Abstracts Education

Online Study of Melanoma Identification: The Roles of ABC Information and Photographic Examples in Lesion Discrimination

by Ella Cornell

Public education campaigns designed to increase awareness about malignant melanoma, the most fatal form of skin cancer, currently use written criteria (ABCD) to describe its common features, but an increasing body of evidence has suggested that the public would benefit more from the use of photographic examples of lesions. This study explored possible public education techniques to optimize laypeople’s recognition of melanoma through an online melanoma identification task. We were particularly interested in (a) exploring the role of dermatological expertise in selecting lesion training examples, (b) comparing performance with ABC information to that of melanoma examples, and (c) determining the effect of adding benign training examples to melanomas. Before beginning with the online portion of the study we developed a set of melanoma training examples to compare against those selected by dermatologists, by statistically extracting eight lesions from similarities seen independently by laypeople. The online part of study consisted of 6 conditions: no training, training using written ABC criteria, using photographic examples of melanoma selected by dermatologists, photographic examples of melanoma selected by laypeople, a combination of both ABC information and melanoma examples, and photographic examples of melanoma and of benign (harmless) lesions. We calculated measures of sensitivity, specificity and accuracy in melanoma detection for 976 participants. We found that dermatologist-selected melanoma examples were in fact useful in increasing specificity (p=.001) and accuracy (p<.001), that the provision of ABC information significantly lowered specificity (p=.001), and that the provision of both melanoma and benign examples had significantly higher specificity (p<.001) and accuracy (p<.001) than melanomas alone. All conditions raised sensitivity as compared to no control, but the substantial increase in specificity and accuracy seen with both melanoma and benign examples made it the best preforming condition.