A longitudinal study of consistency in diagnostic accuracy of teledermatology tools

Kanthraj, Garehatty Rudrappa

doi:10.4103/0378-6323.116735

Cited by 15 publications

(9 citation statements)

References 64 publications

(130 reference statements)

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“…a large (>100 subjects) prospective study without a gold standard comparison. [ 14 ] The present study showed that 10 common diagnoses account for more than three-fourths of the skin disorders encountered in primary healthcare clinic. The PCPs thus need to be trained on these 10 common skin conditions so that they can appropriately manage a large proportion of patients with common dermatologic complaints.…”

Section: Discussionmentioning

confidence: 69%

Diagnostic agreement between a primary care physician and a teledermatologist for common dermatological conditions in North India

Patro

Tripathy

et al. 2015

Indian Dermatol Online J

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Background:Primary care physicians (PCPs) encounter a large number of patients with dermatological diseases. However, delivering appropriate management is a challenge considering the inadequate dermatology training offered during the undergraduate medical curriculum. Teledermatology is the clinical evaluation of skin lesions by dermatologists and allows patients to be diagnosed and treated from a distant site. It is seen as a potential solution to the shortage of specialists and providing equitable service in remote areas.Aim:The study was aimed at estimating the diagnostic agreement of common dermatological conditions between a PCP and a teledermatologist.Materials and Methods:Consecutive patients with dermatological ailments who attended a primary health care clinic were recruited into the study, examined by the PCP and offered a diagnosis. The clinical images and patients’ history were collected and transferred to a dermatologist at a tertiary center who also made a diagnosis. Agreement between diagnosis made by the PCPs and the teledermatologist was measured using kappa (κ) statistics.Results:Overall agreement between the diagnoses made by a PCP and the dermatologist was found to be 56%. Poor κ agreement (<0.4) was seen in the diagnosis of psoriasis and eczema.Conclusion:Teledermatology can supplement specialist dermatology service in remote areas. There was poor agreement in the diagnosis of psoriasis, classifying various types of eczematous conditions and fungal infections. Scarce manpower in dermatology at the primary health care level compounded by the burden of skin ailments necessitates training of PCPs in common dermatological conditions.

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Section: Discussionmentioning

confidence: 69%

Diagnostic agreement between a primary care physician and a teledermatologist for common dermatological conditions in North India

Patro

Tripathy

et al. 2015

Indian Dermatol Online J

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“…This makes it ideal for the utilization of virtual medicine. In India, Kantiraj et al validated the store and forward teledermatology and videoconferencing in a large number of patients while using gold standard (face-to-face) comparison between teledermatologists and clinical dermatologists [40]. Nair and Nair also reported that teledermatology is a viable alternative to face to face encounters via both store and forward and videoconferencing options.…”

Section: Involvement Of Private Enterprise In the Field Of Telemedicimentioning

confidence: 99%

Evolving Role of Telemedicine in Health Care Delivery in India

Mathur¹,

Srivastava²,

Lalch³

et al. 2017

Primary Health Care

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Introduction: India is the world's largest democratic country, and second most populous country in the world. Despite recent successes in the economic front, India still faces many social challenges like poverty, illiteracy, sanitation, gender inequality, and lack of healthcare for all. The healthcare disparity is mainly due to shortage of trained health care professionals and lack of necessary infrastructure in remote areas of the country. Telemedicine as a tool for health care delivery, particularly in the rural areas where 68% of the population lives, has been addressed by the Government of India since the turn of the century using telemedicine. Telemedicine as a method of healthcare delivery has been successfully tested all over the country, and the results have been very promising.Methods: Literature search was done on Medline, Web of science and Google search engines using keywordstelemedicine, India model of health care delivery. Results:We found that telemedicine as a healthcare delivery system has been effectively used in several underserved areas of India, through the initiatives taken by the federal, state governments as well as private sector. Conclusion:Although not a substitute for traditional healthcare system, telemedicine can be used to overcome healthcare disparities in the underserved areas. This approach for healthcare delivery can be replicated around the world, especially in the developing countries

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“…The diagnostic accuracy for general teledermatology practice using store and forward, video conference and mobile teledermatology tools is 73%, 70% and 70% respectively. The diagnostic accuracy for subspecialty teledermatology for pediatric and geriatric is 65% and 88% respectively 15 . Several studies have demonstrated acceptable diagnostic accuracy for various teledermatology tools.…”

Section: Introduction Introductionmentioning

confidence: 99%

“…[3] A recent longitudinal study analyzed the diagnostic accuracy of various teledermatology tools and recommended that plans for implementing a teledermatology practice could be based on this classification. [15] The dermatology conditions that were classified for teledermatology practice as a) Regular teledermatology practice b) tertiary teledermatology practice and c) subspecialty (pediatric and geriatric) teledermatology practice. [15] The advantage is assessment of feasibility and diagnostic accuracy with respect to each subdivision of teledermatology practice could be audited and analyzed for implementation.…”

Section: Introduction Introductionmentioning

confidence: 99%

“…[15] The dermatology conditions that were classified for teledermatology practice as a) Regular teledermatology practice b) tertiary teledermatology practice and c) subspecialty (pediatric and geriatric) teledermatology practice. [15] The advantage is assessment of feasibility and diagnostic accuracy with respect to each subdivision of teledermatology practice could be audited and analyzed for implementation. The diagnostic accuracy for general teledermatology practice using store and forward, video conference and mobile teledermatology tools is 73%, 70% and 70% respectively.…”

Section: Introduction Introductionmentioning

confidence: 99%

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Patient-assisted teledermatology practice: What is it? When, where, and how it is applied?

Kanthraj¹

2015

Indian J Dermatol Venereol Leprol

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Recent teledermatology practice has been focused on different models made possible by robust advances in information technology leading to consistent interaction between the patient and health care professionals. Patient-assisted teledermatology practice also called patient-enabled teledermatology or home based teledermatology is one such novel model. There is a lack of scientific literature and substantive reviews on patient-assisted teledermatology practice. The present article reviews several studies and surveys on patient-assisted teledermatology practice and outlines its advantages and barriers to clinical utility and analyses the potentiality of this concept. Incorporating patient-assisted teledermatology practice as a novel model in the revised classification of teledermatology practice is proposed. In patient-assisted teledermatology, the patient can upload his/her clinical images as a first contact with the dermatologist or an initial face-to-face examination can be followed by teledermatology consultations. The latter method is well suited to chronic diseases such as psoriasis, vitiligo, and leg ulcers, which may need frequent follow-up entailing significant costs and time, particularly in the elderly. Teledermatology may also be used by the treating dermatologist to seek expert opinion for difficult cases. Studies have demonstrated the importance and usability of the concept of patient-assisted teledermatology practice. Various teledermatology care models are available and the appropriate model should be chosen depending on whether the clinical situation is that of easily diagnosed cases ("spotters"), chronic cases or doubtful cases and difficult-to-manage cases.

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A longitudinal study of consistency in diagnostic accuracy of teledermatology tools

Cited by 15 publications

References 64 publications

Diagnostic agreement between a primary care physician and a teledermatologist for common dermatological conditions in North India

Diagnostic agreement between a primary care physician and a teledermatologist for common dermatological conditions in North India

Evolving Role of Telemedicine in Health Care Delivery in India

Patient-assisted teledermatology practice: What is it? When, where, and how it is applied?

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