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Algorithm based smartphone apps to assess risk of skin cancer in adults: systematic review of diagnostic accuracy studies.
Freeman, Karoline; Dinnes, Jacqueline; Chuchu, Naomi; Takwoingi, Yemisi; Bayliss, Sue E; Matin, Rubeta N; Jain, Abhilash; Walter, Fiona M; Williams, Hywel C; Deeks, Jonathan J.
Afiliação
  • Freeman K; Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
  • Dinnes J; Warwick Medical School, University of Warwick, Coventry, UK.
  • Chuchu N; Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
  • Takwoingi Y; NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK.
  • Bayliss SE; Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
  • Matin RN; London School of Hygiene and Tropical Medicine, London, UK.
  • Jain A; Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
  • Walter FM; NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK.
  • Williams HC; Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
  • Deeks JJ; Department of Dermatology, Churchill Hospital, Oxford, UK.
BMJ ; 368: m127, 2020 02 10.
Article em En | MEDLINE | ID: mdl-32041693
ABSTRACT

OBJECTIVE:

To examine the validity and findings of studies that examine the accuracy of algorithm based smartphone applications ("apps") to assess risk of skin cancer in suspicious skin lesions.

DESIGN:

Systematic review of diagnostic accuracy studies. DATA SOURCES Cochrane Central Register of Controlled Trials, MEDLINE, Embase, CINAHL, CPCI, Zetoc, Science Citation Index, and online trial registers (from database inception to 10 April 2019). ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies of any design that evaluated algorithm based smartphone apps to assess images of skin lesions suspicious for skin cancer. Reference standards included histological diagnosis or follow-up, and expert recommendation for further investigation or intervention. Two authors independently extracted data and assessed validity using QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies 2 tool). Estimates of sensitivity and specificity were reported for each app.

RESULTS:

Nine studies that evaluated six different identifiable smartphone apps were included. Six verified results by using histology or follow-up (n=725 lesions), and three verified results by using expert recommendations (n=407 lesions). Studies were small and of poor methodological quality, with selective recruitment, high rates of unevaluable images, and differential verification. Lesion selection and image acquisition were performed by clinicians rather than smartphone users. Two CE (Conformit Europenne) marked apps are available for download. SkinScan was evaluated in a single study (n=15, five melanomas) with 0% sensitivity and 100% specificity for the detection of melanoma. SkinVision was evaluated in two studies (n=252, 61 malignant or premalignant lesions) and achieved a sensitivity of 80% (95% confidence interval 63% to 92%) and a specificity of 78% (67% to 87%) for the detection of malignant or premalignant lesions. Accuracy of the SkinVision app verified against expert recommendations was poor (three studies).

CONCLUSIONS:

Current algorithm based smartphone apps cannot be relied on to detect all cases of melanoma or other skin cancers. Test performance is likely to be poorer than reported here when used in clinically relevant populations and by the intended users of the apps. The current regulatory process for awarding the CE marking for algorithm based apps does not provide adequate protection to the public. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016033595.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Cutâneas / Dermoscopia / Aplicativos Móveis / Smartphone / Melanoma Tipo de estudo: Diagnostic_studies / Etiology_studies / Guideline / Prognostic_studies / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Revista: BMJ Assunto da revista: MEDICINA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Reino Unido País de publicação: ENGLAND / ESCOCIA / GB / GREAT BRITAIN / INGLATERRA / REINO UNIDO / SCOTLAND / UK / UNITED KINGDOM

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Cutâneas / Dermoscopia / Aplicativos Móveis / Smartphone / Melanoma Tipo de estudo: Diagnostic_studies / Etiology_studies / Guideline / Prognostic_studies / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Revista: BMJ Assunto da revista: MEDICINA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Reino Unido País de publicação: ENGLAND / ESCOCIA / GB / GREAT BRITAIN / INGLATERRA / REINO UNIDO / SCOTLAND / UK / UNITED KINGDOM