American Journal of Epidemiology Vol. 126, No. 5: 901-911
Copyright © 1987 by The Johns Hopkins University School of Hygiene and Public Health
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OBSERVER PERCEPTION OF SKIN COLOR IN A STUDY OF MALIGNANT MELANOMA
1Division of Occupational and Environmental Health, Department of Health Care and Epidemiol ogy, University of British Columbia Vancouver, B.C., Canada
2Department of Clinical Epidemiology and Biostatistics, McMaster University Hamilton, Ontario, Canada
3Departments of Pathology and Medicine, Univer sity of Toronto and the Women's College Hospital Toronto, Ontario, Canada
4Sunnybrook Aids-for-Living Centre, University of Toronto Toronto, Ontario, Canada
Reprint requests to Dr. Clyde Hertzman, Division of Occupational and Environmental Health, Depart ment of Health Care and Epidemiology, University of British Columbia, 5804 Fairview Avenue, Vancouver, B.C. V6T 1W5, Canada
Observer perceptions of skin color with a 15-step skin tone panel were evaluated during an as yet unpublished case-control study of malignant mela noma. Skin color is a risk factor for melanoma, and the skin tone panel was Introduced in an effort to reduce Its misclassification. Reflectances of the 15 artificial skin tones were measured at four wavelengths with a reflectance spectrophotometer. Six observers each evaluated the skin color of eight study subjects twice under three lighting conditions, and the results were transformed to reflectance values. Components of variance analysis demonstrated that between-subject variability contributed 63% or more of the variance at wave lengths of 400–600 nm, white observers, light source, observation time, and error contrIbuted 30% or less. At 700 nm, only 25.5% of the variance was due to subjects, indicating lower levels of reliability. Similarly, the correlation of visual and spectrophotonietric assessment of skin reflectance was higher at 400–600 nm (r = 0.63–0.71) than at 700 nm (r = 0.41). Thus, the value of the skin tone panel-based assessments depends upon knowledge of which wavelengths most closely relate to the physiologic risk factor. For instance, reflectance at 650–700 nm is a better measure of skin melanin content than reflectance at lower wavelengths. Since the role of melanin as a risk factor remains in doubt, the utility of this technique has yet to be demonstrated. However, data from the casecontrol study and from this validity and reliability study will allow us to de velop an analytic approach that minimizes misclassification of skin color as a confounder.
analysis of variance; melanoma; perception; skin; spectrophotometry
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