A reliability study using Network-Oriented Research Assistant to evaluate the use of digital photographs in the assessment of atopic dermatitis

Hughes, Meagan; Aralis, Hilary; Bruhn, Kevin W.; Cotliar, Jonathan; Craft, Noah; DeLuca, Ilana J.; Hamidi, Reyhaneh; Nguyen, Kathy; Patel, Mayha; Patel, Vishal; Sofen, Howard; Tan, Belinda H.; David, C. G.

doi:10.1016/j.jaad.2019.01.043

Cited by 6 publications

(6 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although many of these tools have been validated when used in in-person settings, it is unknown to what extent they can be applied to assess photographs remotely. To our knowledge, only one study by Hughes et al [ 7 ] has investigated the concordance between assessment of AD in person compared to a standardized set of full-body digital photographs captured by a clinical research coordinator. They reported an excellent agreement between in-person assessment and remote assessment of photographs with respect to body surface area, Eczema Area and Severity Index, and Scoring AD (SCORAD) scales.…”

Section: Introductionmentioning

confidence: 99%

Remote Rating of Atopic Dermatitis Severity Using Photo-Based Assessments: Proof-of-Concept and Reliability Evaluation

Ali

Joergensen²,

Andersen³

et al. 2021

JMIR Form Res

View full text Add to dashboard Cite

Background Digital imaging of dermatological patients is a novel approach to remote assessment and has recently become more relevant since telehealth and remote decentralized clinical trials are gaining ground. Objective We aimed to investigate whether photographs taken by a smartphone are of adequate quality to allow severity assessments to be made and to explore the usefulness of an established atopic dermatitis severity assessment instrument on photograph evaluation. Methods During scheduled visits in a previously published study, the investigating doctor evaluated the severity of atopic dermatitis using the Scoring AD (SCORAD) index and took photographs of the most representative lesions (target lesions) with both a smartphone and a digital single-lens reflex camera (DSLR). The photographs were then assessed by 5 dermatologists using the intensity items of the SCORAD (iSCORAD), which consists of erythema, oedema/papulation, excoriations, lichenification, oozing/crusts, and dryness (scale 0-3, maximum score 18). The mean iSCORAD of the photographs was calculated and compared with in-person assessments using Pearson correlation and Bland-Altman plots. Intraclass correlation coefficients were used for interrater reliability. Results A total of 942 photographs from 95 patients were assessed. The iSCORAD based on smartphone photographs correlated strongly with the evaluations performed in person (iSCORAD: r=0.78, P<.001; objective SCORAD: r=0.81, P<.001; and total SCORAD: r=0.78, P<.001). For iSCORAD specifically, a Bland-Altman plot showed a difference in mean score of 1.31 for in-person and remote iSCORAD. In addition, the interrater agreement between the 5 rating dermatologists was 0.93 (95% CI 0.911-0.939). A total of 170 lesions were photographed, and the difference in mean scores was 1.32, 1.13, and 1.43 between in-person and remote evaluations based on photographs taken by a DSLR camera, a smartphone without flash, and a smartphone with flash, respectively. Conclusions In terms of quality, remote atopic dermatitis severity assessments based on photographs are comparable to in-person assessments, and smartphone photos can be used to assess atopic dermatitis severity to a similar degree as photographs from a DSLR camera. Further, the variation in how the dermatologists in this study rated the iSCORAD based on the photographs was very low.

show abstract

Section: Introductionmentioning

confidence: 99%

Remote Rating of Atopic Dermatitis Severity Using Photo-Based Assessments: Proof-of-Concept and Reliability Evaluation

Ali

Joergensen²,

Andersen³

et al. 2021

JMIR Form Res

View full text Add to dashboard Cite

show abstract

“…Wolkerstorfer et al 14 showed an excellent inter‐rater agreement of the EASI (Cohen's kappa = 0.82; p < 0.001) in a study of 20 patients and three assessors. Hughes et al 15 . in a reliability study, with 37 children and 33 adults, evaluated levels of agreement between assessments of AD in‐person and via digital photographs and found that AD can be reliably assessed via digital photographs using EASI, SCORAD, BSA, and IGA.…”

Section: Discussionmentioning

confidence: 99%

Mild to moderate atopic dermatitis severity can be reliably assessed using smartphone‐photographs taken by the patient at home: A validation study

Ali

Chiriac

Bjerre-Christensen³

et al. 2022

Skin Research and Technology

View full text Add to dashboard Cite

Background: The use of photographs to diagnose and monitor skin diseases is gaining ground.Objectives: To investigate the validity and reliability of photographic assessments of atopic dermatitis (AD) severity.Methods: AD severity was evaluated in the clinic by two assessors using the Eczema Area and Severity Index (EASI), SCOring Atopic Dermatitis (SCORAD), and Investigator's Global Assessment (IGA). Participants photographed the lesions with their own smartphone and completed a questionnaire about the extent of eczema the same day from home. The photographs were assessed twice with an 8 weeks interval by five dermatologists experienced in photographic evaluations. Intraclass correlation coefficients (ICC) with 95% confidence interval (CI) were applied.Results: Seventy-nine participants were enrolled. The ICC between clinical EASI and photographic EASI was 0.88 (95% CI 0.81-0.93), and 0.86 (0.70-0.93) between clinical SCORAD and photographic SCORAD.Perfect agreement between clinical IGA and photograph IGA was observed for 62%, with the difference between the two never deviating with more than 1 score.The inter-rater ICC for photographic EASI and photographic SCORAD, respectively, was 0.90 (0.85-0.94), and 0.96 (0.91-0.98). The intra-rater agreements between the first and second assessments varied from 0.95 to 0.98 for photographic EASI, and from 0.86 to 0.94 for photographic SCORAD.

show abstract

“…Both the Eczema Area and Severity Index (EASI) and the Severity Scoring of Atopic Dermatitis Index (SCORAD) have been developed to assess the clinical signs of atopic dermatitis, and they have been validated in the in-person setting ( Schmitt et al., 2013 ). Given the rise of teledermatology, investigators have compared remote atopic dermatitis severity assessments on the basis of photographs with in-person assessments ( Ali et al., 2021 ; Hughes et al., 2021 ). Results showed strong correlations between assessments performed in person and those done using photographs; however, photographs were taken by study coordinators or physicians in a controlled environment.…”

Section: Ai Policies and Positionsmentioning

confidence: 99%

Development of High-Quality Artificial Intelligence in Dermatology: Guidelines, Pitfalls, and Potential

Kovarik¹

2022

JID Innovations

View full text Add to dashboard Cite

A reliability study using Network-Oriented Research Assistant to evaluate the use of digital photographs in the assessment of atopic dermatitis

Cited by 6 publications

References 4 publications

Remote Rating of Atopic Dermatitis Severity Using Photo-Based Assessments: Proof-of-Concept and Reliability Evaluation

Remote Rating of Atopic Dermatitis Severity Using Photo-Based Assessments: Proof-of-Concept and Reliability Evaluation

Mild to moderate atopic dermatitis severity can be reliably assessed using smartphone‐photographs taken by the patient at home: A validation study

Development of High-Quality Artificial Intelligence in Dermatology: Guidelines, Pitfalls, and Potential

Contact Info

Product

Resources

About