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Lasheras-Pérez MA, Taberner R, Martínez-Jarreta B. Bioethical Conflicts in Current Dermatology: A Narrative Review. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:867-882. [PMID: 38556205 DOI: 10.1016/j.ad.2024.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/14/2024] [Accepted: 02/26/2024] [Indexed: 04/02/2024] Open
Abstract
Both the functions and equipment of dermatologists have increased over the past few years, some examples being cosmetic dermatology, artificial intelligence, tele-dermatology, and social media, which added to the pharmaceutical industry and cosmetic selling has become a source of bioethical conflicts. The objective of this narrative review is to identify the bioethical conflicts of everyday dermatology practice and highlight the proposed solutions. Therefore, we conducted searches across PubMed, Web of Science and Scopus databases. Also, the main Spanish and American deontological codes of physicians and dermatologists have been revised. The authors recommend declaring all conflicts of interest while respecting the patients' autonomy, confidentiality, and privacy. Cosmetic dermatology, cosmetic selling, artificial intelligence, tele-dermatology, and social media are feasible as long as the same standards of conventional dermatology are applied. Nonetheless, the deontological codes associated with these innovations need to be refurbished.
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Affiliation(s)
- M A Lasheras-Pérez
- Servicios de Dermatología, Hospital Universitario y Politécnico la Fe, Valencia, España
| | - R Taberner
- Unidad de Dermatología, Hospital Universitari Son Llàtzer, Palma de Mallorca, España.
| | - B Martínez-Jarreta
- Departamento de Medicina Legal y Forense, Universidad de Zaragoza, Zaragoza, España
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Lasheras-Pérez MA, Taberner R, Martínez-Jarreta B. [Translated article] Bioethical Conflicts in Current Dermatology: A Narrative Review. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T867-T882. [PMID: 39111571 DOI: 10.1016/j.ad.2024.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/14/2024] [Accepted: 02/26/2024] [Indexed: 10/05/2024] Open
Abstract
Both the functions and equipment of dermatologists have increased over the past few years, some examples being cosmetic dermatology, artificial intelligence, tele-dermatology, and social media, which added to the pharmaceutical industry and cosmetic selling has become a source of bioethical conflicts. The objective of this narrative review is to identify the bioethical conflicts of everyday dermatology practice and highlight the proposed solutions. Therefore, we conducted searches across PubMed, Web of Science and Scopus databases. Also, the main Spanish and American deontological codes of physicians and dermatologists have been revised. The authors recommend declaring all conflicts of interest while respecting the patients' autonomy, confidentiality, and privacy. Cosmetic dermatology, cosmetic selling, artificial intelligence, tele-dermatology, and social media are feasible as long as the same standards of conventional dermatology are applied. Nonetheless, the deontological codes associated with these innovations need to be refurbished.
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Affiliation(s)
- M A Lasheras-Pérez
- Servicios de Dermatología, Hospital Universitario y Politécnico la Fe, Valencia, Spain
| | - R Taberner
- Unidad de Dermatología, Hospital Universitari Son Llàtzer, Palma de Mallorca, Spain.
| | - B Martínez-Jarreta
- Departamento de Medicina Legal y Forense, Universidad de Zaragoza, Zaragoza, Spain
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Uchida T, Kin T, Saito T, Shono N, Kiyofuji S, Koike T, Sato K, Niwa R, Takashima I, Oyama H, Saito N. De-Identification Technique with Facial Deformation in Head CT Images. Neuroinformatics 2023; 21:575-587. [PMID: 37226013 PMCID: PMC10406725 DOI: 10.1007/s12021-023-09631-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2023] [Indexed: 05/26/2023]
Abstract
Head CT, which includes the facial region, can visualize faces using 3D reconstruction, raising concern that individuals may be identified. We developed a new de-identification technique that distorts the faces of head CT images. Head CT images that were distorted were labeled as "original images" and the others as "reference images." Reconstructed face models of both were created, with 400 control points on the facial surfaces. All voxel positions in the original image were moved and deformed according to the deformation vectors required to move to corresponding control points on the reference image. Three face detection and identification programs were used to determine face detection rates and match confidence scores. Intracranial volume equivalence tests were performed before and after deformation, and correlation coefficients between intracranial pixel value histograms were calculated. Output accuracy of the deep learning model for intracranial segmentation was determined using Dice Similarity Coefficient before and after deformation. The face detection rate was 100%, and match confidence scores were < 90. Equivalence testing of the intracranial volume revealed statistical equivalence before and after deformation. The median correlation coefficient between intracranial pixel value histograms before and after deformation was 0.9965, indicating high similarity. Dice Similarity Coefficient values of original and deformed images were statistically equivalent. We developed a technique to de-identify head CT images while maintaining the accuracy of deep-learning models. The technique involves deforming images to prevent face identification, with minimal changes to the original information.
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Affiliation(s)
- Tatsuya Uchida
- Department of Neurosurgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Taichi Kin
- Department of Neurosurgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
- Department of Medical Information Engineering, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Toki Saito
- Department of Medical Information Engineering, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Naoyuki Shono
- Department of Neurosurgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Satoshi Kiyofuji
- Department of Neurosurgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tsukasa Koike
- Department of Neurosurgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Katsuya Sato
- Department of Neurosurgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Ryoko Niwa
- Department of Neurosurgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Ikumi Takashima
- Data Science Office, Clinical Research Promotion Center, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroshi Oyama
- Department of Clinical Information Engineering, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Eapen BR. Artificial Intelligence in Dermatology: A Practical Introduction to a Paradigm Shift. Indian Dermatol Online J 2020; 11:881-889. [PMID: 33344334 PMCID: PMC7735013 DOI: 10.4103/idoj.idoj_388_20] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/27/2020] [Accepted: 09/13/2020] [Indexed: 12/13/2022] Open
Abstract
Artificial Intelligence (AI) has surpassed dermatologists in skin cancer detection, but dermatology still lags behind radiology in its broader adoption. Building and using AI applications are becoming increasingly accessible. However, complex use cases may still require specialized expertise for design and deployment. AI has many applications in dermatology ranging from fundamental research, diagnostics, therapeutics, and cosmetic dermatology. The lack of standardization of images and privacy concerns are the foremost challenges stifling AI adoption. Dermatologists have a significant role to play in standardized data collection, curating data for machine learning, clinically validating AI solutions, and ultimately adopting this paradigm shift that is changing the way we practice.
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Affiliation(s)
- Bell R. Eapen
- Information Systems, McMaster University, Hamilton, ON, Canada
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Arimany Manso J, Taberner Ferrer R, Pidevall I, Mascaró Ballester J, Martin-Fumadó C. Use of Photography in Dermatology: Ethical and Legal Implications. ACTAS DERMO-SIFILIOGRAFICAS 2020. [DOI: 10.1016/j.adengl.2019.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Caffery LJ, Clunie D, Curiel-Lewandrowski C, Malvehy J, Soyer HP, Halpern AC. Transforming Dermatologic Imaging for the Digital Era: Metadata and Standards. J Digit Imaging 2019; 31:568-577. [PMID: 29344752 DOI: 10.1007/s10278-017-0045-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Imaging is increasingly being used in dermatology for documentation, diagnosis, and management of cutaneous disease. The lack of standards for dermatologic imaging is an impediment to clinical uptake. Standardization can occur in image acquisition, terminology, interoperability, and metadata. This paper presents the International Skin Imaging Collaboration position on standardization of metadata for dermatologic imaging. Metadata is essential to ensure that dermatologic images are properly managed and interpreted. There are two standards-based approaches to recording and storing metadata in dermatologic imaging. The first uses standard consumer image file formats, and the second is the file format and metadata model developed for the Digital Imaging and Communication in Medicine (DICOM) standard. DICOM would appear to provide an advantage over using consumer image file formats for metadata as it includes all the patient, study, and technical metadata necessary to use images clinically. Whereas, consumer image file formats only include technical metadata and need to be used in conjunction with another actor-for example, an electronic medical record-to supply the patient and study metadata. The use of DICOM may have some ancillary benefits in dermatologic imaging including leveraging DICOM network and workflow services, interoperability of images and metadata, leveraging existing enterprise imaging infrastructure, greater patient safety, and better compliance to legislative requirements for image retention.
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Affiliation(s)
- Liam J Caffery
- Centre for Online Health, Centre for Health Services Research, The University of Queensland, Ground Floor, Building 33, Princess Alexandra Hospital, Woolloongabba, Brisbane, QLD, 4102, Australia.
| | | | - Clara Curiel-Lewandrowski
- University of Arizona Cancer Center/Skin Cancer Institute and Division of Dermatology, University of Arizona, Tucson, AZ, USA
| | - Josep Malvehy
- Dermatology Department, Hospital Clinic, IDIBAPS, CIBER de enfermedades raras, University of Barcelona, Barcelona, Spain
| | - H Peter Soyer
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia
- Dermatology Department, Princess Alexandra Hospital, Brisbane, Australia
| | - Allan C Halpern
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Dumestre DO, Fraulin F. Avoiding Breach of Patient Confidentiality: Trial of a Smartphone Application That Enables Secure Clinical Photography and Communication. Plast Surg (Oakv) 2019; 28:12-18. [PMID: 32110641 DOI: 10.1177/2292550319880910] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background To evaluate a smartphone application for clinical photography that prioritizes and facilitates patient security. Methods Ethics was obtained to trial the application Sharesmart. Calgary plastic surgeons/residents used the application for clinical photography and communication. Surveys gauging the application usability, incorporated consent process, and photograph storage/sharing were then sent to surgeons and patients. Results Over a 1-year trial period, 16 Calgary plastic surgeons and 24 residents used the application to photograph 84 patients. Half (56%) of the patients completed the survey. The majority of patients found the applications consent process acceptable (89%) and felt their photograph was secure (89%). Half (51%) of the surgeons/residents completed the survey and would use the application as is (67%) or with modifications (33%). The consent process was felt to be superior (73%) or equivalent (23%) to participant's prior methods and was felt to resolve issues present with current photography practices of secure transmission and storage of photographs by 100% and 95% of respondents, respectively. Perceived limitations of the application included difficulties in use with poor cellphone service or Internet, decreased speed compared to current practices, the lack of a desktop platform, video capability, and ability to transmit the photograph directly to the patient's medical record. Conclusions A smartphone clinical photography application addresses the risks of patient confidentiality breach present with current photography methods; broad implementation should be considered.
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Affiliation(s)
- Danielle O Dumestre
- Sections of Pediatric Surgery and Plastic Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Frankie Fraulin
- Sections of Pediatric Surgery and Plastic Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada
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Arimany Manso J, Taberner Ferrer R, Pidevall I, Mascaró Ballester JM, Martin-Fumadó C. Use of Photography in Dermatology: Ethical and Legal Implications. ACTAS DERMO-SIFILIOGRAFICAS 2019; 111:107-114. [PMID: 31629461 DOI: 10.1016/j.ad.2019.04.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/22/2019] [Accepted: 04/26/2019] [Indexed: 12/17/2022] Open
Abstract
Photographs are necessary in the clinical practice of dermatology, but there are ethical implications to consider. Moreover, dermatologists must be aware of and comply with certain legal requirements affecting the use of photographs. The main ethical principles are respect for patient autonomy and the physician's obligation to do no harm. The law differentiates between 2 bases for protection: one concerns the photographed person's rights over the image and the other protects personal data. Recent legislation places restrictions on taking photographs and exhibiting them. Photographs taken to be stored with a medical history have not been called into question, but the physician is recommended to inform the patient that they exist. When a photograph is exhibited for the purpose of teaching or illustrating concepts, it is necessary to determine whether or not the patient can be identified. If the answer is yes, the patient must give explicit permission. Caution should be exercised when publishing medical photographs on social media.
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Affiliation(s)
- J Arimany Manso
- Servicio de Responsabilidad Profesional, Área de Praxis, Colegio de Médicos de Barcelona, Consejo de Colegios de Médicos de Catalunya, Barcelona, España; Unidad de Medicina Legal y Forense, Departamento de Salud Pública, Facultad de Medicina, Universidad de Barcelona, Barcelona, España; Cátedra de Responsabilidad Profesional Médica y Medicina Legal, Universitat Autònoma de Barcelona (UAB), Barcelona, España.
| | - R Taberner Ferrer
- Servicio de Dermatología, Hospital Son Llàtzer, Palma, Islas Baleares, España
| | - I Pidevall
- Asesoría jurídica, Colegio de Médicos de Barcelona, Barcelona, España
| | | | - C Martin-Fumadó
- Servicio de Responsabilidad Profesional, Área de Praxis, Colegio de Médicos de Barcelona, Consejo de Colegios de Médicos de Catalunya, Barcelona, España; Cátedra de Responsabilidad Profesional Médica y Medicina Legal, Universitat Autònoma de Barcelona (UAB), Barcelona, España; Departamento de Medicina, Facultad de Medicina, Universitat Internacional de Catalunya, Barcelona, España
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Dumestre DO, Fraulin FOG. Balancing the Need for Clinical Photography With Patient Privacy Issues: The Search for a Secure SmartPhone Application to Take and Store Clinical Photographs. Plast Surg (Oakv) 2018; 25:255-260. [PMID: 29619348 DOI: 10.1177/2292550317731761] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Physicians are increasingly using smartphones to take clinical photographs. This study evaluates a smartphone application for clinical photography that prioritizes and facilitates patient security. Methods Ethics approval was obtained to trial a smartphone clinical photography application, PicSafe Medi. Calgary plastic surgeons and residents used the application to obtain informed consent and photograph patients. Surveys gauging the application's usability, consent process, and photograph storage/sharing were then sent to surgeons and patients. Results Over a 6-month trial period, 15 plastic surgeons and residents used the application to photograph 86 patients. Over half of the patients (57%) completed the survey. The majority of patients (96%) were satisfied with the application's consent process, and all felt their photographs were secure. The majority (93%) of surgeons/residents completed the survey. The application was felt to overcome issues with current photography practices: inadequate consent and storage of photographs (100%), risk to patient confidentiality (92%), and unsecure photograph sharing (93%). Barriers to regular use of the application included need for cellphone service/Internet (54%), sanitary concerns due to the need for patients to sign directly on the phone (46%), inability to obtain proactive/retroactive consent (85%), and difficulty viewing photographs (80%). The majority of surgeons (85%) believe a smartphone application would be suitable for clinical patient photography, but due to its limitations, only 23% would use the trialed application. Conclusions A smartphone clinical photography application addresses the patient confidentiality risks of current photography methods; however, limitations of the trialed application prevent its broad implementation.
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Affiliation(s)
- Danielle O Dumestre
- Section of Plastic Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Frankie O G Fraulin
- Sections of Pediatric Surgery and Plastic Surgery, Department of Surgery, University of Calgary, Alberta, Canada
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Perception and Acceptability of Medical Photography in Chinese Dermatologic Patients: A Questionnaire Survey. Dermatol Surg 2017; 43:437-442. [PMID: 28099200 DOI: 10.1097/dss.0000000000000984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Medical photography is increasingly used by physicians, but studies assessing the perception and acceptability of medical photography by Chinese dermatologic patients are scarce. OBJECTIVE To assess the perception and acceptability of medical photography in Chinese dermatologic patients. MATERIALS AND METHODS From July to December 2014, adult patients visiting the Dermatology Clinic of The First Affiliated Hospital of Third Military Medical University were included in this study. They were required to fill an anonymous questionnaire regarding perception and acceptability of medical photography. RESULTS A total of 509 consecutive patients completed the questionnaire, with 35 and 474 declining and undergoing medical photography, respectively. Meanwhile, 81.0% of the patients preferred to be photographed by attending physicians; 63.3% favored clinic-owned cameras, and 81.0% would rather have their photographs stored in the department's database. Besides, most patients allowed their photographs to be used in case studies (92.8%) or medical record keeping (90.3%). CONCLUSION Most Chinese dermatologic patients accept medical photography. However, the principles of privacy protection and informed consent should be strictly enforced in clinical practice, and appropriate photographic devices and storage methods should be used, for better acceptance.
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Allen KG, Eleftheriou P, Ferguson J. A thousand words in the palm of your hand: management of clinical photography on personal mobile devices. Med J Aust 2016; 205:499-500. [DOI: 10.5694/mja16.00520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 07/25/2016] [Indexed: 11/17/2022]
Affiliation(s)
- Kieran G Allen
- Monash University, Melbourne, VIC
- Queensland University of Technology, Brisbane, QLD
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Cockayne S, Hewitt C, Hashmi F, Hicks K, Concannon M, McIntosh C, Thomas K, Hall J, Watson J, Torgerson D, Watt I. Implementation of blinded outcome assessment in the Effective Verruca Treatments trial (EverT) - lessons learned. J Foot Ankle Res 2016; 9:21. [PMID: 27408622 PMCID: PMC4941023 DOI: 10.1186/s13047-016-0155-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 07/08/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Trials using inadequate levels of blinding may report larger effect sizes than blinded studies. It has been suggested that blinded outcome assessment in open trials may in some cases be undertaken by assessments of photographs. The aim of this paper is to explore the effect of using different methods to assess the primary outcome in the EVerT (Effective Verruca Treatments) trial. It also aims to give an overview of the experiences of using digital photographs within the trial. METHODS We undertook a secondary analysis to explore the effect of using three different methods to assess the primary outcome in the EVerT trial: assessment of digital photographs by blinded healthcare professionals; blinded healthcare professional assessment at the recruiting site and patient self-report. The verruca clearance rates were calculated using the three different methods of assessment. A Cohen's kappa measure of inter-rater agreement was used to assess the agreement between the methods. We also investigated the experiences of healthcare professionals using digital photographs within the trial. RESULTS Digital photographs for 189 out of 240 (79 %) patients in the trial were received for outcome assessment. Of the 189 photographs, 30 (16 %) were uninterpretable. The overall verruca clearance rates were 21 % (43/202,) using the unblinded patient self-reported outcome, 6 % (9/159,) using blinded assessment of digital photographs and 14 % (30/210,) using blinded outcome assessment at the site. CONCLUSIONS Despite differences in the clearance rates found using different methods of outcome assessment, this did not change the original conclusion of the trial, that there is no evidence of a difference in effectiveness between cryotherapy and salicylic acid. Future trials using digital photographs should consider individual training needs at sites and have a backup method of assessment agreed a priori. TRIAL REGISTRATION ISRCTN Registry ISRCTN18994246.
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Affiliation(s)
- Sarah Cockayne
- Department of Health Sciences, York Trials Unit, University of York, York, UK
| | - Catherine Hewitt
- Department of Health Sciences, York Trials Unit, University of York, York, UK
| | - Farina Hashmi
- School of Health Sciences, University of Salford, Salford, UK
| | - Kate Hicks
- Department of Health Sciences, York Trials Unit, University of York, York, UK
| | - Michael Concannon
- The School of Human & Health Sciences, Division of Podiatry, University of Huddersfield, Huddersfield, UK
| | - Caroline McIntosh
- Discipline of Podiatry, The National University of Ireland, Galway, Republic of Ireland
| | - Kim Thomas
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - Jill Hall
- The Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Judith Watson
- Department of Health Sciences, York Trials Unit, University of York, York, UK
| | - David Torgerson
- Department of Health Sciences, York Trials Unit, University of York, York, UK
| | - Ian Watt
- Department of Health Sciences, York Trials Unit, University of York, York, UK ; Hull York Medical School, York, UK
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Informed Consent, Use, and Storage of Digital Photography Among Mohs Surgeons in the United States. Dermatol Surg 2016; 42:305-9. [PMID: 26863597 DOI: 10.1097/dss.0000000000000634] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Digital photography is pervasive in dermatology. Potential uses include monitoring untreated disease, disease progression and treatment response, evaluating medical and cosmetic treatment, determining surgical sites, educating trainees and colleagues, and publishing reports in scientific journals. However, the nature of use, storage, and informed consent practices for digital photography among dermatologic surgeons has not been investigated. OBJECTIVE This study used a comprehensive survey to elucidate these elements to better define standard practice. MATERIALS AND METHODS A survey was created on SurveyMonkey. An email with the survey link was sent to all members of the American College of Mohs Surgery listserv with 2 follow-up emails. RESULTS One hundred fifty-eight Mohs surgeons responded to the survey. Respondents indicated a wide variety in the type of camera and storage modality used for patient photographs. There was a variety of opinions on how to conceal a patient's identity when using photographs for educational purposes, and what features of a photo make it identifiable. CONCLUSION Dermatologic surgeons vary widely on practices of photo storage and opinions of identifiability. Dermatology as a specialty may consider generating a consensus statement on appropriate use and storage of digital photography in dermatology practice.
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Indu M, Sunil S, Rathy R, Binu MP. Imaging and image management: A survey on current outlook and awareness in pathology practice. J Oral Maxillofac Pathol 2015; 19:153-7. [PMID: 26604489 PMCID: PMC4611921 DOI: 10.4103/0973-029x.164525] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Flexibility of digital photography enables it to be an integral part of pathology practice. An assessment of guidelines of imaging is essential for proper usage of photographs. OBJECTIVES The purpose of the study was to assess awareness of oral pathologists about various aspects of medical photography. METHODS Questionnaire based on the availability of facilities, usage, technical details and ethical issues of medical photography was sent to postgraduate students and teaching faculties of Oral Pathology in various localities in India. RESULTS Photographs were taken mostly for the purposes of publication, medical documentation and education. Significant number of postgraduate students and faculties of Oral Pathology didn't receive any training or hadn't gone through any publications/books (P = 0.000) about medical photography. Consent for patient photography was taken by significant number of respondents (P = 0.000) but in a verbal form. Majority of people used image editing software, but 19.0% of faculties and 21.1% of postgraduate students were unaware of deleterious effect of image editing. Firm and sensible instructions concerning image storage, sharing and accessibility were not yet created. CONCLUSION This survey drew attention towards lack of proper understanding about the technical details, medical protocols and ethical issues related to medical photography. These findings recommend implementation of basic training for medical photography and policy for image management for students and faculties in every health care institution.
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Affiliation(s)
- M Indu
- Department of Oral and Maxillofacial Pathology, Azeezia College of Dental Sciences and Research, Kollam, Kerala, India
| | - S Sunil
- Department of Oral and Maxillofacial Pathology, Pushpagiri College of Dental Sciences and Research, Thiruvalla, Kerala, India
| | - R Rathy
- Department of Oral and Maxillofacial Pathology, Azeezia College of Dental Sciences and Research, Kollam, Kerala, India
| | - M P Binu
- Private Practitioner, Consultant Dental Surgeon, Vayalar (P.O), Cherthala, Alappuzha, Kerala, India
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Abstract
Telemedicine is a technological tool that is improving the health of children around the world. This report chronicles the use of telemedicine by pediatricians and pediatric medical and surgical specialists to deliver inpatient and outpatient care, educate physicians and patients, and conduct medical research. It also describes the importance of telemedicine in responding to emergencies and disasters and providing access to pediatric care to remote and underserved populations. Barriers to telemedicine expansion are explained, such as legal issues, inadequate payment for services, technology costs and sustainability, and the lack of technology infrastructure on a national scale. Although certain challenges have constrained more widespread implementation, telemedicine's current use bears testimony to its effectiveness and potential. Telemedicine's widespread adoption will be influenced by the implementation of key provisions of the Patient Protection and Affordable Care Act, technological advances, and growing patient demand for virtual visits.
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Ashique KT, Kaliyadan F, Aurangabadkar SJ. Clinical photography in dermatology using smartphones: An overview. Indian Dermatol Online J 2015; 6:158-63. [PMID: 26009708 PMCID: PMC4439742 DOI: 10.4103/2229-5178.156381] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The smartphone is one of the biggest revolutions in the era of information technology. Its built in camera offers several advantages. Dermatologists, who handle a specialty that is inherently visual, are most benefited by this handy technology. Here in this article, we attempt to provide an overview of smartphone photography in clinical dermatology in order to help the dermatologist to get the best out of the available camera for clinical imaging and storage.
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Affiliation(s)
- K T Ashique
- Department of Dermatology, KIMS ALSHIFA Super Speciality Hospital, Perinthalmanna, Malappuram Dt., Kerala, India
| | - Feroze Kaliyadan
- Department of Dermatology, Faculty of Dermatology, College of Medicine, King Faisal University, Al Ahsa 31982, Saudi Arabia
| | - Sanjeev J Aurangabadkar
- Department of Dermatology, Skin and Laser Clinic, Brij Tarang, Green Lands, Begumpet, Hyderabad, India
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17
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Teledermatology: From historical perspective to emerging techniques of the modern era. J Am Acad Dermatol 2015; 72:577-86; quiz 587-8. [DOI: 10.1016/j.jaad.2014.08.014] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 07/21/2014] [Accepted: 08/07/2014] [Indexed: 11/22/2022]
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Abstract
OBJECTIVE The increasing capabilities of camera-equipped mobile phones have led to a growing body of evidence regarding their use in medical imaging across a broad range of medical specialties. This article reviews the current evidence for the use of mobile health (m-health) in medical imaging. MATERIALS AND METHODS We performed a structured review of the published literature regarding m-health in medical imaging using the Medline, PubMed, and Web of Science databases (January 2002-August 2013). The two authors independently extracted data regarding type of specialty, purpose, and study design of publications. RESULTS In total, 235 articles were identified. The majority of studies were case reports or noncomparative product validation studies. The greatest volume of publications originated in the fields of radiology (21%), dermatology (15%), laboratory techniques (15%), and plastic surgery (12%). Among these studies, m-health was used as diagnostic aids, for patient monitoring, and to improve communication between health practitioners. With the growing use of mobile phones for medical imaging, considerations need to be given to informed consent, privacy, image storage and transfer, and guidelines for healthcare workers and patients. CONCLUSIONS There are several novel uses of mobile devices for medical imaging that show promise across a variety of areas and subspecialties of healthcare. Currently, studies are mostly exploratory in nature. To validate these devices, studies with higher methodological rigor are required.
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Abstract
BACKGROUND Clinical photography enhances medical care, research, and teaching. Empirical data are needed to guide best practices regarding dermatologic photography. OBJECTIVE To investigate patient opinion about clinical photography and identify demographic factors that influence these opinions. METHODS AND MATERIALS Four hundred patients representing a broad range of ages, self-identified ethnic/racial groups, and socioeconomic levels were recruited from 4 dermatology settings in New York City. Patients were administered a survey about perceptions of photography, willingness to allow photographs to be used in a variety of settings, preferences for photographer and photographic equipment, and methods of consent. RESULTS Eighty-eight percent of patients agreed that photography enhanced their quality of care. Most patients would allow their photographs to be used for medical, teaching, and research purposes with significantly more acceptance when patients were not identifiable. Patients preferred photographs taken by a physician rather than a nurse or student, photographers of the same gender, clinic-owned cameras to personal cameras or cell phones, and written consent to verbal consent. There were significant racial/ethnicity and age-related variations in responses, with white and older patients being more permissive than other groups. CONCLUSION We use the results of this study to recommend best practices for photography in dermatology.
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20
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Godwin ZR, Bockhold JC, Webster L, Falwell S, Bomze L, Tran NK. Development of novel smart device based application for serial wound imaging and management. Burns 2013; 39:1395-402. [DOI: 10.1016/j.burns.2013.03.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 03/26/2013] [Accepted: 03/27/2013] [Indexed: 10/26/2022]
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21
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Hacard F, Maruani A, Delaplace M, Caille A, Machet L, Lorette G, Samimi M. Patients' acceptance of medical photography in a French adult and paediatric dermatology department: a questionnaire survey. Br J Dermatol 2013; 169:298-305. [DOI: 10.1111/bjd.12345] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2013] [Indexed: 11/29/2022]
Affiliation(s)
- F. Hacard
- Dermatology Department; CHU de Tours; Université François Rabelais; Tours France
| | - A. Maruani
- Dermatology Department; CHU de Tours; Université François Rabelais; Tours France
- INSERM U930; CHU de Tours; Université François Rabelais; Tours France
| | - M. Delaplace
- Dermatology Department; CHU de Tours; Université François Rabelais; Tours France
| | - A. Caille
- INSERM CIC 202; CHU de Tours; Université François Rabelais; Tours France
| | - L. Machet
- Dermatology Department; CHU de Tours; Université François Rabelais; Tours France
- INSERM U930; CHU de Tours; Université François Rabelais; Tours France
| | - G. Lorette
- Dermatology Department; CHU de Tours; Université François Rabelais; Tours France
- INRA ISP; UMR 1282; CHU de Tours; Université François Rabelais; Tours France
| | - M. Samimi
- Dermatology Department; CHU de Tours; Université François Rabelais; Tours France
- INRA ISP; UMR 1282; CHU de Tours; Université François Rabelais; Tours France
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22
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Kunde L, McMeniman E, Parker M. Clinical photography in dermatology: ethical and medico-legal considerations in the age of digital and smartphone technology. Australas J Dermatol 2013; 54:192-7. [PMID: 23713892 DOI: 10.1111/ajd.12063] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 03/14/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVE Clinical photography has long been an important aspect in the management of dermatological pathology and has many applications in contemporary dermatology practice. With the continuous evolution of digital and smartphone technology, clinicians must maintain ethical and medico-legal standards. This article reviews how dermatology trainees are utilising this technology in their clinical practice and what procedures they follow when taking photos of patients. We review the ethical and legal considerations of clinical photography in dermatology and present a hypothetical medico-legal scenario. METHODS Dermatology registrars were surveyed on their use of personal smartphones and digital equipment for photographing patients in their clinical practice. Numerous medico-legal providers were approached to provide medico-legal advice about a hypothetical scenario. CONCLUSIONS We found that the use of these technologies is prevalent among dermatology registrars and all respondents reported regular use. Clinicians should routinely obtain and document adequate patient consent in relation to clinical photography, utilise strict privacy settings on smartphones and other digital devices and ensure that the images are stored on these devices for minimal periods. Express consent documentation in the clinical file puts the clinician in a more defensible position if a complaint is made to the medical board or privacy commissioner.
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Affiliation(s)
- Lauren Kunde
- Queensland University of Technology, Brisbane, Queensland, Australia.
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23
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Kaliyadan F. Teledermatology update: Mobile teledermatology. World J Dermatol 2013; 2:11-15. [DOI: 10.5314/wjd.v2.i2.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 03/08/2013] [Accepted: 04/29/2013] [Indexed: 02/06/2023] Open
Abstract
Mobile teledermatology is a relatively recent modification of teledermatology, which involves using mobile platforms like cellular phones to transmit images and data for the purpose of teleconsultations. With the rapidly improving quality of smart phone cameras combined with easier access to mobile internet, mobile teledermatology is emerging as a feasible and cost-effective method for teledermatology practice. Mobile teledermatology has shown good results in concordance studies comparing it to face-to-face consultations. Mobile teledermatology can be used for most types of clinical dermatology cases. Mobile teledermatology has been found to be useful in diagnosis, screening and triage of skin lesions including skin cancers. It is also useful as a tool to follow up patients with chronic dermatological problems like psoriasis and chronic wounds. The obvious advantage of mobile teledermatology is it’s cost-effectiveness and the fact that access to expert dermatology care is made easier for patients especially in remote areas. Further research is however required to standardize protocols for mobile teledermatology. Collaborative research among people working in this field would be very useful in this standardization and would help in optimizing the opportunities provided by this interesting tool. This article gives a brief overview of mobile teledermatology including definitions, tools involved, indications, limitations and future applications.
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25
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Ernst EJ, Speck PM, Fitzpatrick JJ. Evaluation of image quality of digital photo documentation of female genital injuries following sexual assault. JOURNAL OF FORENSIC NURSING 2011; 7:182-189. [PMID: 22123038 DOI: 10.1111/j.1939-3938.2011.01103.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
With the patient's consent, physical injuries sustained in a sexual assault are evaluated and treated by the sexual assault nurse examiner (SANE) and documented on preprinted traumagrams and with photographs. Digital imaging is now available to the SANE for documentation of sexual assault injuries, but studies of the image quality of forensic digital imaging of female genital injuries after sexual assault were not found in the literature. The Photo Documentation Image Quality Scoring System (PDIQSS) was developed to rate the image quality of digital photo documentation of female genital injuries after sexual assault. Three expert observers performed evaluations on 30 separate images at two points in time. An image quality score, the sum of eight integral technical and anatomical attributes on the PDIQSS, was obtained for each image. Individual image quality ratings, defined by rating image quality for each of the data, were also determined. The results demonstrated a high level of image quality and agreement when measured in all dimensions. For the SANE in clinical practice, the results of this study indicate that a high degree of agreement exists between expert observers when using the PDIQSS to rate image quality of individual digital photographs of female genital injuries after sexual assault.
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Affiliation(s)
- E J Ernst
- California State University Dominguez Hills, Carson, California, USA.
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26
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Abstract
Dermatologic surgery and aesthetic dermatology are rapidly emerging and expanding specialties in India. However, dermatologists practicing surgeries and aesthetics in India represent a highly selected group and are mostly confined to metros. Dermatologists in the peripheral and remote regions need to reach these specialists for the benefit of their patients and teledermatology is an invaluable tool for this purpose. Video-conference, store and forward, Satellite communication, Hybrid teledermatology, mobile teledermatology, Integration model, nurse-led teledermatology, teledermatology focusing difficult-to-manage cases, screening and triage services are the various teledermatology services developed to suit the needs of dermatology care from a distance. Types of teledermatology service, pattern of net work connectivity and purpose of dermatology service are the three cardinal parameters for management of the dermatoses from a distance. This article reviews the literature, and analyzes the possible options available for a teledermatosurgery practice.
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Affiliation(s)
- Garehatty Rudrappa Kanthraj
- Department of Dermatology, Venereology and Leprosy, Jagadguru Sri Shivarathreshwara University Medical College Hospital, Ramanuja Road, Mysore, Karnataka, India
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27
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Abstract
A fotografia dermatológica é complementar ao exame dermatológico. Sua função é ser um veículo de informação do conhecimento e sua qualidade depende da perícia do fotógrafo-dermatologista em registrar os elementos relevantes de uma cena. Por isso o dermatologista deve conhecer os princípios básicos da fotografia e os editores dos periódicos devem assegurar que os artigos tenham imagens de alta qualidade. Este artigo sugere critérios para melhorar a qualidade das fotos submetidas aos periódicos.
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Van Poucke S, Nelissen R, Jorens P, Vander Haeghen Y. Comparative analysis of two methods for wound bed area measurement. Int Wound J 2011; 7:366-77. [PMID: 20609029 DOI: 10.1111/j.1742-481x.2010.00701.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Wound bed area measurements are considered to be an essential part of the wound assessment process. Wound care professionals should be aware of the reliability and validity of the techniques they use. The purpose of this study was to assess whether wound care professionals are able to make as accurate and reproducible a measurement of the wound bed area using two methods for area measurement. Five wound care professionals independently assessed 2285 digital wound images for the wound bed area. Each image was measured in random order, three times, and in four angles by providing the rotated versions of each image (0°, 90°, 180° and 270°). Two techniques were compared: free hand drawing and closed polygon (CP) graph algorithm. Comparison of the two techniques showed differences that are, in our opinion, not acceptable in clinical practice when these techniques are used interchangeably and/or the measurements are carried out by different observers. Variations observed between wounds and observers seem related to the difference in perception of the wound bed margin. Our results indicate that repetition of CP graph area measurement results in the lowest difference in repetitive measurements. Study limitations are related to an incomplete consensus on definitions of wound, wound bed, wound edge and wound border. The development of an ontology related to wound images could aid to reduce these ambiguities.
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Affiliation(s)
- Sven Van Poucke
- Department of Anaesthesia, Critical Care, Emergency Care ZOL, Genk, Belgium.
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29
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Affiliation(s)
- Kate London
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.
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30
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Van Poucke S, Haeghen YV, Vissers K, Meert T, Jorens P. Automatic colorimetric calibration of human wounds. BMC Med Imaging 2010; 10:7. [PMID: 20298541 PMCID: PMC2850874 DOI: 10.1186/1471-2342-10-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2009] [Accepted: 03/18/2010] [Indexed: 11/17/2022] Open
Abstract
Background Recently, digital photography in medicine is considered an acceptable tool in many clinical domains, e.g. wound care. Although ever higher resolutions are available, reproducibility is still poor and visual comparison of images remains difficult. This is even more the case for measurements performed on such images (colour, area, etc.). This problem is often neglected and images are freely compared and exchanged without further thought. Methods The first experiment checked whether camera settings or lighting conditions could negatively affect the quality of colorimetric calibration. Digital images plus a calibration chart were exposed to a variety of conditions. Precision and accuracy of colours after calibration were quantitatively assessed with a probability distribution for perceptual colour differences (dE_ab). The second experiment was designed to assess the impact of the automatic calibration procedure (i.e. chart detection) on real-world measurements. 40 Different images of real wounds were acquired and a region of interest was selected in each image. 3 Rotated versions of each image were automatically calibrated and colour differences were calculated. Results 1st Experiment: Colour differences between the measurements and real spectrophotometric measurements reveal median dE_ab values respectively 6.40 for the proper patches of calibrated normal images and 17.75 for uncalibrated images demonstrating an important improvement in accuracy after calibration. The reproducibility, visualized by the probability distribution of the dE_ab errors between 2 measurements of the patches of the images has a median of 3.43 dE* for all calibrated images, 23.26 dE_ab for all uncalibrated images. If we restrict ourselves to the proper patches of normal calibrated images the median is only 2.58 dE_ab! Wilcoxon sum-rank testing (p < 0.05) between uncalibrated normal images and calibrated normal images with proper squares were equal to 0 demonstrating a highly significant improvement of reproducibility. In the second experiment, the reproducibility of the chart detection during automatic calibration is presented using a probability distribution of dE_ab errors between 2 measurements of the same ROI. Conclusion The investigators proposed an automatic colour calibration algorithm that ensures reproducible colour content of digital images. Evidence was provided that images taken with commercially available digital cameras can be calibrated independently of any camera settings and illumination features.
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Affiliation(s)
- Sven Van Poucke
- Department of Anaesthesia, Critical Care, Emergency Care, Genk, Belgium.
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31
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Nelson CA, Freeman SR, Dellavalle RP. Reviewing Dermatology Manuscripts and Publications. Dermatol Clin 2009; 27:201-4, viii. [DOI: 10.1016/j.det.2008.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Marghoob AA, Changchien L, DeFazio J, Dessio WC, Malvehy J, Zalaudek I, Halpern AC, Scope A. The most common challenges in melanoma diagnosis and how to avoid them. Australas J Dermatol 2009; 50:1-13; quiz 14-5. [DOI: 10.1111/j.1440-0960.2008.00496_1.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Geiderman JM, Moskop JC, Derse AR. Privacy and confidentiality in emergency medicine: obligations and challenges. Emerg Med Clin North Am 2006; 24:633-56. [PMID: 16877134 PMCID: PMC7132767 DOI: 10.1016/j.emc.2006.05.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Respect for privacy and confidentiality have been professional responsibilities of physicians throughout recorded history. This article reviews the moral, religious, and legal foundations of privacy and confidentiality and discusses the distinction between these two closely related concepts. Current federal and state laws are reviewed, including HIPAA regulations and their implications for research and care in the emergency department. In the emergency department, privacy and confidentiality often are challenged by physical design, crowding, visitors, film crews, communication, and other factors. These problems are reviewed, and advice and guidelines are offered for helping preserve patients' dignity and rights to privacy and confidentiality.
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Affiliation(s)
- Joel Martin Geiderman
- Ruth and Harry Roman Emergency Department, Department of Emergency Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
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34
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Starr JC. Integrating digital image management software for improved patient care and optimal practice management. Dermatol Surg 2006; 32:834-40. [PMID: 16792650 DOI: 10.1111/j.1524-4725.2006.32169.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Photographic images provide vital documentation of preoperative, intraoperative, and postoperative results in the clinical dermatologic surgery practice and can document histologic findings from skin biopsies, thereby enhancing patient care. Images may be printed as part of text documents, transmitted via electronic mail, or included in electronic medical records. OBJECTIVES To describe existing computer software that integrates digital photography and the medical record to improve patient care and practice management. CONCLUSIONS A variety of computer applications are available to optimize the use of digital images in the dermatologic practice.
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Affiliation(s)
- Jon C Starr
- Department of Dermatology, Stanford University School of Medicine, Palo Alto, California 94304-2201, USA.
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35
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Integrating Digital Image Management Software for Improved Patient Care and Optimal Practice Management. Dermatol Surg 2006. [DOI: 10.1097/00042728-200606000-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
A tecnologia digital promoveu grande popularização do registro fotográfico em diversas áreas médicas. A dermatologia, por sua natureza visual, vem absorvendo os benefícios dessa ferramenta na prática clínica e na pesquisa. Este artigo visa orientar o dermatologista não familiarizado com essa tecnologia, oferecendo noções para o melhor uso do equipamento de fotografia digital.
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