| Summary: | Abstract
Background
Skin cancer is the most common cancer in humans, and its incidence is escalating rapidly. The need for accurate skin cancer diagnosis is essential to minimise the associated morbidity and mortality, and subsequently improve patient outcomes.
Aim
To conduct a systematic review to see if educational interventions improve primary care clinicians’ diagnostic accuracy of skin cancer.
Search Strategy
The Cochrane Central Register of Controlled Trials (The Cochrane Library 2007, Issue 1), MEDLINE (1950-August 2009), EMBASE (1980-August 2009) and The Cochrane Database of Systematic Reviews were searched. Reference lists were also searched. Unpublished articles were not located.
Selection Criteria
Randomised controlled trials of educational interventions for improving the diagnostic accuracy of skin cancer in primary care.
Data Collection and Analysis
Data were extracted independently. The Cochrane Collaboration’s tool was used to assess methodological quality of included studies. Results were reported narratively, and meta-analysis was performed on three studies.
Results
Five studies were identified for inclusion in the review. All studies showed improvements in participants’ diagnostic accuracy of skin cancer following the educational intervention employed, although only two studies’ improvements were statistically significant. The meta-analysis of homogenous studies favoured educational interventions. No patterns were identified according to country. Of the two studies which presented results according to lesion type, one study was unsuccessful in improving squamous cell carcinoma diagnosis. With exception to this, the diagnostic accuracy of all types of skin cancer improved after the intervention. Studies showing statistically significant improvements in diagnostic accuracy collected their results within the earliest time frame, suggesting that the interventions were more effective on a short-term rather than long-term basis. Interventions with a multi faceted, interactive or internet-based design were the most effective.
Conclusions
Educational interventions can effectively improve primary care clinicians’ diagnostic accuracy of skin cancer. More research is needed to substantiate the findings of this review and apply them specifically to nursing.
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