Validity of clinical diagnosis in dermatology

Abstract

Objective: We evaluated the accuracy of the clinical diagnostic process performed by dermatologists. Material and Methods: We conducted a cross-sectional study, based on a retrospective search of data at a dermatology outpatient department. Fifteen skin diseases were selected. A group of patients with those diseases at their first outpatient visit and a further histopathological study were included. The accuracy of any given clinical diagnosis was studied taking the histopathological diagnosis as the gold standard. Validity indices were calculated. Results: We studied 2188 patients. Skin diseases were more prevalent among women (P < 0.05). While the clinical diagnostic process displayed a high level of validity in melanocytic naevi and basal cell carcinoma, a poor level was nevertheless observed for Bowen’s disease (sensitivity 22.8%, specificity 96.5%). The most frequent sites of appearance of dermatological problems were face and trunk. Conclusions: Evaluation of diagnosis in pathologies having an available “gold standard” enables the accuracy of clinical diagnoses to be verified. The validity of clinical diagnosis was high.