging, and histopathological examination. In China, the field of dermatology faces unique challenges, including a high volume of patients and a limited number of dermatologists. With only around 24,000 dermatologists in the country, the ratio of dermatologists to the population is approximately one for every 60,000 people, and even lower in underdeveloped regions. This scarcity of specialists, combined with the increasing prevalence of skin tumors, underscores the need for improved diagnostic capabilities among Chinese dermatologists.
The development of advanced imaging technologies has significantly enhanced the diagnostic accuracy and efficiency of dermatologists. In 2017, Chinese experts launched the Chinese Skin Image Database (CSID), a comprehensive platform for research, education, and application of skin imaging in China. To assess the imaging diagnosis ability of skin tumors among Chinese dermatologists, experts from CSID designed a questionnaire consisting of 20 questions. These questions included cases of malignant, borderline, and benign skin tumors, all of which had been previously diagnosed through pathological examination. The questionnaire presented participants with brief medical histories, clinical images, and dermoscopic images, requiring them to classify the tumors and diagnose the diseases.
The study was conducted on Youmai, a professional online study platform with over 20,000 registered Chinese dermatologists. Participants were asked to provide basic information and complete the questionnaire, which scored five points for each correct answer. The study analyzed the classification recognition and disease diagnosis scores of 963 dermatologists from 31 provinces, autonomous regions, or municipalities in China. These dermatologists were employed across 616 medical institutions, including primary, secondary, tertiary, and other types of hospitals. The professional titles of the participants ranged from senior titles (professor, associate professor, chief physician, or associate chief physician) to intermediate titles (attending physician or lecturer) and primary titles (physician, resident physician, or teaching assistant).
The results revealed significant variations in the imaging diagnosis ability of skin tumors among dermatologists from different levels of hospitals. Dermatologists from tertiary hospitals achieved higher mean scores in both classification recognition and disease diagnosis compared to those from secondary and primary hospitals. However, the differences in scores among dermatologists with different professional titles were not statistically significant. The study also highlighted regional disparities, with dermatologists from certain provinces demonstrating higher diagnostic accuracy than others. Overall, the mean scores for disease diagnosis were below 50 points, indicating a relatively low level of imaging diagnosis ability among Chinese dermatologists.
The findings of this study underscore the urgent need for action to improve the imaging diagnosis ability of skin tumors in China. Experts recommend several strategies to address this issue. First, Chinese skin image experts should promote education on skin image analysis through conferences, videos, textbooks, and other mediums. Second, dermatologists should receive support from hospital administrations to acquire necessary imaging equipment. Third, collaboration with international dermatologists and contributions to the development of a comprehensive skin image dataset for the Chinese population are essential. Finally, the development of dermatological intelligent diagnostic systems tailored to the Chinese population could significantly enhance diagnostic accuracy and efficiency.
The relatively low imaging diagnosis ability of skin tumors among Chinese dermatologists is a concerning issue that requires immediate attention. By improving education, equipping hospitals with advanced imaging technologies, fostering international collaboration, and developing intelligent diagnostic systems, the diagnostic capabilities of Chinese dermatologists can be significantly enhanced. This, in turn, will lead to better care for patients with skin tumors and contribute to the prevention of these conditions in the general population.
doi.org/10.1097/CM9.0000000000000389
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