Reliability of Web-based teledermatology consultations (original) (raw)
Related papers
Concordance studies of a web based system in teledermatology
2009
Introduction: Implementation of teledermatology in primary care offers the possibility of treating patients using specific dermatologic knowledge in far away places with infrequent availability to these services. It is a priority to implement teledermatology services which demonstrate diagnostic reliability and satisfaction among users. Objectives and methods: To measure the diagnostic reliability of an asynchronous teledermatology web based application by means of intraobserver and interobserver concordance during teleconsultation and traditional presential («face to face») consultation. Furthermore, to evaluate user satisfaction regarding the teleconsultation and the web application. Results: A sample of 82 patients with 172 dermatologic diagnoses was obtained, in which an intraobserver concordance between 80.8% and 86.6%, and an interobserver concordance between 77.3% and 79.6% were found. Satisfaction was evaluated to be on an average of 92.5%. Conclusions: The teleconsultation reliability in teledermatology is evidenced to be high, and is susceptible of improvement through the implementation of health information standards and digital dermatologic photography protocols.
Two years' experience with Web-based teleconsulting in dermatology
A non-commercial teledermatology network based on store-and-forward operation was established in April 2002. The aim was to create an easy-to-use platform for teleconsultation services, where physicians could seek diagnostic advice in dermatology from a pool of expert consultants and where they could present and discuss challenging dermatology cases with special emphasis on diagnosis and therapy. An online moderated discussion forum was added in October 2003. During the first two years, 348 health-care professionals from 45 countries registered to use the Website. A total of 783 requests for consultations were answered; 285 requests concerned pigmented skin lesions, 440 requests were from the whole range of clinical dermatology and 58 requests were about non-melanoma skin cancer. Of a total of 133 requests analysed, 80 (60%) were answered within one day, 47 (35%) within one week, five (4%) within two weeks and one (1%) consultation was answered in more than two weeks. Our experience with a discretionary, non-commercial, multilingual Website for open-access teleconsulting in dermatology appears to be successful. The Website represents an example of user-generated content, together with active interaction between users, who can present and discuss cases with remote colleagues.
Telemedicine in dermatology : Evaluation of secondary and tertiary teledermatology
2013
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Journal of Telemedicine and Telecare, 2019
Introduction Few studies have assessed the perception of teledermatologists about the utility and limitations of teledermatology, especially to diagnose a broad range of skin diseases. This study aimed to evaluate dermatologists’ confidence in teledermatology, its utility and limitations for dermatological conditions in primary care. Methods An analytical study that used a survey for dermatologists who diagnosed 30,916 patients with 55,012 lesions through teledermatology during a 1-year project in São Paulo, Brazil. Results Dermatologists found teledermatology useful for triage and diagnosis, especially for xerotic eczema, pigmentary disorders and superficial infections. Their confidence in teledermatology was statistically higher by the end of the project ( p = 0.0012). Limitations included some technical issues and the impossibility to suggest how soon the patient should be assisted face-to-face by a dermatologist. The most treatable group of diseases by teledermatology was superf...
Telemedicine versus in-person dermatology referrals: an analysis of case complexity
Telemedicine journal and e-health : the official journal of the American Telemedicine Association, 2002
The goal of this study was to determine whether teledermatology referrals differ significantly from in-person referrals with respect to case complexity and diagnosis of cases referred. Teledermatology cases were compared to in-person cases seen by the same university dermatologist who also reviews the teledermatology cases. These were also compared with in-person cases evaluated by a different dermatologist at local clinics using traditional referral patterns. Study parameters included Current Procedural Terminology (CPT) codes as a measure of case complexity, International Classification of Disease (ICD) codes as a measure of case types, and time from referral to actual consultation. The most common CPT codes used for teledermatology were 99241 and 99242 with no significant differences in the frequency of assigned CPT codes for teledermatology versus in-person consultation. An analysis of the diagnostic codes revealed no significant differences between the types of cases referred t...
Using Telemedicine in the Provision of Dermatology
This study examines the extent to which patient characteristics are associated with the use of telemedicine in a single medical specialty-dermatology. Numerous studies 1-4 have found teledermatology to be as effective as a face-to-face visit in diagnosing conditions in 75 to 85 percent of cases; there are still certain conditions for which telemedicine is not adequate or appropriate. Clinically, these previous studies also indicate that teledermatology is a feasible alternative in cases where circumstances, such as geography, do not allow for convenient face-to-face consultation with a dermatologist.
JMIR dermatology, 2022
Background: Dermatologists rely on visual findings; thus, teledermatology is uniquely compatible to providing dermatologic care. The use of mobile phones in a store-and-forward approach, where gathered data are sent to a distant health provider for later review, may be a potential bridge in seeking dermatologic care. Objective: This study aimed to determine the agreement between face-to-face consultations and teledermatologic consultations through the store-and-forward approach using mobile phones and its accuracy compared to a histopathologic diagnosis. Methods: The study design was a cross-sectional study of participants consecutively recruited from dermatology patients who presented with skin or mucosal complaint and without prior dermatologist consultation. Photographs were taken using a standard smartphone (iPhone 6s Plus), and a 4-mm skin punch biopsy was taken on each patient-the gold standard to which the study result was compared to. The photographs were sent to 3 consultant dermatologists using a store-and-forward approach, for independent diagnosis and treatment plan. Results: A total of 60 patients were included, with a median age of 41 years. There was moderate-to-almost perfect agreement in terms of final diagnosis between the face-to-face dermatologic diagnosis and teledermatologic diagnoses. The third teledermatologist had the highest agreement with the clinical dermatologist in terms of final diagnosis (κ=0.84; P<.001). Among the 3 dermatologists, there was moderate-to-almost perfect agreement as well. Agreement between pairs of teledermatologists ranged from 0.45 to 0.84. The 3 teledermatologists had moderate-to-substantial agreement with the biopsy results, with the third teledermatologist having the highest accuracy (κ=0.77; P<.001). Overall, there was a moderate agreement in the diagnosis of patients across raters. Conclusions: Teledermatology is a viable alternative to face-to-face consultations. Our results show moderate-to-substantial agreement in diagnoses from a face-to-face consultation and store-and-forward teledermatology.
Teledermatology and In-Person Examinations
Archives of Dermatology, 1998
To compare physician and patient impressions and interphysician diagnostic agreement between live teledermatology and in-person examinations. Design: Paired video and in-person examinations with different dermatologists. Setting: An urban Veterans Affairs dermatology clinic. Patients: One hundred thirty-nine patients. Main Outcome Measures: Satisfaction questionnaires and interphysician diagnostic agreement. Results: Patient and physician satisfaction was high. Agreement between video and in-person diagnoses was 80%. Conclusions: Physicians and patients were satisfied with teledermatology examinations. Diagnostic agreement between in-person and video dermatologists was high.
Accuracy and efficiency of telemedicine in atopic dermatitis
JAAD International, 2020
Background: Telemedicine provides accurate diagnoses for skin disorders and has gained emphasis. It may be used for the triage and management of common skin diseases in primary care, improving patients' access and reducing time to treatment. Objective: To evaluate the proportion of atopic dermatitis patients who could be managed with the support of telemedicine and its accuracy. Second, we aimed to assess the frequency of atopic dermatitis, demographics, clinical features, and therapies dispensed in relation to the disease. Methods: Retrospective study in a population of 30,976 individuals, assisted by telemedicine. We assessed patients with the diagnosis of atopic dermatitis and evaluated the proportion of cases referred to biopsy, inperson dermatologists, or to be managed by primary care; the treatments suggested; and telemedicine accuracy to diagnose atopic dermatitis. Results: Atopic dermatitis was diagnosed in 1648 patients (5.3%), the sixth most common dermatosis, with 2058 lesions (3.7%) analyzed. Primary care physicians were able to manage 72% of the atopic dermatitis patients, whereas 28% of them were referred to in-person dermatologists. Accuracy for atopic dermatitis diagnosis was 84.4%. Conclusion: Telemedicine was an accurate method and helped primary care physicians to treat 72% of the atopic dermatitis lesions, thereby optimizing the availability of in-person appointments with dermatologists for more severe cases.