Diagnostic accuracy and image fidelity in dermatology

Abstract

We examined the effect of decreasing image fidelity on clinicians’ ability to accurately diagnose two dermatological conditions. Two groups of clinicians (dermatologists and general practitioners) were recruited for the study. Seven images were constructed from two common skin lesions (seborrhoeic keratosis and keratoacanthoma). The first two images were those of the original lesions. The remaining five images were created from the first two images using morphing and cloning techniques to reduce image fidelity (e.g. one image comprised 50% of each of the originals). As the image composition fell from 100 to 50%, there was a decrease in diagnostic accuracy in both groups of observers. This was significant (P< 0.0001). Dermatologists were more accurate in the diagnosis of images compared to GPs (odds ratio 2.5, 95% CI 1.7–3.8). The results underline the importance of maintaining high standards of image fidelity to ensure the best diagnostic accuracy.