Teaching non-specialist health care professionals how to identify the atypical mole syndrome phenotype: a multinational study

The atypical mole syndrome (AMS) phenotype is the strongest known risk fact or for cutaneous melanoma but recognition of the phenotype has been claimed to be problematic and to require specialist assessment. This study determi ned the ability of previously unskilled doctors and nurses in five countrie s to recognize the phenotype after brief training. The system used was the AMS scoring system. This incorporates melanocytic naevus counts, clinical a typia of naevi and distribution of naevi, The agreement in scoring between the dermatologist and trained personnel was determined in 986 patients: ove rall agreement in diagnosis was 94.5% (kappa 0.70, P < 0.0001). The kappa s cores in different countries ranged from 0.65 to 0.77 for individual naevus characteristics, indicative of good agreement. Accurate diagnosis of the a typical mole syndrome phenotype is possible by non-specialists. This has im plications for collaborative studies of naevi, for screening and for both p rimary and secondary prevention of melanoma.