Page 12 - Noninvasive Diagnostic Techniques for the Detection of Skin Cancers

Guiding Question 4. What is the projected diffusion of these different
techniques/modalities in the near future? What are potential areas for
future research that are most meaningful given the current state of the
evidence and the projected diffusion of these techniques/modalities?

Analytic Framework

The analytic framework addresses the evaluation of patients with suspicious skin lesions,
who, based on their own characteristics (such as prior history or other risk factors) or the setting
in which they seek care (primary, specialty, or subspecialty care), may be considered as
candidates for assessment with noninvasive techniques. Eligible patients would be considered for
one or more of the noninvasive techniques prior to or in lieu of biopsy. The specific device(s)
selected could be those in general clinical use (i.e., photography and dermoscopy), limited
clinical use or investigational, based on availability and suitability of the device to address the
clinical problem. The framework is designed to include a feedback loop that leads to biopsy if
either the evaluation were positive or referred back for further followup. The importance of
clinical setting (availability of the device and suitable levels of training/competency) and the
patient’s individual characteristics are considered at multiple junctures within the framework.
Solid wiggly lines generally indicate associations/relationships that are present, but not direct or
not of our interest. They can be impact of effect modifiers, or adverse effects of interventions.
The dotted wiggly line between the noninvasive test box and the biopsy box indicates that we
were comparing between the two tests.

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