A comparison of real‐time and store‐and‐forward teledermatology: a cost–benefit study

Loane, Maria; Bloomer, S E; Corbett, R; Eedy, D.J.; Hicks, Nicholas; Lotery, Helen; Mathews, C; Paisley, Judy; Steele, K; Wootton, Richard

doi:10.1046/j.1365-2133.2000.03895.x

Cited by 124 publications

(89 citation statements)

References 17 publications

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“…4 Three studies compared the two modes. 14,23,24 In one study, 23 patients were not seen in-person, while another found identical diagnoses with in-person for 64% of patients with greater agreement for live interactive than store-and-forward that was not statistically significant. 24 A third study showed combining methods significantly increases concordance with in-person exams.…”

Section: Introductionmentioning

confidence: 99%

“…14 Although live interactive and store-and-forward methods have been compared before 14,23,24 the studies comparing remote methods to in-person 14,24 used diagnoses of single inperson dermatologists. This study extends teledermatology research by directly comparing concordance between inperson, live interactive, and store-and-forward methods with two in-person dermatologists establishing a diagnostic comparison baseline, while also addressing confidence and biopsy decisions and effects of video quality in live interactive consultations.…”

Section: Introductionmentioning

confidence: 99%

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Comparing High Definition Live Interactive and Store-and-Forward Consultations to In-Person Examinations

Marchell

Locatis

Burges

et al. 2017

Telemedicine and e-Health

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Background: There is little teledermatology research directly comparing remote methods, even less research with two inperson dermatologist agreement providing a baseline for comparing remote methods, and no research using high definition video as a live interactive method. Objective: To compare inperson consultations with store-and-forward and live interactive methods, the latter having two levels of image quality. Methods: A controlled study was conducted where patients were examined in-person, by high definition video, and by store-and-forward methods. The order patients experienced methods and residents assigned methods rotated, although an attending always saw patients in-person. The type of high definition video employed, lower resolution compressed or higher resolution uncompressed, was alternated between clinics. Primary and differential diagnoses, biopsy recommendations, and diagnostic and biopsy confidence ratings were recorded. Results: Concordance and confidence were significantly better for in-person versus remote methods and biopsy recommendations were lower. Store-and-forward and higher resolution uncompressed video results were similar and better than those for lower resolution compressed video. Limitations: Dermatology residents took store-and-forward photos and their quality was likely superior to those normally taken in practice. There were variations in expertise between the attending and second and third year residents. Conclusion: The superiority of in-person consultations suggests the tendencies to order more biopsies or still see patients in-person are often

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparing High Definition Live Interactive and Store-and-Forward Consultations to In-Person Examinations

Marchell

Locatis

Burges

et al. 2017

Telemedicine and e-Health

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show abstract

“…Furthermore, it is a viable option for almost all medical specialties, particularly those for which images comprise the main diagnostic tool (4)(5)(6)(7) . Thus, the fields of radiology, dermatology, pathology, ultrasound, and ophthalmology, among others (8)(9)(10)(11)(12) , are especially favorable for the establishment of data transmission protocols with diagnostic purposes (13,14) . Ophthalmology, for example, can greatly benefit from telemedicine (15,16) , as it is crucial to identify patients that present urgent cases in order to avoid morbidity and permanent disorders (17) .…”

Section: Introductionmentioning

confidence: 99%

A teleophthalmology system for the diagnosis of ocular urgency in remote areas of Brazil

Ribeiro

Rodrigues

Guerreiro

et al. 2014

Arquivos Brasileiros De Oftalmologia

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Purposes: To validate a teleophthalmology mobile system aimed at improving and providing eye urgency screenings in remote and poor area settings in Brazil. The system enables one or more ophthalmologists to remotely examine a patient's condition and submit a decision describing the gravity of the case. If necessary, the patient can be forwarded to a hospital for further consultation. Methods: A cellphone (Nexus One model, with a 5 megapixel camera) was used to collect data and pictures from 100 randomly selected patients at the Ophthalmology Emergency Room located at the General Hospital of the Federal University of São Paulo (UNIFESP). Data was then sent remotely to an online recording system to be reviewed by an ophthalmologist who provided feedback regarding the state of ocular urgency. Results were then compared to the gold standard diagnosis provided at the hospital. Results: The diagnosis of urgency was given by two ophthalmologists: one in the hospital (gold standard) and one remotely. When we compared both diagnoses we obtained results of 81.94% specificity, 92.85% sensitivity, and 85% accuracy, with a negative predictive value of 96.72%. This work also included a processing time analysis, resulting in an average time of 8.6 min per patient for remote consultations. Conclusions: This study is the first that has used only a cellphone for diagnosing the urgency of ocular cases. Based on our results, the system can provide a reliable distinction between urgent and non-urgent situations and can offer a viable alternative for the servicing of underprivileged areas. In screening techniques, the most important outcome is to identify urgent cases with a high level of sensitivity and predictive negative value. Thus, our results demonstrate that this tool is robust and we suggest that a major study aimed to verify its efficiency in resource-poor areas should be initiated.

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“…There are two possibilities for teleconsultation: store-and-forward and videoconferencing. Store-andforward teleconsultation is older and cheaper than videoconferencing -at least in dermatology [6,7], but the goal of both of them is to improve the health care delivery.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of teleconsultation systems

Kern

2006

International Journal of Medical Informatics

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A comparison of real‐time and store‐and‐forward teledermatology: a cost–benefit study

Cited by 124 publications

References 17 publications

Comparing High Definition Live Interactive and Store-and-Forward Consultations to In-Person Examinations

Comparing High Definition Live Interactive and Store-and-Forward Consultations to In-Person Examinations

A teleophthalmology system for the diagnosis of ocular urgency in remote areas of Brazil

Evaluation of teleconsultation systems

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