{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:55:31Z","timestamp":1790733331862,"version":"4.1.0"},"reference-count":53,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,2,27]],"date-time":"2020-02-27T00:00:00Z","timestamp":1582761600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The diagnostic accuracy of reflectance confocal microscopy (<jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content>) of cutaneous malignant melanoma (<jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content>) seems promising. However, clinical scenarios in which <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> is most useful are still to be established.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess the diagnostic accuracy of <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> for <jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content> diagnosis according to study design, lesion type and diagnostic modality. Secondary outcomes include a comparison with dermoscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic literature search was conducted on PubMed, Embase, Scopus and Cochrane Public Library Databases for English articles published prior to January 2019. Statistical analyses were conducted with Meta\u2010Disc v. 1.4, <jats:styled-content style=\"fixed-case\">STATA<\/jats:styled-content> 14.0 software and the <jats:styled-content style=\"fixed-case\">QUADAS<\/jats:styled-content>\u20102 tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 32 studies (7352 lesions) were included in the meta\u2010analysis. Pooled sensitivity and specificity resulted 92% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.91\u20130.93) and 70% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.69\u20130.71), respectively. According to study design, diagnostic sensitivity was high for all study types, confirming a lower specificity for prospective interventional studies. Diagnostic accuracy remained high for all lesion types, with the highest specificity obtained for consecutive lesions of 77% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.75\u20130.78) vs. 65% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.63\u20130.66) for lesions highly suspicious for <jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> diagnostic accuracy was superior to dermoscopy, most notably in terms of specificity of 56% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.52\u20130.60) vs. 38% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.34\u20130.42), respectively. Studies were generally assessed across all domains as low or unclear risk of bias with a mainly low concern regarding applicability of evidence. Publication bias was asymmetrical (11.2\u00a0\u00b1\u00a04.0; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.97\u201319.43; <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Independent of study design, <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> has a high diagnostic power for <jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content> detection, and unnecessary excisions are reduced compared to dermoscopy. This reduction is most evident in non\u2010decisional <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> scenarios and for lesions analysed at <jats:styled-content style=\"fixed-case\">RCM<\/jats:styled-content> consecutively compared to those selected highly suspicious for <jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content>. However, the scarcity, heterogeneity and bias associated with the data in literature should be considered when interpreting present conclusions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.16248","type":"journal-article","created":{"date-parts":[[2020,1,30]],"date-time":"2020-01-30T07:19:26Z","timestamp":1580368766000},"page":"2268-2279","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["Reflectance confocal microscopy diagnostic accuracy for malignant melanoma in different clinical settings: systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8628-3918","authenticated-orcid":false,"given":"C.","family":"Pezzini","sequence":"first","affiliation":[{"name":"Dermatology Unit University of Modena and Reggio Emilia Modena 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