Comparison of elements in clinical prediction rules for malignant melanoma
| (a) Clinical rules | ||||
|---|---|---|---|---|
| Clinical CPR name | ||||
| Elements | ABCD | ABCDE | 7-point checklist | Revised 7-point checklist |
| Asymmetry | X | X | X | |
| Border irregularity | X | X | X | |
| Colour variegation | X | X | X | X |
| Diameter (>6 mm) | X | X | X (>7 mm) | X (>7 mm) |
| Evolving (eg, size, shape, colour) | X | X (size) | X | |
| Altered sensation | X | X | ||
| Inflammation | X | X | ||
| Crusting, bleeding | X | X | ||
| Cut-point | ≥1 | ≥1 or ≥2 | ≥3 | ≥3 |
| (b) Dermoscopic rules | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CPR name | ||||||||||||||||
| Element | ABCD | 7-point checklist | Revised 7-point checklist | Menzies 1996 | 3-point checklist | 7FFM | CASH | ABCDE | 3-colour test | Kreusch 1992 | Nilles 1994 | Menzies 2008—melanoma | Menzies 2008—skin cancer | DynaMel | Simplified ABC | AC rule |
| Asymmetry | X | X | X | X | X | X | X | X | X | X | X | X | ||||
| Multiple colours (light/dark brown, black, red, white, blue) | X | X | X | X | X | X | X | X | X | X | X | X | X | |||
| Architectural disorder (structures and colours) | X | X | X | X | X | X | X | X | ||||||||
| Atypical network | X | X | X | X | X | X | X | X | X | |||||||
| Blue-white veil | X | X | X | X | X | X | ||||||||||
| Blue-white structures | X | X | ||||||||||||||
| Streaks/radial streaming/pseudopods | X | X | X | X | X | X | X | X | X | X | ||||||
| Dots, globules | X | X | X | X | X | X | X | X | X | |||||||
| Regression structures or erythema | X | X | X | X | X | X | X | X | ||||||||
| Scarring | X | X | ||||||||||||||
| Blotches (structure less region >10% | X | X | X | |||||||||||||
| Atypical vascular pattern | X | X | X | X | X | X | X | |||||||||
| Recognisable as benign | X | |||||||||||||||
| Abrupt cut-off border pigment | X | X | X | X | ||||||||||||
| Blue-grey dots | X | |||||||||||||||
| Change | X | X | X | X | ||||||||||||
| Cut-point | ≥4.75 ≥5.45 | ≥3 | ≥1 | ≥1, no features | ≥1 | ≥2 | ≥2 | Not reported | ≥3 | Not reported | Not reported | ≥1 | ≥0 (high sensitivity) ≥1 (high specificity) | ≥3 | ≥4 | Not reported |
ABC, Asymmetry, irregular Borders, more than one or uneven distribution of Colour; ABCD, Asymmetry, irregular Borders, more than one or uneven distribution of Colour, or a large (greater than 6 mm) Diameter; ABCDE, Asymmetry, irregular Borders, more than one or uneven distribution of Colour, or a large (greater than 6mm)Diameter, Evolution of moles; AC, asymmetry, colour variation; CASH, color, architecture, symmetry, and homogeneity; CPR, clinical prediction rules; FFM, features for melanoma.