Many primary care physicians are unable to proficiently triage skin lesions suspicious for cancer, compromising patients' health. Decision support software could help in the early detection of skin cancer, decreasing morbidity and mortality related to skin cancer misdiagnoses. It also could reduce unnecessary referrals to specialists, lowering health care costs. In Phase I, we demonstrated that decision support software can significantly improve physicians' ability to arrive at appropriate triage decisions for a variety skin lesions, including cancerous lesions. In Phase II, we propose to l) expand the decision support software to triage for pigmented lesions and a wider range of nonpigmented skin lesions; 2) incorporate case-based reasoning methods into the software to enable users to conduct a confidence check on their final triage decision and to help them make the correct decision at each branch point in the decision tree; 3) develop a teaching application based on the decision tree; 4) enable the software to produce for patients individualized information on skin cancer prevention and treatment; 5) interface the decision support software with the computerized patient medical record; and 6) test the effectiveness, utility, and feasibility of the decision support software with a sample of primary care physicians and patients.
This research is designed to produce comprehensive decision support software that will be a commercially viable product. Two large potential markets for this product are medical schools, which may use the software as a teaching aid, and medical settings, which may use the software as a clinical tool for practicing primary care physicians.
