Background: Australian general practice prevention guidelines recommend a stratified approach to melanoma screening based on individualised risk levels. Melanoma risk prediction tools, based on multiple risk factors, may assist general practitioners (GPs) in risk estimation and targeting melanoma screening. Several melanoma risk prediction tools have been developed and validated, but none are routinely used in clinical practice. The future implementation of prediction tools could be supported by understanding GPs current approach to melanoma risk estimation and their perspectives on clinical implementation.
Method: Participants were recruited through GPs Down Under, a Facebook group comprising over 6000 authenticated GPs from Australia and New Zealand. The GP participants were purposively sampled for semi-structured telephone interviews, which were audio-recorded and professionally transcribed. The transcripts were analysed using Grounded Theory method as described by Corbin and Strauss. Earlier analytic insights informed latter data collection (theoretical sampling) which continued until saturation was reached.
Results: Twenty Australian GPs were interviewed. The explanatory model that emerged consisted of six major themes. These themes showed GPs conceptualisation of melanoma risk estimation in practice could be understood as a linear clinical process that connects five of the six themes: patient selection, clinical assessment, risk estimation, management recommendation, and patient education. The GPs perceived prospective roles for melanoma risk prediction tools at each clinical process theme.
Discussion: GPs estimation of melanoma risk may not reflect practice guidelines, in terms of the risk factors considered and the risk factor analysis. Their perceptions on the role of melanoma prediction tools were informed by existing tools and they were willing to consider using melanoma risk prediction tools in clinical practice.
Implications for practice: Explicitly aligning the incorporation of a risk prediction tool to the identified themes may improve its implementation in general practice.