The "INFORMED" program
May 25th, 2017
The mortality rate for late stage melanoma is very high. The most effective way we can reduce the mortality rate is with early detection. We know that if working aggressively to catch it in its earliest stages melanoma can have a very minimal effect on a person’s life. But we can be too aggressive. The old standard had been “When in doubt, cut it out”. This can lead to unnecessary discomfort and scars for patients if the biopsy tests negative. Identification of suspicious skin lesions can be problematic and can be subject to the interpretation of whichever doctor is being seen. Most often these initial appointments are with the primary care physician who may not have had a lot of training or experience with dermatology. This can lead to either an over aggressive determination or one so cautious that something is missed.
To this end Dr. Martin A. Weinstock PhD has developed a short online training curriculum. This training program for PCP’s and is looking to get the word out. This training gives medical professionals the skills to examine and identify suspicious spots more effectively. The main goals of this program are to minimize harm and maximize benefits, improve on the ABCD’s method, prevent referral and surgery for seborrheic keratoses and other melanoma mimics, and to make this readily available to everyone. The online training is approximately 80 minutes long and includes an interactive photo gallery and an interactive case examination so a virtual examination can be conducted. This can be used by both PCP’s and nurses. With a few more steps it can be approved as a CME, or for nursing, a CUE. I found the program helpful to myself as a layperson. With the knowledge gained from this program noncancerous lesions are less likely to be sent as a referral and truly suspicious ones will be identified more accurately.
“Informed” has been proven to have sustained improvement in diagnosing lesions while reducing unnecessary referrals. In one HMO setting it reduced new patient visits to their dermatologists without reducing the number of biopsies and diagnosis. “Informed” program increased melanoma diagnosis’s and when implemented and showed few negative effects. Using this information we can definitely improve upon the 25 year old A, B, C, D, and E approach to public awareness. The big picture still is that most doctors still do not thoroughly examine skin for cancerous lesions and most patients do not do this for themselves. If no one is looking how will early detection happen?
This program has been created and validated with funds from the Melanoma Research Alliance and is available free to anyone that wants to access it worldwide. If visiting your PCP bring them this piece of information so they might add it to their tool box of knowledge.
The website is