黑素瘤检测的标准度量是活检所需的数量(NNB)。该指标已用于评估执业皮肤科医生,皮肤科高级实践专业人员,和初级保健提供者。这个指标,然而,很少应用于住院医师诊所。我们旨在确定科罗拉多大学住院医师诊所的NNB。此外,我们试图确定2019年冠状病毒病(COVID-19)大流行对NNB的影响。这项研究是对2016年至2022年在丹佛健康医学中心和落基山地区退伍军人事务皮肤科诊所进行的活检的回顾性分析。活检时的鉴别诊断搜索关键词,包括黑色素瘤,原位黑色素瘤,还有恶性扁豆.排除包括再切除的皮肤活检。随后通过将活检的疑似黑素瘤病变的数量除以组织学证实的黑素瘤的数量来产生NNB。数据进一步按COVID-19之前的数据(2016-2020年2月)分开,COVID-19关闭期(2020年3月至2020年7月),和后COVID-19(2020年3月至今)。人口统计数据,包括年龄,性别,种族,和Fitzpatrick类型,被收集。从2016年到2022年,在两个临床地点的鉴别诊断中均有2230例疑似黑色素瘤的活检。其中,362例经组织学证实为黑色素瘤。NNB总数为6.16。前COVID-19NNB为5.86,后COVID-19NNB为6.91。住院医师诊所的NNB与执业皮肤科医生的公开值相似。此外,在这些诊所里,COVID-19大流行的影响得到了一位亲戚的赞赏,虽然统计上微不足道,NNB的增加。
A standard metric for
melanoma detection is the number needed to biopsy (NNB). This metric has been used to evaluate practicing dermatologists, dermatology advanced practice professionals, and primary care providers. This metric, however, has rarely been applied to residency clinics. We aimed to determine the NNB at the University of Colorado residency clinics. Moreover, we sought to determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on NNB. This study is a retrospective analysis of biopsies performed from 2016 to 2022 at the Denver Health Medical Center and the Rocky Mountain Regional Veteran Affairs dermatology clinics. Differential diagnosis at the time of biopsy was searched for keywords including
melanoma,
melanoma in situ, and lentigo maligna.
Skin biopsies that included re-excisions were excluded. The NNB was subsequently generated by dividing the number of biopsied lesions with suspected
melanoma by the number of histologically confirmed melanomas. The data was further separated by pre-COVID-19 (2016-February 2020), COVID-19 shutdown period (March 2020-July 2020), and post-COVID-19 (March 2020-present). Demographic data, including age, sex, race, and Fitzpatrick type, were collected. There were 2230 biopsies with suspected melanoma in the differential diagnosis at both clinic sites from 2016 to 2022. Of these, 362 were histologically confirmed
melanoma. Total NNB was 6.16. The pre-COVID-19 NNB was 5.86, and the post-COVID-19 NNB was 6.91. Residency clinics have NNB similar to published values of practicing dermatologists. Furthermore, within these clinics, the impact of the COVID-19 pandemic was appreciated by a relative, although statistically insignificant, increase in NNB.