OBJECTIVE To provide a formal statistical comparison of the efficacy of melanoma detection among different clinical settings. METHODS A systematic review and meta-analysis of all relevant observational studies on number needed to treat (NNT) in relation to melanoma was performed in MEDLINE. We performed a random-effects model meta-analysis and reported NNTs with 95% confidence intervals (CIs). The subgroup analysis was related to clinical setting. RESULTS In all, 29 articles including a total of 398,549 biopsies/excisions were analyzed. The overall NNT was 9.71 (95% CI, 7.72-12.29): 22.62 (95% CI, 12.95-40.10) for primary care, 9.60 (95% CI, 6.97-13.41) for dermatology, and 5.85 (95% CI, 4.24-8.27) for pigmented lesion specialists. LIMITATIONS There is heterogeneity in data reporting and the possibility of missing studies. In addition, the incidence of melanoma varies among clinical settings, which could affect NNT calculations. CONCLUSION Pigmented lesion specialists have the lowest NNT, followed by dermatologists, suggesting that involving specialists in the diagnosis and treatment of pigmented skin lesions can likely improve patient outcomes.

中文翻译：

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通过临床背景诊断黑色素瘤所需治疗的数量的荟萃分析。

目的提供正式的统计学比较，以比较不同临床环境中黑色素瘤检测的功效。方法在MEDLINE中对所有与黑色素瘤相关的治疗所需数量（NNT）的相关观察性研究进行了系统的回顾和荟萃分析。我们进行了随机效应模型荟萃分析，并报告了具有95％置信区间（CI）的NNT。亚组分析与临床环境有关。结果总共对29篇文章进行了分析，包括398,549例活检/切除。总体NNT为9.71（95％CI，7.72-12.29）：初级保健为22.62（95％CI，12.95-40.10），皮肤科为9.60（95％CI，6.97-13.41），5.85（95％CI，4.24） -8.27）适用于色素沉着病变专家。局限性数据报告存在异质性，有可能遗漏研究。此外，黑色素瘤的发生率因临床情况而异，这可能会影响NNT的计算。结论色素沉着病变专家的NNT最低，其次是皮肤科医生，这表明让色素沉着皮肤病变的诊断和治疗专家参与可能会改善患者的预后。