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The persisting pseudomelanoma problem.

M Chang·L E Zimmerman·I McLean
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Abstract

We reviewed 6,169 cases in which whole eyes were submitted to the Armed Forces Institute of Pathology (AFIP), Washington, DC, between January 1970 and December 1980. We sought to determine whether there had been any change in the frequency of incorrect diagnoses of malignant melanoma since two previous studies had been conducted at the AFIP. Of 744 eyes with clear media submitted with the clinical diagnosis of malignant melanoma, the rate of incorrect diagnosis was 6.4% (48 of 744 cases). During the 11-year study, the rate of incorrect diagnoses declined from 12.5% to 1.4%. Despite that overall decrease, the locations and frequency of simulating lesions were comparable with those found in the two previous studies. We believe our current findings reflect a significant increase in diagnostic accuracy among clinicians practicing outside of major academic centers.

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Choroid NeoplasmsCiliary BodyDiagnosis, DifferentialDiagnostic ErrorsEye DiseasesHumansMelanomaUveal NeoplasmsJournal ArticleResearch Support, Non-U.S. Gov'tResearch Support, U.S. Gov't, P.H.S.

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M Chang, L E Zimmerman, I McLean. 1984. The persisting pseudomelanoma problem.. https://doi.org/10.1001/archopht.1984.01040030582024

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Feasibility of keying data from screen-displayed facsimile images in an ongoing trial: the collaborative ocular melanoma study.

As part of an ongoing clinical trial, we conducted an experiment to assess the feasibility and to determine the reliability of data entry from a computer screen display of images of data collection forms transmitted by facsimile (fax) machines directly into a computer for paper forms designed without consideration of fax or image display requirements. Feasibility was assessed on the basis of accuracy and reliability of data entry and on operator satisfaction. During a 2-week period, half of the forms received at the Collaborative Ocular Melanoma Study (COMS) coordinating center were key-entered twice, using the paper forms as the source (paper source entry). The remaining forms were entered once using paper source and were later reentered using the screen display of images of the faxed forms as the source (image source entry). The latter group of forms, or 50% of all forms received, were entered a third time, using the image source entry. Two data entry operators participated in the experiment. Discrepancy rates between and within data entry operators were calculated for both modes of entry. A total of 50,861 keystrokes (28,095 items) across 1122 records were checked for consistency. The overall discrepancy rate associated with double paper source entry was approximately 21 per 10,000 keystrokes (20 per 10,000 items). Discrepancy rates associated with paper source versus image source entry (53 per 10,000 keystrokes [57 per 10,000 items]) and double image source entry (57 per 10,000 keystrokes [47 per 10,000 items]) were similar in magnitude. Image source entry of forms received by facsimile may provide an acceptable alternative to paper entry in ongoing multicenter clinical trials where the costs of converting existing forms and systems to automated data capture may be unacceptable. This experiment confirmed the feasibility of such an alternative and suggested that improved screen displays and changes in equipment to facilitate entry of data from the screen display may enhance accuracy of entries.

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