Teledermatology as a filtering system in pigmented lesion clinics

Abstract

Teledermatology was evaluated as a filtering system for a pigmented lesion clinic (PLC). A total of 219 teleconsultations were received at the PLC in a 12-week period. The outcome of the teleconsultation was that 49% of patients were referred to the face-to-face clinic. Teleconsultation reports were available to the general practitioner (GP) in a mean time of 44 h and patients attended the face-to-face clinic within the following two weeks. Agreement between different dermatologists was almost perfect, with k =0.91 (95% confidence interval [CI] 0.87-0.96) for diagnosis and kappa =0.92 (95% CI 0.86-0.98) for management options ("referral" or "non- referral"). Agreement within observers was excellent, with kappa =0.93 (95% CI 0.87-0.98). The accuracy of diagnosis, as judged by the histology, was less good, with kappa =0.79 (95% CI 0.70-0.89). In all, 86% of patients and 97% of GPs stated that they were "very satisfied" with the new system. Teledermatology performed well as a filtering system for the PLC. However, more experience is needed to detect the real effect, if any, of teleconsultation on the early diagnosis and prognosis of melanoma.

Comparing High Definition Live Interactive and Store-and-Forward Consultations to In-Person Examinations

“…10 The other studies had more than one teledermatologist. [14][15][16][17][18][19][20][21] Of the four studies, measuring inter-observational agreement for in-person exams, two showed significantly better agreement among in-person clinicians than distant teledermatologists, 11,12 especially for primary diagnoses, and two did not. 10,13 A PubMed search for teledermatology research done after the latest research reviews published in 2011 9 identified only one additional study having two in-person dermatologists.…”

Teledermatology for diagnosis and management of skin conditions: A systematic review

“…All studies used a repeated measures study design with the exception of one randomized controlled trial. 11 Based on location, most of the studies were conducted in the United States (n = 14), [3][4][5][6]22,24,25,33,35,37,[41][42][43]45 followed by the United Kingdom (n = 9), 11,12,15,18,29,30,32,38,44 Italy (n = 6), 7,8,20,21,36,39 Spain (n = 4), 9,10,13,17 Australia/New Zealand (n = 3), 14,31,40 Turkey (n = 2), 16,19 and one study each from Germany, 23 Netherlands, 24 Pakistan, 27 Brazil, 28 and Switzerland. 34 Patient and skin condition characteristics.…”

“…Fourteen studies included subjects younger than 18 years. 3,6,8,13,14,16,17,20,21,29,30,35,36,39 In 22 studies reporting gender, most of the subjects were male (57% overall, range 29%-98%). Only 6 studies, all conducted in the United States, reported racial or ethnic characteristics.…”

Teledermatology—A Hitherto Underestimated Tool in Occupational Medicine—Indications and Limitations

“…Therefore, teledermatology did not develop until the 1990s 4) , but has been utilised in many fields of application since then. It can be applied to melanoma screenings [7][8][9][10] , in the surveillance of the long-term therapy of leg ulcers 11) , or in medical attendance in rural or remote areas 12,13) . There is ample proof that telecare and teledermatology is practicable and well accepted by patients [14][15][16][17] .…”