Primary Care Physician Use of Elastic Scattering Spectroscopy on Skin Lesions Suggestive of Skin Cancer

Objectives: To evaluate the performance of noninvasive, elastic scattering spectroscopy, algorithm-powered device (DermaSensor) to detect melanoma and basal and squamous cell cancers in the primary care setting. Patients & Methods: DERM-SUCCESS, a blinded, prospective, multicenter pivotal study,...

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Main Authors: Stephen P. Merry, Ivana T. Croghan, Kimberly A. Dukes, Brian C. McCormick, Gerard T. Considine, Michelle J. Duvall, Curtis T. Thompson, David J. Leffell
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:Journal of Primary Care & Community Health
Online Access:https://doi.org/10.1177/21501319251344423
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author Stephen P. Merry
Ivana T. Croghan
Kimberly A. Dukes
Brian C. McCormick
Gerard T. Considine
Michelle J. Duvall
Curtis T. Thompson
David J. Leffell
author_facet Stephen P. Merry
Ivana T. Croghan
Kimberly A. Dukes
Brian C. McCormick
Gerard T. Considine
Michelle J. Duvall
Curtis T. Thompson
David J. Leffell
author_sort Stephen P. Merry
collection DOAJ
description Objectives: To evaluate the performance of noninvasive, elastic scattering spectroscopy, algorithm-powered device (DermaSensor) to detect melanoma and basal and squamous cell cancers in the primary care setting. Patients & Methods: DERM-SUCCESS, a blinded, prospective, multicenter pivotal study, enrolled adult patients between August 17, 2020, and December 9, 2021, with lesions that their primary care physicians (PCPs) suspected of skin cancer at clinics in the US (n = 18) and Australia (n = 4). These lesions were assessed by PCPs and scanned with the DermaSensor device. Biopsy specimens were collected, and histopathologic analysis was performed by dermatopathologists. The diagnostic performance of the device, dermatopathologist discordance, and subgroup analyses of clinical interest were calculated. Results: Of the 1579 skin lesions enrolled, dermatopathologic analysis identified 224 (14.2%) cancers. Device sensitivity was 95.5% (95% CI, 91.7%-97.6%) overall and 96.3% (92.9%-98.4%) for patients in the FDA-approved age group 40 years and older (90.2% for melanoma, 97.8% for basal cell carcinoma, and 97.7% for squamous cell carcinoma). Device specificity was 20.7%. The negative predictive value was 96.6%, and the positive predictive value was 16.6% (NNB 6). The device misclassified as “ monitor ” rather than “ investigate further ” 4 keratinocyte carcinomas and 4 melanomas in patients aged 40 years or older (n = 8, 0.5% of lesions, 3.7% of cancers biopsied). Conclusions: The DermaSensor device is an easy-to-use, point-of-care, hand-held skin cancer adjunctive diagnostic device with high sensitivity and NPV to help inform PCP decision-making about skin lesions suspicious for cancer that need further evaluation and those that may be monitored.
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spelling doaj-art-ec0e1e5c738d4355bd3decdb9f89cf242025-08-20T03:26:38ZengSAGE PublishingJournal of Primary Care & Community Health2150-13272025-06-011610.1177/21501319251344423Primary Care Physician Use of Elastic Scattering Spectroscopy on Skin Lesions Suggestive of Skin CancerStephen P. Merry0Ivana T. Croghan1Kimberly A. Dukes2Brian C. McCormick3Gerard T. Considine4Michelle J. Duvall5Curtis T. Thompson6David J. Leffell7Department of Family Medicine, Mayo Clinic, Rochester, MN, USADepartment of Internal Medicine, Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USADepartment of Biostatistics, Boston University School of Public Health, Boston, MA, USAHampton Family Practice, Hampton, VA, USAClare Medical Centre, Clare, SA, AustraliaDepartment of Family Medicine, Mayo Clinic, Rochester, MN, USADepartment of Dermatology and Department of Pathology, Oregon Health & Science University, Portland, Oregon, USA; CTA Pathology: Curtis Thompson, MD & Associates, Beaverton, OR, USADepartment of Dermatology, Section of Dermatologic Surgery and Cutaneous Oncology, Yale School of Medicine, New Haven, CT, USAObjectives: To evaluate the performance of noninvasive, elastic scattering spectroscopy, algorithm-powered device (DermaSensor) to detect melanoma and basal and squamous cell cancers in the primary care setting. Patients & Methods: DERM-SUCCESS, a blinded, prospective, multicenter pivotal study, enrolled adult patients between August 17, 2020, and December 9, 2021, with lesions that their primary care physicians (PCPs) suspected of skin cancer at clinics in the US (n = 18) and Australia (n = 4). These lesions were assessed by PCPs and scanned with the DermaSensor device. Biopsy specimens were collected, and histopathologic analysis was performed by dermatopathologists. The diagnostic performance of the device, dermatopathologist discordance, and subgroup analyses of clinical interest were calculated. Results: Of the 1579 skin lesions enrolled, dermatopathologic analysis identified 224 (14.2%) cancers. Device sensitivity was 95.5% (95% CI, 91.7%-97.6%) overall and 96.3% (92.9%-98.4%) for patients in the FDA-approved age group 40 years and older (90.2% for melanoma, 97.8% for basal cell carcinoma, and 97.7% for squamous cell carcinoma). Device specificity was 20.7%. The negative predictive value was 96.6%, and the positive predictive value was 16.6% (NNB 6). The device misclassified as “ monitor ” rather than “ investigate further ” 4 keratinocyte carcinomas and 4 melanomas in patients aged 40 years or older (n = 8, 0.5% of lesions, 3.7% of cancers biopsied). Conclusions: The DermaSensor device is an easy-to-use, point-of-care, hand-held skin cancer adjunctive diagnostic device with high sensitivity and NPV to help inform PCP decision-making about skin lesions suspicious for cancer that need further evaluation and those that may be monitored.https://doi.org/10.1177/21501319251344423
spellingShingle Stephen P. Merry
Ivana T. Croghan
Kimberly A. Dukes
Brian C. McCormick
Gerard T. Considine
Michelle J. Duvall
Curtis T. Thompson
David J. Leffell
Primary Care Physician Use of Elastic Scattering Spectroscopy on Skin Lesions Suggestive of Skin Cancer
Journal of Primary Care & Community Health
title Primary Care Physician Use of Elastic Scattering Spectroscopy on Skin Lesions Suggestive of Skin Cancer
title_full Primary Care Physician Use of Elastic Scattering Spectroscopy on Skin Lesions Suggestive of Skin Cancer
title_fullStr Primary Care Physician Use of Elastic Scattering Spectroscopy on Skin Lesions Suggestive of Skin Cancer
title_full_unstemmed Primary Care Physician Use of Elastic Scattering Spectroscopy on Skin Lesions Suggestive of Skin Cancer
title_short Primary Care Physician Use of Elastic Scattering Spectroscopy on Skin Lesions Suggestive of Skin Cancer
title_sort primary care physician use of elastic scattering spectroscopy on skin lesions suggestive of skin cancer
url https://doi.org/10.1177/21501319251344423
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