RT Journal
A1 Wolf JA, Moreau JF, Akilov O, et al
T1 DIagnostic inaccuracy of smartphone applications for melanoma detection
JF JAMA Dermatology
JO JAMA Dermatology
YR 2013
FD April 1
VO 149
IS 4
SP 422
OP 426
DO 10.1001/jamadermatol.2013.2382
UL http://dx.doi.org/10.1001/jamadermatol.2013.2382
AB Objective 
                  To measure the performance of smartphone applications that evaluate photographs of skin lesions and provide the user with feedback about the likelihood of malignancy.Design 
                  Case-control diagnostic accuracy study.Setting 
                  Academic dermatology department.Participants and Materials 
                  Digital clinical images of pigmented cutaneous lesions (60 melanoma and 128 benign control lesions) with a histologic diagnosis rendered by a board-certified dermatopathologist, obtained before biopsy from patients undergoing lesion removal as a part of routine care.Main Outcome Measures 
                  Sensitivity, specificity, and positive and negative predictive values of 4 smartphone applications designed to aid nonclinician users in determining whether their skin lesion is benign or malignant.Results 
                  Sensitivity of the 4 tested applications ranged from 6.8% to 98.1%; specificity, 30.4% to 93.7%; positive predictive value, 33.3% to 42.1%; and negative predictive value, 65.4% to 97.0%. The highest sensitivity for melanoma diagnosis was observed for an application that sends the image directly to a board-certified dermatologist for analysis; the lowest, for applications that use automated algorithms to analyze images.Conclusions 
                  The performance of smartphone applications in assessing melanoma risk is highly variable, and 3 of 4 smartphone applications incorrectly classified 30% or more of melanomas as unconcerning. Reliance on these applications, which are not subject to regulatory oversight, in lieu of medical consultation can delay the diagnosis of melanoma and harm users.