Online Training on Skin Cancer Diagnosis in Rheumatologists: Results from a Nationwide Randomized Web-Based Survey

Manuelle Viguier (1) , Stéphanie Rist (2) , François Aubin (3) , Marie-Thérèse Leccia (4) , Marie-Aleth Richard (5, 6) , Marina Esposito-Farèse (7) , Philippe Gaudin (8) , Thao Pham (9) , Pascal Richette (10) , Daniel Wendling (11) , Jean Sibilia (12) , Florence Tubach (7) , Charles Dufrene (13) , Yannick Darras (13) , Eric Sauvage (13) , Sophie Carret (13) , Zahir Amoura (13) , Olivier Benveniste (13) , Olivier Boyer (13) , Patrick Durez (13) , Bruno Fautrel (13) , Pierre-André Guerne (13) , Eric Hachulla (13) , Denis Jullien (13) , Luc Mouthon (13) , Xavier Puechal (13) , Jérémie Sellam (13)

1 Hôpital Saint-Louis
2 Service de Rhumatologie
3 CEF2P / CARCINO - Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181)
4 Clinique de Dermatologie Allergologie et Photobiologie
5 CRO2 - Centre de Recherches en Oncologie biologique et Oncopharmacologie
6 Service de Dermatologie
7 CHU Pitié-Salpêtrière [AP-HP]
8 Clinique Universitaire de Rhumatologie
9 Service de Rhumatologie
10 Service de Rhumatologie
11 Service de Rhumatologie
12 IRM - Immuno-Rhumatologie Moléculaire
13 Club Rhumatismes et Inflammation

Patients with inflammatory rheumatisms, such as rheumatoid arthritis, are more prone to develop skin cancers than the general population, with an additional increased incidence when receiving TNF blockers. There is therefore a need that physicians treating patients affected with inflammatory rheumatisms with TNF blockers recognize malignant skin lesions, requiring an urgent referral to the dermatologist and a potential withdrawal or modification of the immunomodulatory treatment. We aimed to demonstrate that an online training dedicated to skin tumors increase the abilities of rheumatologists to discriminate skin cancers from benign skin tumors. A nationwide randomized web-based survey involving 141 French rheumatologists was conducted. The baseline evaluation included short cases with skin lesion pictures and multiple choice questions assessing basic knowledge on skin cancers. For each case, rheumatologists had to indicate the nature of skin lesion (benign; premalignant/ malignant), their level of confidence in this diagnosis (10-points Likert scale), and the precise dermatological diagnosis among 5 propositions. Different scores were established. After randomization, only one group had access to the online formation consisting in 4 elearning modules on skin tumors, of 15 minutes each (online training group). After reevaluation, the trained and the non-trained group (control group) were compared. The primary end-point was the number of adequate diagnoses of the nature of the skin lesions. The mean number of adequate diagnosis for the benign versus premalignant/malignant nature of the lesions was higher in the online training group (13.4 vs. 11.2 points; p value <0.0001). While the other knowledge scores were also significantly higher, no statistical difference was observed on the level of self-confidence between the 2 groups. In conclusion, the online formation was effective to improve the rheumatologists' ability to diagnose skin cancer.

Mots clés: NECROSIS-FACTOR INHIBITORS; RHEUMATOID-ARTHRITIS; METAANALYSIS; THERAPY; RISK

Domaines: Cancer

Manuelle Viguier, Stéphanie Rist, François Aubin, Marie-Thérèse Leccia, Marie-Aleth Richard, et al.. Online Training on Skin Cancer Diagnosis in Rheumatologists: Results from a Nationwide Randomized Web-Based Survey. PLoS ONE, 2015, ⟨10.1371/journal.pone.0127564⟩. ⟨hal-01211398⟩