Dermoscopy could assist osteopathic primary care physicians improve their diagnostic accuracy for skin cancer, thus preventing unwarranted referrals to specialists; however, more knowledge to encourage the use of dermascopes is warranted, according to findings published in the Journal of the American Osteopathic Association.
“Osteopathic physicians (ie, DOs) in primary care may play a critical role in the early detection of skin cancer,” Jeffrey B. Morris, OMS III, from Nova Southeastern University College of Osteopathic Medicine in Ft. Lauderdale, Florida, and colleagues wrote. “Dermoscopy improves diagnostic accuracy; however, its use among primary care DOs remains understudied.”
To address this issue, Morris and colleagues evaluated use and barriers to use of dermascopes among DOs in primary care, as well as physician and practice characteristics associated with use and awareness of dermoscopy. Between September 2015 and February 2016, they recruited 768 osteopathic physicians (79% were white and 60.3% were male) across the nation to complete a brief, anonymous cross-sectional survey that assessed demographic factors, physician and practice characteristics, confidence in differentiating skin lesions, knowledge and dermascope use and barriers to dermascope use. The researchers performed bivariate analyses and entered significant factors into two separate logistic regressions.
Survey data indicated 54% (n = 410) of participants had heard of a dermascope, while 15% (n = 123) had used one in the past and 6% (n = 193) were currently using one in practice. Forty-eight percent of participants (n = 360) reported seeing at least 10 patients monthly for skin lesions suspicious of skin cancer and 53% (n = 402) reported being confident or very confident in differentiating between cancerous and noncancerous skin lesions.
Morris and colleagues found that graduating from medical school after 1989 and having more confidence in differentiating skin lesions were statistically significant multivariate predictors for dermascope use. Compared with participants who graduated before 1990, dermascope use was 9.5-times and 4.3-times more common for those who graduated after 2009 and for those who graduated between 2000 and 2009, respectively. Female participants, those practicing in a group, academic or community center, as well as those with greater confidence in differentiating skin lesions were more likely to have heard of a dermascope.
“Our study represents an initial step in understanding dermascope use among primary care DOs in the United States,” Morris and colleagues concluded. They added, “Because knowledge and use of dermascopes in our sample was low, efforts to disseminate knowledge to primary care DOs about the benefits of using dermascopes are needed.” – by Alaina Tedesco
Disclosure: The researchers report they receive support from the Research Fellowship Program at Nova Southeastern University College of Osteopathic Medicine.