Comparison of melanoma diagnostic algorithms

The increase in the incidence of melanoma calls for accurate methods of early diagnosis and the use of dermoscopy has been shown to increase the diagnostic accuracy of dermatologists

Pattern analysis is known to be the most sensitive method of diagnosing melanoma, but it is difficult to use.
Researchers in Turkey have compared the sensitivity, specificity and diagnostic accuracy of four dermoscopic diagnostic algorithms that use calculation to provide a total score: the ABCD rule of dermoscopy, the seven-point checklist, the three-point checklist and the CASH algorithm.

In this study, three experienced dermoscopists examined 115 dermoscopic images of melanocytic lesions retrospectively and diagnosed each lesion as benign or malignant using each of the four diagnostic algorithms. Their results were then compared with histopathological diagnosis.

The sensitivity, specificity and diagnostic accuracy of the algorithms were as follows:

  • ABCD rule 91.6%, 60.4% and 66.9% respectively
  • Seven-point checklist 87.5%, 65.9% and 70.4%
  • Three-point checklist 79.1%, 62.6% and 66%
  • CASH algorithm 91.6%, 64.8% and 70.4%

The study found the ABCD rule and the CASH algorithm to be the most sensitive at diagnosing melanoma.
Unlu E, Akay BN, Erdem C. Comparison of dermatoscopic diagnostic algorithms based on calculation: the ABCD rule of dermatoscopy, the seven-point checklist, the three-point checklist and the CASH algorithm in dermatoscopic evaluation of melanocytic lesions.

J Dermatol 2014; 41: 598-603

Read these next

Editorial: Skin cancer detection is key to prompt treatment of melanoma

With summer trying to make an appearance, it is a good...

Expert Opinion: Latest developments in skin cancer screening

Expert Opinion: Latest developments in skin cancer screening

Dr Stephen Hayes discusses the outcomes of a recent...

Detection of melanoma

Detection of melanoma

This multicentre, prospective, blinded clinical study...

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Already registered?
Sign in

Register or Subscribe to MIMS

GPs can get MIMS print & online and GPonline for free when they register online – take 2 minutes, and make sure you get your free MIMS access! If you're not a GP, you can subscribe to MIMS for full access.

Register or subscribe

MIMS bulletins

News and updates straight to your inbox.

Prescribing Update: Fortnightly news bulletin
Urgent prescribing updates
Spotlight: Disease-themed monthly round-up

Sign me up

MIMS Dermatology

Read the latest issue online exclusively on MIMS Learning.

Read MIMS Dermatology

MIMS Adviser

Especially created for prescribing influencers.

Request free copy

Mobile apps

MIMS: access the full drug database and quick-reference tables on the go

MIMS Diagnosis and Management: concise information on signs and symptoms, investigations and diseases