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Comment & Response
August 2016

A Closer Inspection of the Number Needed to Biopsy

Author Affiliations
  • 1Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
JAMA Dermatol. 2016;152(8):952-953. doi:10.1001/jamadermatol.2016.0936

To the Editor To reduce the costs of treating skin cancer, Shahwan and Kimball1 suggest restricting the performance of biopsies for skin cancer to clinicians with favorable number-needed-to-biopsy (NNB) ratios. However, when viewed in isolation, the NNB is a limited surrogate for diagnostic accuracy and a problematic metric for assessing cost-effectiveness.

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