Nurses are increasingly used in the practice of dermatology in order to reduce costs and improve access to health care, but they are more often than dermatologists perform unnecessary skin biopsies to check for cancer, although diagnose early stage cancer kozhimozhno other method, according to new research conducted by the University School of Medicine Pittsburgh.
The research, conducted by Laura Ferris, Ph.D., Associate Professor, Department of Dermatology, University of Pittsburgh, published today in JAMA Dermatology.
"Although assistants can help to increase access to care and reduce waiting time, these results have important implications for teaching assistants and other doctors who are not specialists in dermatology", - said Ferris. "Currently there is no official program of training or certification in dermatology for nurses."
Ferris suggests that the results of the study should be considered when evaluating the cost of care. Nurses usually have lower salaries than physicians, and health systems are increasingly transferred responsibilities to the patients they care to control costs.
"In an age of expensive medicine is important to consider more than just the salary physician - Ferris said. "Missed diagnoses and unnecessary biopsies of benign lesions should be considered in decisions on the extent of the practice, making decisions about hiring, monitoring of suppliers and solutions for patients who provides their dermatological care."
The study examined the medical records of 33,647 screening of skin cancer examinations at 20,270 unique patients who in 2011-2015 were screened in the departments of dermatology related to UPMC. Ferris and her team found that a lower detection rate among nurses was only for melanoma and skin cancer early stage, and that they and dermatologists have been the same detection rates of invasive melanoma and nemetalomalnyh skin cancers, which are often more clinically obvious.
In addition, the study found that in each case the diagnosis of melanoma had more than 39 biopsy of pigmented lesions and dermatologists needed to biopsy a little more than 25 of these lesions. In other words, for each suspected case of melanoma suspicions were correct once out of 39, compared with one out of 25 for dermatologists.