Nine studies, assessing a total of 4213 lesions, were included in the review.
Only three instruments (four studies) were compared with a human diagnosis in the clinical field with a meaningful sample size that could allow some generalization with the wider clinical arena.
DB-MIPS (two studies): One study showed no significant difference between the instrument and human diagnosis, for either sensitivity or specificity. The other study showed similar sensitivities for instrument and human, with the human (trained dermatologist) showing higher specificity (human diagnosis 99%, 95% CI 98 to 100; instrument diagnosis 74%, 95% CI 69 to 79) when a clinician with minimal training was used, specificities were similar.
Telespectrometry (one study): This study showed similar sensitivities (no significant difference) for the telespectrometry system (80%) and clinical specialists (surgical oncologists with more than five years experience; 91%). The specificity of telespectrometry was found to be significantly lower (49%) than that of the specialists (74%).
Electrical impedance (one study): There was no significant difference between clinician diagnosis and the instrument for sensitivity. However, specificity was significantly poorer for the instrument (58%) than for the clinician (81%) specificity. The instrument could not discriminate melanoma on the head or neck due to different impedance properties of the skin at these sites.
Data from studies of other instruments with smaller sample sizes and studies comparing clinical management as the endpoint rather than diagnosis were reported separately.