To measure the performance of smartphone applications that evaluate photographs of skin lesions and provide the user with feedback about the likelihood of malignancy, Joel A. Wolf, B.A., and colleagues at the University of Pittsburgh Medical Center, tested the sensitivity, specificity, and positive and negative predictive values of four smartphone applications.
The authors included 188 images of lesions in the analysis, each of which was evaluated by the four smartphone applications, and the test result was recorded as positive, negative or unevaluable. Of these lesions, 60 were melanoma and the remaining 128 were benign.
Sensitivity of the four applications tested ranged from 6.8 percent to 98.1 percent; specificity ranged from 30.4 percent to 93.7 percent; positive predictive value ranged from 33.3 percent to 42.1 percent; and negative predictive value ranged from 65.4 percent to 97 percent. The highest sensitivity for melanoma diagnosis was observed for an application that sends the image directly to a board-certified dermatologist for analysis, while the lowest sensitivity for melanoma diagnosis were applications that use automated algorithms to analyze images.
The authors suggest that reliance on these applications, which are not subject to regulatory oversight, and not seeking medical consultation can delay the diagnosis of melanoma and potentially harm users.
"Physicians must be aware of these applications because the use of medical applications seems to be increasing over time... the dermatologist should be aware of those relevant to our field to aid us in protecting and educating our patients," the authors conclude. (JAMA Dermatology
Editor's Note: This study was supported by grants from the National Institutes of Health. Dr. Ferris also reported having served as an investigator and consultant for MELA Sciences, Inc. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.