Assessing the impact of color blindness on the ability of identifying benign and malignant skin lesions by naked-eye examination.

BACKGROUND: Color vision deficiency describes the inability to distinguish certain shades of color. The aim of this study was to assess the impact of having color vision deficiency on the accuracy of distinguishing benign and malignant skin lesions by naked-eye examination. METHODS: This was a cross-sectional study conducted during the period August 2020 to February 2021. We randomly selected a total of 20 nevi and 20 melanoma images from an open access image database. The 40 images were divided into four sets of images, each set contained 5 benign and 5 malignant skin lesion images simulated as if they were seen by a protanope physician, deuteranope physician, tritanope physician, and a set of images presented without simulation. In an online survey, students who were in their final year of medical school or had newly graduated were asked to diagnose each image as benign or malignant. RESULTS: A total of 140 participants were included with a mean (SD) age of 24.88 (1.51). We found a significantly higher mean accuracy for non-simulated images compared to deuteranope simulated images (p< 0.001, mean difference = 11.07, 95% CI 8.40 to 13.74). We did not find a significant difference in accuracy classification for protanope simulated images (p = 0.066), nor for tritanope simulated images (p = 0.315). Classification accuracy for malignant lesions was higher than classification accuracy for benign lesions, with the highest difference belonging to deuteranope simulated images, with a difference in mean accuracy of classifying malignant lesions by 32.2 (95% CI 27.0 to 37.6). CONCLUSION: Deuteranope participants (i.e., green color deficiency) had a significantly lower accuracy of distinguishing pigmented skin lesions as benign or malignant, an impact not found for other color vision deficiencies, which was mainly for misdiagnosing benign lesions as malignant.

Comparing the Attention Score Between American and European Cardiology Guidelines.

INTRODUCTION: The American College of Cardiology (ACC) in USA and the European Society of Cardiology (ESC) in Europe have issued around 25 practice cardiology guidelines since 2008. The attention and impact of these guidelines have not been investigated yet. AIM: In this study, we aim to compare the attention brought up by ACC and ESC guidelines. METHODS: Guideline documents were defined as documents published by either the ACC or the ESC, where recommendations with a specific level of evidence are clearly indicated. These documents were posted on their respective websites. For each document, we extracted the attention on blogs, news, social media, and other platforms to calculate a total score known as the Altmetric Attention Score (AAS). Then we compared AAS, citations, and other indices between ACC and ESC guideline documents. RESULTS: A total of 26 US and 24 European cardiology guidelines were released between 2008 and 2018. We found a significant difference in the median AAS between American and European guidelines (p = 0.048). The median AAS for European and for American guidelines were 159 (104.25-392.5) and 79 (24-169.75), respectively. The US Contribution to the AAS was significantly higher than the European in both the European guidelines (p < 0.001, median contribution values were 7.6% vs 3.4%, respectively), and the American guidelines (p = 0.011, median contribution values were 12% vs 7%, respectively). CONCLUSION: The attention brought up by the European guideline documents was higher than the American guidelines, although most of the attention in both guidelines was contributed to by USA.