Accuracy of teledermatology for nonpigmented neoplasms

Warshaw, Erin M.; Lederle, Frank A.; Grill, Joseph P.; Gravely, Amy; Bangerter, Ann; Fortier, Lawrence A.; Bohjanen, Kimberly; Chen, Karen; Lee, Peter K.; Rabinovitz, Harold; Johr, Robert H.; Kaye, Valda N.; Bowers, Stephanie; Wenner, Rachel; Askari, Sharone K.; Kedrowski, Deborah A.; Nelson, David B.

doi:10.1016/j.jaad.2008.11.892

Cited by 88 publications

(99 citation statements)

References 30 publications

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“…35 Another study from the same group of investigators, but analyzing nonpigmented lesions in two scenarios (using macro images only and macro images plus polarized light dermoscopy images), found worse results of telediagnosis when compared to FTF diagnosis (accuracy 59.5%-64.7% vs 76.1%-76.0%). 34 In all the other studies, teledermatology diagnosis achieved at least an acceptable level of concordance to the FTF diagnosis and/or histopathological results. Baumeister et al 27 compared tele-examination to FTF examination analyzing a subjective grading scale and score for detection of minimal skin lesions in 100 male metal workers exposed to cutting fluids.…”

Section: Diagnostic Accuracymentioning

confidence: 62%

“…[27][28][29][30][31][32][33][34][35] Studies were predominantly from high income countries. Three studies were from the United States, 30,34,35 two studies from Germany, 27,28 and one from each of the following countries: Australia, 29 South Korea, 31 and New Zealand. 32 There was one study performed in Brazil, 33 which is an upper middle income country (Table S4).…”

Section: Diagnostic Accuracymentioning

confidence: 99%

“…Two studies reported that teledermatology was not equivalent 35 or even inferior to FTF. 34 Warshaw et al 35 compared FTF consultation to teledermatology in three scenarios (using macro images only, macro images plus polarized light dermoscopy images, and macro images plus contact immersion dermatoscopy) for the assessment of diagnostic and management accuracy analyzing pigmented lesions. In all scenarios, telediagnosis showed inferiority to FTF diagnosis (accuracy 64.0%-67.0% versus 80.3%-80.8%), but the management plan was at least equivalent.…”

Section: Diagnostic Accuracymentioning

confidence: 99%

See 2 more Smart Citations

Teledermatology: current perspectives

Oliveira¹,

Wolff²,

Ribeiro³

et al. 2017

SHTT

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Section: Diagnostic Accuracymentioning

confidence: 62%

Section: Diagnostic Accuracymentioning

confidence: 99%

Section: Diagnostic Accuracymentioning

confidence: 99%

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Teledermatology: current perspectives

Oliveira¹,

Wolff²,

Ribeiro³

et al. 2017

SHTT

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“…Several studies have found diagnostic accuracy of S&F teledermatology to be comparable to in-person consultations (Barnard & Goldyne 2000;High et al, 2000;Krupinski et al, 1999;Oakley et al, 1997;Whited et al, 1999). Other studies have found that in-person consultation provides a significantly greater diagnostic accuracy than S&F teledermatology (Warshaw et al 2009a;Warshaw et al 2009b). One study found that S&F teledermatology had a significantly greater diagnostic accuracy than in-person consultation (Lozzi et al, 2007).…”

Section: Diagnostic Accuracy Of Store-and-forward Teledermatologymentioning

confidence: 99%

Teledermatology: Outcomes and Economic Considerations

Pathipati¹,

Armstrong²

2011

Telemedicine Techniques and Applications

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IntroductionTeledermatology is defined as the provision of dermatologic care through the use of communications technology (Goldyne & Armstrong, 2010). It offers many benefits that include increased access to dermatologic services and potential reduction in costs associated with care. Teledermatology is traditionally categorized into two different models based on the technology that is employed: store-and-forward (S&F) teledermatology, and live, interactive (LI) teledermatology (Goldyne & Armstrong, 2010). While hybrid models (a combination of S&F and LI technology) are practiced at selected institutions, this chapter focuses primarily on S&F and LI models. We will present operational flows of these two technology-enabled modalities, common outcomes measures used for evaluation of teledermatology quality metrics, and economic analyses. At the end of the chapter (in section 5), we will consider a novel, technology-independent framework for categorizing teledermatology models as well. This system relies on classification of teledermatology based on healthcare delivery models, and serves as an alternative way to organize and evaluate the provision of teledermatologic care. Store-and-forward teledermatologyStore-and-forward teledermatology is an asynchronous means for providing dermatologic care, as it relies on the asynchronous transmission of static digital images, patient histories, and specialist recommendations rather than real-time interaction between the specialist and the patient (Goldyne & Armstrong, 2010). In the S&F model, a medical staff personnel at the referral site typically takes images of the relevant skin condition and obtains medical history. This information is then sent to a dermatologist via a secure internet connection. The dermatologist evaluates the patient's condition asynchronously and transmits the recommendations back to the primary care provider at the referral site (Pak et al., 2009). Outcomes measures of store-and-forward teledermatologyTeledermatology studies have assessed numerous outcomes measures, including learning effects, length of consultation, and technical aspects (Eminovic et al., 2007). We will focus this discussion on four extensively used outcomes measures: diagnostic accuracy, diagnostic reliability, clinical outcomes, and satisfaction.

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“…[1][2][3][4][5] While diagnostic accuracy and appropriateness of directed management plans have been shown to be noninferior to faceto-face (FTF) dermatology, 6 concerns remain regarding the safety of SFT in the diagnosis of malignant melanoma. [7][8][9][10][11] This concern is more related to the perceived inability of primary care providers (PCPs) to direct imaging of suspicious lesions than to the SFT dermatologist's ability to diagnose them. [12][13][14] At least three previous studies have ascertained the frequency of ''incidental'' melanomas in populations of patients referred for FTF dermatology care.…”

Section: Introductionmentioning

confidence: 99%

Unimaged Melanomas in Store-and-Forward Teledermatology

Gendreau

Gemelas

Wang

et al. 2017

Telemedicine and e-Health

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Background: Store-and-forward teledermatology (SFT) readers can only diagnose what is imaged. This limitation has caused concern regarding the ability of primary care to direct imaging of lesions suspicious for melanoma. Melanomas not imaged by primary care providers (PCPs) are termed unimaged melanomas. Objective: To determine the frequency of unimaged melanomas among Veterans referred for care in a SFT program. Materials and Methods: All SFT patients with melanoma diagnosis were ascertained by query of the VA corporate data warehouse, Veterans Integrated Service Network 20 store-andforward program database, and the VA Computerized Patient Record System. Results: Between July 1, 2009 and December 31, 2011, 12,863 SFT consultations were conducted on 7,960 Veterans. Sixty-nine melanomas met inclusion and exclusion criteria; 13 melanomas were unimaged. The frequency of unimaged melanoma was 10.1 per 10,000 consultations. Discussion: Our calculated frequency of unimaged melanomas associates SFT with noninferiority to face-to-face care. This study was conducted on an exclusively Veteran population, precluding generalizability to the general population. Conclusions: PCPs referring to store-and-forward teledermatology may fail to image melanomas.

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Accuracy of teledermatology for nonpigmented neoplasms

Cited by 88 publications

References 30 publications

Teledermatology: current perspectives

Teledermatology: current perspectives

Teledermatology: Outcomes and Economic Considerations

Unimaged Melanomas in Store-and-Forward Teledermatology

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