Choosing to biopsy or refer suspicious melanocytic lesions in general practice
<p>Abstract</p> <p>Background</p> <p>General practitioners (GPs) are involved in the management of most melanocytic skin lesions in Australia. A high quality biopsy technique is a crucial first step in management, as it is recognized that poor techniques can mislead, de...
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| Format: | Article |
| Language: | English |
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BMC
2012-08-01
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| Series: | BMC Family Practice |
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| Online Access: | http://www.biomedcentral.com/1471-2296/13/78 |
| _version_ | 1811227397053218816 |
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| author | Robison Sean Kljakovic Marjan Barry Peter |
| author_facet | Robison Sean Kljakovic Marjan Barry Peter |
| author_sort | Robison Sean |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>General practitioners (GPs) are involved in the management of most melanocytic skin lesions in Australia. A high quality biopsy technique is a crucial first step in management, as it is recognized that poor techniques can mislead, delay, or miss a diagnosis of melanoma. There has been little published on the biopsy decisions and techniques of GPs. This study aims to describe the current management choices made by GPs for suspicious melanocytic skin lesions and to compare their choices with the best practice guidelines.</p> <p>Methods</p> <p>An anonymous survey of GPs presented with three clinical scenarios with increasing complexity of melanoma in which a referral or biopsy decision was specified.</p> <p>Results</p> <p>391 mailed surveys with a 76.3% response rate. Mean biopsy experience was 4.14 biopsies per GP per month. The rates of choosing to refer among the three scenarios were 31%, 52% and 81% respectively, with referral to surgery being the most common choice (81%). Most biopsy techniques (55%) were chosen according to best practice guidelines, although non-guideline biopsy techniques chosen included shave (n = 10), punch biopsy (n = 57), wide excisions (n = 65), and flaps (n = 10). The few GPs (n = 5) who identified themselves as skin specialist GPs were no more likely to adhere to guidelines than their colleagues.</p> <p>Conclusion</p> <p>A majority of referrals and biopsies were chosen by GPs according to best practice guidelines, but concern remains for the high proportion of GPs making non-guideline based choices. How GPs choose to biopsy or refer needs further training, audit, and research if Australia is to improve the outcome of melanoma management in general practice.</p> |
| first_indexed | 2024-04-12T09:40:42Z |
| format | Article |
| id | doaj.art-100c06e04052453ba940413243a8c602 |
| institution | Directory Open Access Journal |
| issn | 1471-2296 |
| language | English |
| last_indexed | 2024-04-12T09:40:42Z |
| publishDate | 2012-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Family Practice |
| spelling | doaj.art-100c06e04052453ba940413243a8c6022022-12-22T03:38:04ZengBMCBMC Family Practice1471-22962012-08-011317810.1186/1471-2296-13-78Choosing to biopsy or refer suspicious melanocytic lesions in general practiceRobison SeanKljakovic MarjanBarry Peter<p>Abstract</p> <p>Background</p> <p>General practitioners (GPs) are involved in the management of most melanocytic skin lesions in Australia. A high quality biopsy technique is a crucial first step in management, as it is recognized that poor techniques can mislead, delay, or miss a diagnosis of melanoma. There has been little published on the biopsy decisions and techniques of GPs. This study aims to describe the current management choices made by GPs for suspicious melanocytic skin lesions and to compare their choices with the best practice guidelines.</p> <p>Methods</p> <p>An anonymous survey of GPs presented with three clinical scenarios with increasing complexity of melanoma in which a referral or biopsy decision was specified.</p> <p>Results</p> <p>391 mailed surveys with a 76.3% response rate. Mean biopsy experience was 4.14 biopsies per GP per month. The rates of choosing to refer among the three scenarios were 31%, 52% and 81% respectively, with referral to surgery being the most common choice (81%). Most biopsy techniques (55%) were chosen according to best practice guidelines, although non-guideline biopsy techniques chosen included shave (n = 10), punch biopsy (n = 57), wide excisions (n = 65), and flaps (n = 10). The few GPs (n = 5) who identified themselves as skin specialist GPs were no more likely to adhere to guidelines than their colleagues.</p> <p>Conclusion</p> <p>A majority of referrals and biopsies were chosen by GPs according to best practice guidelines, but concern remains for the high proportion of GPs making non-guideline based choices. How GPs choose to biopsy or refer needs further training, audit, and research if Australia is to improve the outcome of melanoma management in general practice.</p>http://www.biomedcentral.com/1471-2296/13/78BiopsyGeneral practiceGuidelinesMelanomaAudit |
| spellingShingle | Robison Sean Kljakovic Marjan Barry Peter Choosing to biopsy or refer suspicious melanocytic lesions in general practice BMC Family Practice Biopsy General practice Guidelines Melanoma Audit |
| title | Choosing to biopsy or refer suspicious melanocytic lesions in general practice |
| title_full | Choosing to biopsy or refer suspicious melanocytic lesions in general practice |
| title_fullStr | Choosing to biopsy or refer suspicious melanocytic lesions in general practice |
| title_full_unstemmed | Choosing to biopsy or refer suspicious melanocytic lesions in general practice |
| title_short | Choosing to biopsy or refer suspicious melanocytic lesions in general practice |
| title_sort | choosing to biopsy or refer suspicious melanocytic lesions in general practice |
| topic | Biopsy General practice Guidelines Melanoma Audit |
| url | http://www.biomedcentral.com/1471-2296/13/78 |
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