Method: We used a cross-sectional design. Participants were recruited through GPs Down Under, a Facebook group comprising over 6000 authenticated general practitioners (GPs) from Australia and New Zealand. GP participants completed an online survey with questions on: (1) their overall melanoma risk in both absolute and relative terms, and (2) melanoma risk factors as identified in a validated melanoma risk prediction model to enable the calculation of absolute and relative risk. The relation between clinician- and model- generated melanoma risk prediction (both absolute and relative melanoma risk) was assessed using Pearson correlation coefficients and correlation plots.
Results: 136 of the 150 GP respondents completed the online survey between June to August 2019. The Pearson correlation coefficient for clinician- and model-generated melanoma risk prediction was 0.20 (95% CI 0.03 to 0.36) for remaining lifetime absolute melanoma risk and 0.60 (95% CI 0.48 to 0.70) for relative melanoma risk. There was a tendency for participants to overestimate risk when it is low, and underestimate risk when it is high.
Discussion: This is the first study to compare clinician-generated melanoma risk assessments against a well-validated and prospectively evaluated model. It showed poor correlation between clinician-reported against model-generated melanoma risk.
Implications for practice: Further work is needed on understanding the clinical impact of risk discordance.