Harrison, Simone L., Buettner, Petra, MacLennan, Robert, Kelly, John W., and Rivers, Jason K. (2002) How good are parents at assessing melanocytic nevi on their children? a study comparing parental counts, dermatologist counts, and counts obtained from photographs. American Journal of Epidemiology, 155 (12). pp. 1128-1136.

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Abstract

The objective of this study was to evaluate agreement among counts of melanocytic nevi made by parents, counts made by a dermatologist, and counts made by assessment of photographs. In 1990, 421 schoolchildren aged 6–15 years from Townsville, Queensland, Australia (latitude 19.16°S), participated in the Eastern Australian Childhood Nevus Study. In an agreement study, parents were asked to mark on an anatomic diagram any melanocytic nevi greater than or equal to 2 mm in diameter and greater than or equal to 5 mm in diameter they observed on their child's back prior to the child's examination by a dermatologist; 324 parents responded (a 77% response rate). Standardized slide photographs of each child's back were taken, and melanocytic nevi were counted by an experienced non-medical-examiner upon projection. Agreement was assessed graphically and with the concordance correlation coefficient (rc). Parental counts of melanocytic nevi were similar to counts made by the dermatologist (n = 77; for nevi ≥2 mm, rc = 0.51; for nevi ≥5 mm, rc = 0.78) and counts obtained from the photographs (n = 324; for nevi ≥2 mm, rc = 0.68; for nevi ≥5 mm, rc = 0.68). Few parents reported false-positive lesions. Parents tended to underestimate the number of melanocytic nevi greater than or equal to 2 mm in diameter (mean difference from dermatologist: −3.2, standard deviation 6.8; mean difference from photographs: −1.1, standard deviation 5.1), particularly when the density of melanocytic nevi was high. Agreement between dermatologist counts and photograph counts was high (for nevi ≥2 mm, rc = 0.80; for nevi ≥5 mm, rc = 0.87). The authors conclude that parents are capable of counting melanocytic nevi on their children's skin with some validity. In epidemiologic studies of children, counts of melanocytic nevi obtained from standardized photographs have the potential to replace counts made by physicians.

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