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of Australian primary health care research 2009
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 Professor Jon Emery
Project:
General Practice, School of Primary, Aboriginal and Rural Health Care, University of Western Australia
Funding:
National Health and Medical, Research Council Primary Care and Project Grant |
 Associate Professor Scott Menzies
Project:
Director, The Sydney Melanoma Diagnostic Centre, Sydney Cancer Centre, Royal Prince Alfred Hospital
Funding:
National Health and Medical, Research Council Primary Care and Project Grant |
  Australia has the highest rate of melanoma in the world but this potentially fatal condition remains a diagnostic challenge in primary care. Australian GPs are reasonably sensitive at diagnosing melanoma, but this is estimated to be at the expense of excising 20 to 30 benign skin lesions for each melanoma diagnosed.
This project was conducted by a collaboration of researchers spread across four countries. This trial tested whether training GPs in the use of dermoscopy and digital monitoring improved their management of pigmented skin lesions. Sixty-three GPs from 19 practices in Perth completed training in the diagnostic aids and recruited 324 patients with 374 pigmented skin lesions that would have been excised or referred in routine practice.
The intervention resulted in a 63% reduction in excision or referral of benign lesions. Of the 42 malignant lesions, only one in-situ melanoma was incorrectly managed.
The trial demonstrated that training GPs to use these diagnostic aids made a big difference – significantly reducing the number of skin excisions for benign lesions while enabling GPs to be very sensitive in detecting melanoma.
Australian GPs are increasingly obtaining dermatoscopes (skin surface microscopes for detecting skin lesions) and, to a lesser extent, digital monitoring equipment. The trial’s findings support the wider dissemination of GP education programs in their use and provide strong justification for GPs to learn these important techniques for use in their daily practice.
View the project abstract on ROAR
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