Aid to diagnosis of melanoma in primary medical care

BMJ 1995;310:1328 (20 May)

Letters

Aid to diagnosis of melanoma in primary medical care

Doubling of excisions of genuine disease is the important issue

EDITOR,--After reading the title of Christopher B Del Mar andAdele C Green's paper, "Aid to diagnosis of melanoma in primarymedical care,"¹ I thought, "Great: something to support thebudgeting of medical photography departments," which have alwaysbeen an important part of any dermatology service. I was thereforedisappointed when I examined the findings more closely and realisedthat the authors had distorted the interpretation of their resultsto fit their original beliefs. Their main point is that in thecity in which the intervention was carried out, where clinicalphotography was introduced into primary care, the percentageof lesions excised that were potentially or frankly malignantdiminished. This was taken as evidence of the value of theiralgorithm and photographs in preventing unwarranted excisionof benign lesions. The observation is something of a smokescreenas the main point . . . [Full text of this article]