Abstract
Recently, Marchetti et al. (2021) used decision-curve analysis and hypothetical models of melanoma biopsy prevalence to retrospectively evaluate the clinical utility of the two Gene Expression Profile Pigmented Lesion Assay (PLA) (DermTech, San Diego, CA). Although the further evaluation of the PLA is appreciated, significant concerns exist regarding material flaws in Marchetti et al. (2021)’s analyses and characterizations. These include (i) incorrectly characterizing the PLA as a test for melanoma diagnosis, (ii) significant challenges within the hypothetical models used and the data input and interpretations employed, and (iii) erroneous assumptions and implications that the social cost of not biopsying a melanoma is equivalent to performing an unneeded biopsy.
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