Face-to-Face Diagnosis vs Telediagnosis of Pigmented Skin Tumors

Piccolo, Domenico; Smolle, Josef; Wolf, IH; Peris, Ketty; Hofmann-Wellenhof, R; Dell'Eva, Giordana; Burroni, Marco; Chimenti, Sergio; Kerl, Helmut; Soyer, H. Peter

doi:10.1001/archderm.135.12.1467

Cited by 141 publications

(121 citation statements)

References 37 publications

Supporting

Mentioning

112

Contrasting

Unclassified

Order By: Relevance

“…Most of these studies demonstrate high accordance for the diagnosis of inflammatory and neoplastic skin diseases [17, 18, 19, 20, 21], and particularly for the diagnosis of pigmented skin lesions (teledermoscopy) [22, 23, 24, 25, 26]. Up to now only a few reports have discussed the use of teledermatology in the diagnosis and care of patients with leg ulcers [27, 28, 29, 30].…”

Section: Discussionmentioning

confidence: 99%

Wound Teleconsultation in Patients with Chronic Leg Ulcers

Salmhofer¹,

Hofmann‐Wellenhof²,

Gabler

et al. 2005

Dermatology

Self Cite

View full text Add to dashboard Cite

Background: The treatment of chronic leg ulcers requires frequent assessments of local wound status and adjustment of therapy. The availability of reasonably priced photographic equipment and quick electronic transfer of high-quality digital images should make it possible that the assessment of wound status can be made by remote experts. Objective: This study examines the feasibility of using teledermatology for wound assessment and therapeutic suggestions for patients with chronic leg ulcers. Methods: One hundred ten chronic leg ulcers of different origins were examined in face-to-face consultations. The examining doctor assessed the wound, made therapeutic recommendations and took 1–4 photographs of the wound using a digital camera. The digital images and relevant clinical information were then transmitted via a web application to an expert in wound care, who provided an independent teledermatological assessment of wound status and therapeutic recommendations. Results: In our study, a high accordance between direct consultations and electronic consultations was found in the assessment of chronic leg ulcers, especially for important features like slough (concordance: 84.6%), necrosis (concordance: 98.2%) and granulation tissue formation (concordance: 76.4%). Furthermore, the teledermatologist generally felt confident in recommending further treatment strategies and in planning further wound assessments via the internet. Conclusions: Our results suggest that teledermatology offers great potential for the future in chronic wound care. By reducing the need to travel long distances to the hospital or to consult a physician with expertise in wound care, wound teleconsultation might lower health care costs and improve the quality of life for patients with chronic wounds, while still maintaining a high quality of wound care.

show abstract

Section: Discussionmentioning

confidence: 99%

Wound Teleconsultation in Patients with Chronic Leg Ulcers

Salmhofer¹,

Hofmann‐Wellenhof²,

Gabler

et al. 2005

Dermatology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Similar values could be provided by computer-based expert systems using digital dermoscopy [Schindewolf et al, 1994;Horsch et al, 1997;Binder et al, 1998;Menzies, 1999;Pompl et al, 1999;Seidenari et al, 1999]. Digital images bear also the possibility of teledermoscopy by connecting private dermatological practices with specialists at a dermoscopy center [Glaessl et al, 1999;Piccolo et al, 1999;Glaessl et al, 2000;Argenziano et al, 2000;Braun et al, 2000]. For regular monitoring of melanocytic nevi, simultaneous comparison of images is inevitable and digital dermoscopy appears to be most practicable [Stolz et al, 1996;Kittler et al, 1999;Kittler et al, 2000;Menzies et al, 2001].…”

Section: Patientenvertrauen In Dermatoskopische Methoden Zur Entdeckumentioning

confidence: 94%

Patients’ Confidence in Dermoscopical Methods for Detection of Malignant Melanoma

Schiffner¹,

Schiffner-Rohe²,

Landthaler³

2002

Dermatol Psychosom

View full text Add to dashboard Cite

Background: At present, different methods are available for the detection of malignant melanoma or for monitoring of melanocytic nevi (MN). Diagnostic accuracy and time consumption increase from naked-eye inspection (NEI) to handheld dermoscopy (HHD), digital dermoscopy (DD) including image analysis, and teledermoscopy (TD) supported by a specialist in dermoscopy. Effectiveness in daily routine depends on both physician’s experience and patient’s compliance. Objective: To analyse patient’s confidence in these diagnostic tools. Material and Methods: A self-administered survey was performed in consecutive patients after examination of MN at 13 private dermatological practices and at the Department of Dermatology of the University of Regensburg. Confidence was assessed by a 5-step ordinal scale ranging from 1 to 5 (higher values indicate higher confidence) and by willingness-to-pay (wtp) as health-economic instrument. Additionally, wtp was assessed for a hypothetical method promising 100% accuracy. Results: Data of 96 patients (mean age 35 years, 56% female) could be analysed. Mean confidence was 1.8 ± 0.9 for NEI, 2.9 ± 0.8 for HHD, 4.3 ± 0.6 for DD, and 4.8 ± 0.7 for TD. Mean wtp per examination was 0.6% ± 0.9 of monthly income (EUR 12.70 ± 15.40) for NEI, 1.2% ± 1.8 (EUR 23.60 ± 20.40) for HHD, 2.9% ± 3.1 (EUR 55.50 ± 42.30) for DD, 3.2% ± 3.9 (EUR 57.90 ± 42.60) for TD, and 5.3% ± 8.1 (EUR 96.10 ± 69.10) for the hypothetical method. Differences between methods were statistically significant (p < 0.001). Compared to the hypothetical method, NEI achieved only 13.2%, HHD 24.6%, DD 57.7%, and TD 60.2% of maximum confidence. Conclusions: Patients’ confidence was highest for TD, HHD was clearly underestimated. Wtp was similar for DD and TD – the best methods available at present – but still 40% lower than for a hypothetical diagnostic method providing 100% accuracy. Better information of patients about the diagnostic accuracy of different methods for detection of malignant melanoma is necessary in order to increase their confidence and compliance.

show abstract

“…It has previously been demonstrated [1] that open-access teledermatology may serve as a successful platform [9,10] for challenging dermoscopic cases, where advice on diagnosis and therapy can be provided. This is emphasized by the fact that past studies have shown a high diagnostic concordance between telediagnosis and face-toface diagnosis for pigmented lesions [11][12][13] . The possibility of searching for a combination of dermoscopic and clinical features in the case archive is, to the best of our knowledge, unique and allows the image archive to serve as a form of encyclopaedia.…”

Section: Discussionmentioning

confidence: 99%