PreprintArticleVersion 1Preserved in Portico This version is not peer-reviewed
The level of agreement between self-assessments and expert assessments of melanocytic nevus counts: Findings from an evaluation of 4548 blinded double assessments
Gefeller, O.; Kaiser, I.; Brockmann, E.M.; Uter, W.; Pfahlberg, A.B. The Level of Agreement between Self-Assessments and Examiner Assessments of Melanocytic Nevus Counts: Findings from an Evaluation of 4548 Double Assessments. Curr. Oncol.2024, 31, 2221-2232.
Gefeller, O.; Kaiser, I.; Brockmann, E.M.; Uter, W.; Pfahlberg, A.B. The Level of Agreement between Self-Assessments and Examiner Assessments of Melanocytic Nevus Counts: Findings from an Evaluation of 4548 Double Assessments. Curr. Oncol. 2024, 31, 2221-2232.
Gefeller, O.; Kaiser, I.; Brockmann, E.M.; Uter, W.; Pfahlberg, A.B. The Level of Agreement between Self-Assessments and Examiner Assessments of Melanocytic Nevus Counts: Findings from an Evaluation of 4548 Double Assessments. Curr. Oncol.2024, 31, 2221-2232.
Gefeller, O.; Kaiser, I.; Brockmann, E.M.; Uter, W.; Pfahlberg, A.B. The Level of Agreement between Self-Assessments and Examiner Assessments of Melanocytic Nevus Counts: Findings from an Evaluation of 4548 Double Assessments. Curr. Oncol. 2024, 31, 2221-2232.
Abstract
Cutaneous melanoma (CM) is a candidate for screening programs, since its prognosis is excellent when diagnosed in an early disease stage. Targeted screening of those at high risk for developing CM, a cost-effective alternative to population-wide screening, requires valid procedures to identify the high-risk group. Self-assessment of the number of nevi has been suggested as a component of such procedures, but its validity has not yet been established. We analyzed the level of agreement between self-assessments and expert assessments of the number of melanocytic nevi in the area between the wrist and the shoulder of both arms based on 4548 study subjects in whom mutually blinded double counting of nevi was performed. Nevus counting followed the IARC protocol. Study subjects received written instructions, photographs, a mirror, and a “nevometer” to support self-assessment of nevi larger than 2 mm. Nevus counts were categorized based on the quintiles of the distribution into five levels defining a nevus score. Cohen’s weighted kappa-coefficient was estimated to measure the level of agreement. In the total sample, agreement between self-assessments and expert-assessments was moderate (raw agreement: 50.29%, weighted κ=0.596). Self-assessed nevus counts were higher than those determined by experts (mean differ-ence: 3.33 nevi). The level of agreement was independent of sociodemographic and cutaneous factors; however, participants’ eye color had a significant impact on the level of agreement. Our findings show that even with comprehensive guidance, only a moderate level of agreement between self-assessed and expert-assessed nevus counts can be achieved. Self-assessed nevus information does not appear to be reliable enough to be used in individual risk assessment to target screening activities.
Keywords
cutaneous melanoma; screening; melanocytic nevus; self-counting; eye color
Subject
Public Health and Healthcare, Public, Environmental and Occupational Health
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
