Comparison of the Clinical Informativeness of Photographs and Digital Imaging Media With Multiple-Choice Receiver Operating Characteristic Analysis

Perednia, Douglas A.; Gaines, John A.; Butruille, Tony W.

doi:10.1001/archderm.1995.01690150056012

Cited by 60 publications

(11 citation statements)

References 12 publications

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“…no matter where the patient or relevant information is located' 1 . Specialties suchas radiology 2 , psychiatry 3 , dermatology 4 , pathology 5 and cardiology 6 have provided much of the clinical data on telemedicine todate. Althoughthere have beensome studies of telemedicine in emergency medicine [7][8][9][10][11][12] , there have beenvery fewrandomized controlled studies of telemedicine applications ingeneral, and apparently none in emergency medicine.…”

mentioning

confidence: 99%

Telemedicine in the emergency department: a randomized controlled trial

Brennan¹,

Kealy²,

Gerardi³

et al. 1999

J Telemed Telecare

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Emergency physicians and nurses were trained in telemedicine techniques in two emergency departments, one rural (low volume) and one suburban (high volume). Fifteen patient complaints were selected as appropriate for the study. Of 122 patients who met the inclusion criteria, 104 (85%) consented to participate. They were randomized to control and experimental groups. The suburban emergency physician diagnosed and treated the control patients. Experimental patients presenting to the high-volume emergency department were evaluated and treated by the telemedicine nurse in person and the rural emergency physician via the telemedicine link. Immediately before discharge all telemedicine patients were re-evaluated by the suburban emergency physician. Data collected on each patient included: diagnosis; treatment; 72 h return visits; need for additional care; and satisfaction of patient, physicians and nurses. There were no significant differences (P > 0.05) for occurrence of 72 h return visits, need for additional care or overall patient satisfaction. The average patient throughput time (from admission to discharge) was 106 min for the telemedicine group and 117 min for the control group. Telemedicine was a satisfactory technique for the chosen group of patients in the emergency department and was acceptable to the participants.

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mentioning

confidence: 99%

Telemedicine in the emergency department: a randomized controlled trial

Brennan¹,

Kealy²,

Gerardi³

et al. 1999

J Telemed Telecare

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“…This pilot study was designed to evaluate the informativeness [52] of 35-mm photographic slides (of AMNs and early MMs) viewed on a rearview projector and their telephonically transmitted (Internet), compressed, digitized images viewed on a color computer monitor. For this purpose, we studied the concordance between rearview projector and computer color monitor in the clinical diagnoses of images of AMNs and early MMs, the diagnoses of the dermoscopic images and the evaluation of specific dermoscopic features.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Conventional Photographs and Telephonically Transmitted Compressed Digitized Images of Melanomas and Dysplastic Nevi

et al. 1998

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Background: One of the most difficult problems in the in vivo diagnosis of cutaneous tumors is the differentiation clinically between early malignant melanoma (MM) and atypical (dysplastic) melanocytic nevi (AMNs) because these lesions share clinical features. High-quality digital imaging systems and store-and-forward technology have the potential for use in a teledermatology system with which experts would be able to immediately transmit their diagnostic opinions concerning these challenging lesions. Objective: The main purpose of this study was to determine if the clinical and dermoscopic diagnoses and the dermoscopic features of AMN and early MM are unaltered after telephonic transmission of their digitized images. Methods: Conventional and dermoscopic photographic transparencies of 22 AMNs and 9 early MMs, viewed on rearview projectors and then scanned, compressed, transmitted (Internet) and viewed on color monitors, were evaluated. Results: The concordance in the diagnosis of AMN and of early MM by all four observers, both clinically and dermoscopically, when comparing rearview-projected conventional transparency slides to transmitted, compressed, digitized images, was high. For most specific dermoscopic features, the concordance was good, although less so for the presence or absence of some dermoscopic features, namely ‘dots’, ‘blue/gray’ color and ‘red’ color. Conclusion: The results reported support the conclusion that Internet transmission of digitized images of MMs and AMNs retains sufficient informativeness for diagnostic purposes. This study is a step in the creation of an international teledermoscopy network for pigmented cutaneous lesions.

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“…The new technologies allow high‐quality digital ELM images to be sent with the support of network systems such as the Internet and ISDN by using telephone lines and satellite communication (teledermatology), 79–80,83 which will in the future enable efficient melanoma screening at primary care sites when expert ELM investigators are not available. Analysis of image data shows that ‘informativeness’ 84 of selected dermoscopic structures of lesions employed for naked‐eye diagnosis of pigmented skin lesions is preserved despite their remote location 71,81 …”

Section: Digital Epiluminescencementioning

confidence: 99%

Dermatoscopy in the diagnosis of pigmented skin lesions: a new semiology for the dermatologist

Carli¹,

Giorgi

Soyer

et al. 2000

Acad Dermatol Venereol

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Dermatoscopy or epiluminescence microscopy (ELM), is a noninvasive method that enables clinicians to evaluate fully--by means of a magnified oil immersion diascopy--numerous morphological features, not visible with the naked eye, which enhance the diagnosis of nearly all pigmented skin lesions. In recent years, a burst of research activity in this topic has been carried out, dealing with different aspects, and new frontiers, of this technique. First, a continuous refinement of dermatoscopic terminology is undertaken, paying particular attention to the diagnostic performance of dermatoscopy at peculiar anatomical sites and to the building of different dermatoscopic algorithms aimed at a simplified diagnosis of melanoma, even for less experienced observers. Another point of interest concerns the possible role of dermatoscopy in the pre-operative assessment of melanoma thickness. Finally, promising data about the role of digital equipment in the follow up of melanocytic skin lesions as well as in the automated diagnosis of pigmented skin lesions have been recently reported. This paper should enable readers to become familiar with the procedure and terminology of ELM in the diagnosis of pigmented skin lesions encouraging a greater understanding of different methods (pattern analysis, algorithms) in the diagnosis of melanoma using ELM.

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Comparison of the Clinical Informativeness of Photographs and Digital Imaging Media With Multiple-Choice Receiver Operating Characteristic Analysis

Cited by 60 publications

References 12 publications

Telemedicine in the emergency department: a randomized controlled trial

Telemedicine in the emergency department: a randomized controlled trial

Comparison of Conventional Photographs and Telephonically Transmitted Compressed Digitized Images of Melanomas and Dysplastic Nevi

Dermatoscopy in the diagnosis of pigmented skin lesions: a new semiology for the dermatologist

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