Number needed to biopsy ratio and diagnostic accuracy for melanoma detection Journal Article
| Authors: | Marchetti, M. A.; Yu, A.; Nanda, J.; Tschandl, P.; Kittler, H.; Marghoob, A. A.; Halpern, A. C.; Dusza, S. W. |
| Article Title: | Number needed to biopsy ratio and diagnostic accuracy for melanoma detection |
| Abstract: | Background: The number needed to biopsy (NNB) ratio for melanoma diagnosis is calculated by dividing the total number of biopsies by the number of biopsied melanomas. It is the inverse of positive predictive value (PPV), which is calculated by dividing the number of biopsied melanomas by the total number of biopsies. NNB is increasingly used as a metric to compare the diagnostic accuracy of health care practitioners. Objective: To investigate the association of NNB with the standard statistical measures of sensitivity and specificity. Methods: We extracted published diagnostic accuracy data from 5 cross-sectional skin cancer reader studies (median [min-max] readers/study was 29 [8-511]). Because NNB is a ratio, we converted it to PPV. Results: Four studies showed no association and 1 showed a negative association between PPV and sensitivity. All 5 studies showed a positive association between PPV and specificity. Limitations: Reader study data. Conclusions: An individual health care practitioner with a lower NNB is likely to have a higher specificity than one with a higher NNB, assuming they practice under similar conditions; no conclusions can be made about their relative sensitivities. We advocate for additional research to define quality metrics for melanoma detection and caution when interpreting NNB. © 2020 American Academy of Dermatology, Inc. |
| Keywords: | diagnostic accuracy; sensitivity and specificity; melanoma; basal cell carcinoma; skin biopsy; false negative result; oncological parameters; intraepithelial carcinoma; priority journal; article; melanoma positive predictive value; melanoma screening; melanoma sensitivity; melanoma specificity; nnb; number needed to biopsy; number needed to biopsy ratio |
| Journal Title: | Journal of the American Academy of Dermatology |
| Volume: | 83 |
| Issue: | 3 |
| ISSN: | 0190-9622 |
| Publisher: | Mosby Elsevier |
| Date Published: | 2020-09-01 |
| Start Page: | 780 |
| End Page: | 787 |
| Language: | English |
| DOI: | 10.1016/j.jaad.2020.04.109 |
| PROVIDER: | scopus |
| PUBMED: | 32360723 |
| PMCID: | PMC7484328 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 September 2020 -- Source: Scopus |
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