Mobile Teledermatology is a Valid Method to Estimate Prevalence of Melanocytic Naevi in Children

Abstract

The prevalence of melanocytic naevi in children correlates with sun exposure and may serve as an objective population risk indicator of future melanoma incidence. The aim was to investigate if mobile teledermatology could offer a valid methodology compared with standard manual, face-to-face counting of naevi on the back of children. Ninety-seven children aged 7-16 years were enrolled. One dermatologist performed manual naevi counting and imaging of the child's back using an iPhone 4S comprising a safe-coded mobile application. Two other dermatologists independently counted naevi from the images. Cohen's weighted kappa (κw) coefficient demonstrated substantial agreement for both dermatologists: κw = 0.69 (0.57-0.81 [95% confidence intervals]) and κw = 0.78 (0.70-0.86), compared with the manual assessment. Inter-rater reliability was also substantial (κw = 0.80 [0.73-0.87]). Use of mobile teledermatology proved valid for estimating naevi prevalence on the back and could provide a more feasible methodology following trends in sun exposure in children.

Image-based teleconsultation using smartphones or tablets: qualitative assessment of medical experts

“…1 4 5 The practice is valuable for pictures taken of existing ECGs or radiological images 6 7 and in conditions like ophthalmology, 8 dermatology 9 and burns, 10 where pictures can be taken of a specific body region of concern. However, to ensure effectiveness, the turnaround time has to be kept to a minimum.…”

Teledermatology: current perspectives

“…Three studies focused on pediatric patients. 42,44,48 In the studies analyzed, there was no difference in participants' description between control and intervention groups, as both groups were composed of the same subjects.…”

“…Most of the studies were applied on very specific populations and patient selection could not have represented the general population (Figures 4 and 5). 49 one from Sweden, 44 and one from Panama. 50 Two studies were multicentric: one from Ghana and the United States, 47 and one from Austria and Italy 46 (Table S5).…”

“…7,36,37,40,[45][46][47][50][51][52] Twelve studies analyzed the reliability by kappa statistics. 5,36,[38][39][40][41][42][44][45][46]48,50 From these, one study compared teledermatology and FTF diagnosis to histopathological results, 39 one compared both groups to teledermatology and FTF diagnosis to the definitive diagnosis, 40 all the others considered FTF consultation as standard reference without histopathological confirmation for the diagnosis. In two studies focusing on reliability, teledermatology was used for advising another medical provider.…”

“…40 Of studies that compared telediagnosis to only FTF diagnosis, using kappa statistics, the overall diagnostic agreement between teledermatologists and FTF dermatologists showed high variability, from fair (kappa 0.35) 36 to almost perfect (kappa 0.91), 46 even though the majority of them (eight studies from 10) achieved substantial to almost perfect agreement. 5,38,41,42,[44][45][46]48,50 The agreement of management or therapy plan between both groups was only assessed by two studies, varying from moderate (kappa 0.57) 45 to almost perfect (kappa 0.86). 46 The intra-observer diagnostic reliability was investigated by three studies (kappa ranged from 0.49 to 0.69), 36,38,42 and the intra-observer management reliability by only one of them (kappa 0.58).…”