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The influence of history on interobserver agreement for diagnosing actinic keratoses and malignant skin lesions.

Publication ,  Journal Article
Whited, JD; Horner, RD; Hall, RP; Simel, DL
Published in: J Am Acad Dermatol
October 1995

BACKGROUND: Quantifying interobserver diagnostic agreement is necessary to evaluate skin cancer screening programs, but estimates of variability are incomplete. OBJECTIVE: We sought to measure agreement between dermatologists for diagnosing actinic keratoses (AKs) and malignant skin lesions and to determine the way in which blinding examiners to patient history affects agreement. METHODS: We varied the amount of historical information available to examiners in two consecutive patient series (n = 50) presenting to a Veterans Affairs Medical Center dermatology clinic. Two dermatologists examined each patient independently. RESULTS: Assessing historical features increased the kappa statistic for malignancy recognition from -0.04 to 0.76. kappa Statistics for diagnosing single AKs were 0.17 and 0.15, respectively, and 0.62 and 0.55 for multiple AKs. CONCLUSION: Agreement was high for diagnosing malignant skin lesions when history was included in the evaluation. Agreement for multiple AKs was higher than for single AKs, although neither was influenced by inclusion of historical features.

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Published In

J Am Acad Dermatol

DOI

ISSN

0190-9622

Publication Date

October 1995

Volume

33

Issue

4

Start / End Page

603 / 607

Location

United States

Related Subject Headings

  • Statistics as Topic
  • Skin Neoplasms
  • Single-Blind Method
  • Sensitivity and Specificity
  • Reproducibility of Results
  • Physical Examination
  • Observer Variation
  • Middle Aged
  • Medical History Taking
  • Male
 

Citation

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Whited, J. D., Horner, R. D., Hall, R. P., & Simel, D. L. (1995). The influence of history on interobserver agreement for diagnosing actinic keratoses and malignant skin lesions. J Am Acad Dermatol, 33(4), 603–607. https://doi.org/10.1016/0190-9622(95)91278-9
Whited, J. D., R. D. Horner, R. P. Hall, and D. L. Simel. “The influence of history on interobserver agreement for diagnosing actinic keratoses and malignant skin lesions.J Am Acad Dermatol 33, no. 4 (October 1995): 603–7. https://doi.org/10.1016/0190-9622(95)91278-9.
Whited JD, Horner RD, Hall RP, Simel DL. The influence of history on interobserver agreement for diagnosing actinic keratoses and malignant skin lesions. J Am Acad Dermatol. 1995 Oct;33(4):603–7.
Whited, J. D., et al. “The influence of history on interobserver agreement for diagnosing actinic keratoses and malignant skin lesions.J Am Acad Dermatol, vol. 33, no. 4, Oct. 1995, pp. 603–07. Pubmed, doi:10.1016/0190-9622(95)91278-9.
Whited JD, Horner RD, Hall RP, Simel DL. The influence of history on interobserver agreement for diagnosing actinic keratoses and malignant skin lesions. J Am Acad Dermatol. 1995 Oct;33(4):603–607.
Journal cover image

Published In

J Am Acad Dermatol

DOI

ISSN

0190-9622

Publication Date

October 1995

Volume

33

Issue

4

Start / End Page

603 / 607

Location

United States

Related Subject Headings

  • Statistics as Topic
  • Skin Neoplasms
  • Single-Blind Method
  • Sensitivity and Specificity
  • Reproducibility of Results
  • Physical Examination
  • Observer Variation
  • Middle Aged
  • Medical History Taking
  • Male