Abstract
Commercially available clinical decision support systems (CDSSs) for skin cancer have been designed for the detection of melanoma only. Correct use of the systems requires expert knowledge, hampering their utility for nonexperts. Furthermore, there are no systems to detect other common skin cancer types, that is, nonmelanoma skin cancer (NMSC). As early diagnosis of skin cancer is essential, there is a need for a CDSS that is applicable to all types of skin lesions and is suitable for nonexperts. Nevus Doctor (ND) is a CDSS being developed by the authors. We here investigate ND's ability to detect both melanoma and NMSC and the opportunities for improvement. An independent test set of dermoscopic images of 870 skin lesions, including 44 melanomas and 101 NMSCs, were analysed by ND. Its sensitivity to melanoma and NMSC was compared to that of Mole Expert (ME), a commercially available CDSS, using the same set of lesions. ND and ME had similar sensitivity to melanoma. For ND at 95% melanoma sensitivity, the NMSC sensitivity was 100%, and the specificity was 12%. The melanomas misclassified by ND at 95% sensitivity were correctly classified by ME, and vice versa. ND is able to detect NMSC without sacrificing melanoma sensitivity.
Highlights
Melanoma is the deadliest of all skin cancers
Available clinical decision support systems (CDSSs) for skin cancer have been designed for the detection of melanoma only
As early diagnosis of skin cancer is essential, there is a need for a CDSS that is applicable to all types of skin lesions and is suitable for nonexperts
Summary
Melanoma is the deadliest of all skin cancers. When it is detected early, the treatment is excision of the tumour, and the survival rate is high. Recent developments in melanoma treatment are promising [1, 2], but the survival rate for patients with metastasised melanoma is still poor [3, 4]. But challenging, since early stage melanomas resemble benign skin lesions. Other types of skin cancer, like basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), have high incidence rates but low mortality rates [4]. Detection is beneficiary for the patient to get early treatment and avoid further damaging of the surrounding skin
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