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Betlloch-Mas I, Martínez-Miravete MT, Berbegal-DeGracia L, Sánchez-Vázquez L, Sánchez-Payá J. Teledermatology in paediatrics: Health-care impact on the early treatment of infantile haemangiomas. J Telemed Telecare 2020; 27:424-430. [PMID: 32188311 DOI: 10.1177/1357633x20904901] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Teledermatology can solve diagnostic and therapeutic problems in paediatrics, for example in infantile haemangiomas (IHs) requiring early treatment with propranolol. This study aims to assess the impact of teledermatology following its implementation in a health area of Spain, specifically analysing its effectiveness in reducing the age of first propranolol treatment for IH. METHODS This was a descriptive study of paediatric teledermatology from 2015 to 2018, studying age, sex, diagnosis, time and mode of resolution. All IHs referred via teledermatology were analysed, and age at propranolol initiation was compared to the period prior to implementation (2008-2014). We also analysed IHs according to referral pathways (teledermatology vs. conventional pathways). RESULTS We included 432 consultations (47.7% boys). The main diagnoses were IH, erythematous-desquamative diseases and infections. Concordance in diagnosis between paediatricians and dermatologists was good, and 48.12% of cases consulted via teledermatology were resolved remotely. Response time was 2.81 days on average. Children younger than two months of age showed the highest proportion of in-person visits. In 2015-2018, children with IHs began treatment with propranolol at a mean age of 4.5 months (1.9 months in those referred via teledermatology vs. 5.6 months in those using conventional referral pathways). In 2008-2014, the mean age at referral was 7.1 months. These differences were significant. DISCUSSION Teledermatology is a fast and effective tool to resolve paediatric cases, enabling a significant decrease in the age of treatment in infants with IH.
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Affiliation(s)
- Isabel Betlloch-Mas
- Department of Dermatology, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Spain
| | - María-Teresa Martínez-Miravete
- Department of Paediatrics, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Spain
| | | | | | - José Sánchez-Payá
- Epidemiology Unit, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Spain
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González-Cruz C, Descalzo M, Arias-Santiago S, Molina-Leyva A, Gilaberte Y, Fernández-Crehuet P, Husein-ElAhmed H, Viera-Ramírez A, Fernández-Peñas P, Taberner R, Buendía-Eisman A, García-Doval I, García-Patos V. Análisis de la proporción de derivaciones potencialmente evitables desde Atención Primaria a Dermatología por lesiones quísticas o tumorales benignas en España. Datos del estudio DIADERM. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:659-665. [DOI: 10.1016/j.ad.2019.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 02/03/2019] [Accepted: 02/07/2019] [Indexed: 11/25/2022] Open
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González-Cruz C, Descalzo M, Arias-Santiago S, Molina-Leyva A, Gilaberte Y, Fernández-Crehuet P, Husein-ElAhmed H, Viera-Ramírez A, Fernández-Peñas P, Taberner R, Buendía-Eisman A, García-Doval I, García-Patos V. Proportion of Potentially Avoidable Referrals From Primary Care to Dermatologists for Cystic Lesions or Benign Neoplasms in Spain: Analysis of Data From the DIADERM Study. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Chuchu N, Dinnes J, Takwoingi Y, Matin RN, Bayliss SE, Davenport C, Moreau JF, Bassett O, Godfrey K, O'Sullivan C, Walter FM, Motley R, Deeks JJ, Williams HC. Teledermatology for diagnosing skin cancer in adults. Cochrane Database Syst Rev 2018; 12:CD013193. [PMID: 30521686 PMCID: PMC6517019 DOI: 10.1002/14651858.cd013193] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Early accurate detection of all skin cancer types is essential to guide appropriate management and to improve morbidity and survival. Melanoma and squamous cell carcinoma (SCC) are high-risk skin cancers which have the potential to metastasise and ultimately lead to death, whereas basal cell carcinoma (BCC) is usually localised with potential to infiltrate and damage surrounding tissue. Anxiety around missing early curable cases needs to be balanced against inappropriate referral and unnecessary excision of benign lesions. Teledermatology provides a way for generalist clinicians to access the opinion of a specialist dermatologist for skin lesions that they consider to be suspicious without referring the patients through the normal referral pathway. Teledermatology consultations can be 'store-and-forward' with electronic digital images of a lesion sent to a dermatologist for review at a later time, or can be live and interactive consultations using videoconferencing to connect the patient, referrer and dermatologist in real time. OBJECTIVES To determine the diagnostic accuracy of teledermatology for the detection of any skin cancer (melanoma, BCC or cutaneous squamous cell carcinoma (cSCC)) in adults, and to compare its accuracy with that of in-person diagnosis. SEARCH METHODS We undertook a comprehensive search of the following databases from inception up to August 2016: Cochrane Central Register of Controlled Trials, MEDLINE, Embase, CINAHL, CPCI, Zetoc, Science Citation Index, US National Institutes of Health Ongoing Trials Register, NIHR Clinical Research Network Portfolio Database and the World Health Organization International Clinical Trials Registry Platform. We studied reference lists and published systematic review articles. SELECTION CRITERIA Studies evaluating skin cancer diagnosis for teledermatology alone, or in comparison with face-to-face diagnosis by a specialist clinician, compared with a reference standard of histological confirmation or clinical follow-up and expert opinion. We also included studies evaluating the referral accuracy of teledermatology compared with a reference standard of face-to-face diagnosis by a specialist clinician. DATA COLLECTION AND ANALYSIS Two review authors independently extracted all data using a standardised data extraction and quality assessment form (based on QUADAS-2). We contacted authors of included studies where there were information related to the target condition of any skin cancer missing. Data permitting, we estimated summary sensitivities and specificities using the bivariate hierarchical model. Due to the scarcity of data, we undertook no covariate investigations for this review. For illustrative purposes, we plotted estimates of sensitivity and specificity on coupled forest plots for diagnostic threshold and target condition under consideration. MAIN RESULTS The review included 22 studies reporting diagnostic accuracy data for 4057 lesions and 879 malignant cases (16 studies) and referral accuracy data for reported data for 1449 lesions and 270 'positive' cases as determined by the reference standard face-to-face decision (six studies). Methodological quality was variable with poor reporting hindering assessment. The overall risk of bias was high or unclear for participant selection, reference standard, and participant flow and timing in at least half of all studies; the majority were at low risk of bias for the index test. The applicability of study findings were of high or unclear concern for most studies in all domains assessed due to the recruitment of participants from secondary care settings or specialist clinics rather than from primary or community-based settings in which teledermatology is more likely to be used and due to the acquisition of lesion images by dermatologists or in specialist imaging units rather than by primary care clinicians.Seven studies provided data for the primary target condition of any skin cancer (1588 lesions and 638 malignancies). For the correct diagnosis of lesions as malignant using photographic images, summary sensitivity was 94.9% (95% confidence interval (CI) 90.1% to 97.4%) and summary specificity was 84.3% (95% CI 48.5% to 96.8%) (from four studies). Individual study estimates using dermoscopic images or a combination of photographic and dermoscopic images generally suggested similarly high sensitivities with highly variable specificities. Limited comparative data suggested similar diagnostic accuracy between teledermatology assessment and in-person diagnosis by a dermatologist; however, data were too scarce to draw firm conclusions. For the detection of invasive melanoma or atypical intraepidermal melanocytic variants both sensitivities and specificities were more variable. Sensitivities ranged from 59% (95% CI 42% to 74%) to 100% (95% CI 48% to 100%) and specificities from 30% (95% CI 22% to 40%) to 100% (95% CI 93% to 100%), with reported diagnostic thresholds including the correct diagnosis of melanoma, classification of lesions as 'atypical' or 'typical, and the decision to refer or to excise a lesion.Referral accuracy data comparing teledermatology against a face-to-face reference standard suggested good agreement for lesions considered to require some positive action by face-to-face assessment (sensitivities of over 90%). For lesions considered of less concern when assessed face-to-face (e.g. for lesions not recommended for excision or referral), agreement was more variable with teledermatology specificities ranging from 57% (95% CI 39% to 73%) to 100% (95% CI 86% to 100%), suggesting that remote assessment is more likely recommend excision, referral or follow-up compared to in-person decisions. AUTHORS' CONCLUSIONS Studies were generally small and heterogeneous and methodological quality was difficult to judge due to poor reporting. Bearing in mind concerns regarding the applicability of study participants and of lesion image acquisition in specialist settings, our results suggest that teledermatology can correctly identify the majority of malignant lesions. Using a more widely defined threshold to identify 'possibly' malignant cases or lesions that should be considered for excision is likely to appropriately triage those lesions requiring face-to-face assessment by a specialist. Despite the increasing use of teledermatology on an international level, the evidence base to support its ability to accurately diagnose lesions and to triage lesions from primary to secondary care is lacking and further prospective and pragmatic evaluation is needed.
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Affiliation(s)
- Naomi Chuchu
- University of BirminghamInstitute of Applied Health ResearchBirminghamUKB15 2TT
| | - Jacqueline Dinnes
- University of BirminghamInstitute of Applied Health ResearchBirminghamUKB15 2TT
- University Hospitals Birmingham NHS Foundation Trust and University of BirminghamNIHR Birmingham Biomedical Research CentreBirminghamUK
| | - Yemisi Takwoingi
- University of BirminghamInstitute of Applied Health ResearchBirminghamUKB15 2TT
- University Hospitals Birmingham NHS Foundation Trust and University of BirminghamNIHR Birmingham Biomedical Research CentreBirminghamUK
| | - Rubeta N Matin
- Churchill HospitalDepartment of DermatologyOld RoadHeadingtonOxfordUKOX3 7LE
| | - Susan E Bayliss
- University of BirminghamInstitute of Applied Health ResearchBirminghamUKB15 2TT
| | - Clare Davenport
- University of BirminghamInstitute of Applied Health ResearchBirminghamUKB15 2TT
| | - Jacqueline F Moreau
- University of Pittsburgh Medical CenterInternal MedicineDepartment of Medicine, Office of EducationUPMC Montefiore Hospital, N715PittsburghUSAPA, 15213
| | - Oliver Bassett
- Addenbrooke's HospitalPlastic SurgeryHills RoadCambridgeUKCB2 0QQ
| | - Kathie Godfrey
- The University of Nottinghamc/o Cochrane Skin GroupNottinghamUK
| | | | - Fiona M Walter
- University of CambridgePublic Health & Primary CareStrangeways Research Laboratory, Worts CausewayCambridgeUKCB1 8RN
| | - Richard Motley
- University Hospital of WalesWelsh Institute of DermatologyHeath ParkCardiffUKCF14 4XW
| | - Jonathan J Deeks
- University of BirminghamInstitute of Applied Health ResearchBirminghamUKB15 2TT
- University Hospitals Birmingham NHS Foundation Trust and University of BirminghamNIHR Birmingham Biomedical Research CentreBirminghamUK
| | - Hywel C Williams
- University of NottinghamCentre of Evidence Based DermatologyQueen's Medical CentreDerby RoadNottinghamUKNG7 2UH
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Teledermatology in paediatrics. Observations in daily clinical practice. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.anpede.2015.07.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Batalla A, Suh-Oh HJ, Salgado-Boquete L, Abalde T, de la Torre C. Teledermatología. Capacidad para reducir consultas presenciales según el grupo de enfermedad. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.piel.2015.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bashshur RL, Shannon GW, Tejasvi T, Kvedar JC, Gates M. The Empirical Foundations of Teledermatology: A Review of the Research Evidence. Telemed J E Health 2015; 21:953-79. [PMID: 26394022 PMCID: PMC4776540 DOI: 10.1089/tmj.2015.0146] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 08/20/2015] [Accepted: 08/21/2015] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION This article presents the scientific evidence for the merit of telemedicine interventions in the diagnosis and management of skin disorders (teledermatology) in the published literature. The impetus for this work derives from the high prevalence of skin disorders, the high cost, the limited availability of dermatologists in certain areas, and the promise of teledermatology to address unmet needs in this area. MATERIALS AND METHODS The findings are based on a targeted review of scientific studies published from January 2005 through April 2015. The initial search yielded some 5,020 articles in Google Scholar and 428 in PubMed. A review of the abstracts yielded 71 publications that met the inclusion criteria for this analysis. Evidence is organized according to the following: feasibility and acceptance; intermediate outcomes (use of service, compliance, and diagnostic and treatment concordance and accuracy); outcomes (health improvement and problem resolution); and cost savings. A special section is devoted to studies conducted at the Veterans Health Administration. RESULTS Definitions of teledermatology varied across a wide spectrum of skin disorders, technologies, diagnostic tools, provider types, settings, and patient populations. Outcome measures included diagnostic concordance, treatment plans, and health. CONCLUSIONS Despite these complexities, sufficient evidence was observed consistently supporting the effectiveness of teledermatology in improving accessibility to specialty care, diagnostic and treatment concordance, and skin care provided by primary care physicians, while also reducing cost. One study reported suboptimal clinical results from teledermatology for patients with pigmented skin lesions. On the other hand, confocal microscopy and advanced dermoscopy improved diagnostic accuracy, especially when rendered by experienced teledermatologists.
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Affiliation(s)
- Rashid L. Bashshur
- eHealth Center, University of Michigan Health System, Ann Arbor, Michigan
| | - Gary W. Shannon
- Department of Geography, University of Kentucky, Lexington, Kentucky
| | - Trilokraj Tejasvi
- Department of Dermatology, University of Michigan Health System, Ann Arbor, Michigan
| | - Joseph C. Kvedar
- Center for Connected Health, Partners HealthCare, Boston, Massachusetts
| | - Michael Gates
- eHealth Center, University of Michigan Health System, Ann Arbor, Michigan
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Abstract
This article provides an overview of teledermatology with an emphasis on the evidence most relevant to referring clinicians, who are often primary care clinicians. Discussion includes the different modalities used for teledermatology and their diagnostic reliability, diagnostic accuracy, impact on in-person dermatology visits, clinical outcomes, and user satisfaction.
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Affiliation(s)
- John D Whited
- Research and Development, Durham Veterans Affairs Medical Center, Research and Development (151), 508 Fulton Street, Durham, NC 27705, USA; Division of General Internal Medicine, Duke University School of Medicine, 411 West Chapel Hill Street, Suite 500, Durham, NC 27701, USA.
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Batalla A, Suh-Oh HJ, Abalde T, Salgado-Boquete L, de la Torre C. [Teledermatology in Paediatrics. Observations in daily clinical practice]. An Pediatr (Barc) 2015; 84:324-30. [PMID: 26271410 DOI: 10.1016/j.anpedi.2015.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 06/08/2015] [Accepted: 07/01/2015] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Teledermatology is a technique that is increasingly being developed. There are many studies that assess this discipline in the general population, but few studies analyse the paediatric population exclusively. The aims of this study are to describe the distribution of diseases consulted through teledermatology, the use of this technique to avoid face-to-face consultations, and the agreement between virtual and face-to-face diagnoses, in the paediatric population. MATERIAL AND METHODS The work consisted of an observational and retrospective study of the virtual consultations made between May 2011 and January 2015 through a store-and-forward teledermatology programme, involving patients from 0 to 15 years. We collected demographic data, as well as the diagnoses made by the paediatrician who made the virtual consultation, and by the dermatologists who assessed the virtual and the face-to-face consultations, the indication given by the dermatologist who assessed the virtual consultation (discharge or referral), reason for referral, and diagnostic agreement rate. RESULTS A total of 183 virtual consultations were analysed. The most frequent diagnoses were inflammatory diseases (39%), benign pigmented lesions (23%), and infectious diseases (20%). Almost half of the virtual consultations (48%) were referred for a face-to-face diagnosis. Diagnostic agreement between the dermatologist who evaluated the virtual consultation and the dermatologist who evaluated the face-to-face consultation was 89%, and 66% between the paediatrician who made the virtual consultation and the dermatologist who assessed it. CONCLUSIONS Virtual consultations have a similar disease distribution to conventional (face-to-face) referrals. Approximately half of the virtual consultations do not require a subsequent face-to-face visit. The agreement rate between the diagnoses given by both dermatologists (virtual and face-to-face diagnoses) is high.
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Affiliation(s)
- Ana Batalla
- Servicio de Dermatología, Complejo Hospitalario de Pontevedra, Pontevedra, España.
| | - Hae Jin Suh-Oh
- Servicio de Dermatología, Complejo Hospitalario de Pontevedra, Pontevedra, España
| | - Teresa Abalde
- Servicio de Dermatología, Complejo Hospitalario de Pontevedra, Pontevedra, España
| | | | - Carlos de la Torre
- Servicio de Dermatología, Complejo Hospitalario de Pontevedra, Pontevedra, España
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Moreno-Ramírez D, Ojeda-Vila T, Ríos-Martín JJ, Ruiz-Villaverde R, de-Troya M, Sanz-Trelles A, Liébana RF, Martínez-de-Victoria JM, Aneiros-Fernández J, Naranjo-Sintes R, Amérigo J, Alcalde M, Zulueta T, Domínguez-Cruz JJ, Solís-García E, Tejera-Vaquerizo A, Martín-Castro AM, García-Mellado V, Martínez-García S, Martínez-García A, Herrera-Acosta E, Escámez PJ, Rodríguez-Fernández AM, Salvatierra-Cuenca J, Moreno-Giménez JC, Guerrero-Cauqui R, Armario-Hita JC, Nieto-Garcia A, Ferrándiz L. The role of accessibility policies and other determinants of health care provision in the initial prognosis of malignant melanoma: A cross-sectional study. J Am Acad Dermatol 2014; 71:507-15. [DOI: 10.1016/j.jaad.2014.04.049] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 04/16/2014] [Accepted: 04/17/2014] [Indexed: 11/30/2022]
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Edison KE, Chance L, Martin K, Braudis K, Whited JD. Users and Nonusers of University-Based Dermatology Services Following a Teledermatology Encounter: A Retrospective Descriptive Analysis. Telemed J E Health 2011; 17:14-8. [DOI: 10.1089/tmj.2010.0098] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Karen E. Edison
- Department of Dermatology, University of Missouri School of Medicine, Columbia, Missouri
| | - Louanne Chance
- Department of Dermatology, University of Missouri School of Medicine, Columbia, Missouri
| | - Kari Martin
- Department of Dermatology, University of Missouri School of Medicine, Columbia, Missouri
| | - Kara Braudis
- Department of Dermatology, University of Missouri School of Medicine, Columbia, Missouri
| | - John D. Whited
- Research Service, Departments of Medicine and Dermatology, Harry S. Truman Memorial Veterans' Hospital, University of Missouri School of Medicine, Columbia, Missouri
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Romero G, Sánchez P, García M, Cortina P, Vera E, Garrido JA. Randomized controlled trial comparing store-and-forward teledermatology alone and in combination with web-camera videoconferencing. Clin Exp Dermatol 2010; 35:311-7. [DOI: 10.1111/j.1365-2230.2009.03503.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ferrer RT, Bezares AP, Mañes AL, Mas AV, Gutiérrez IT, Lladó CN, Estaràs GM. [Diagnostic reliability of an asynchronous teledermatology consultation]. Aten Primaria 2009; 41:552-7. [PMID: 19500880 PMCID: PMC7022047 DOI: 10.1016/j.aprim.2008.11.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2008] [Accepted: 11/17/2008] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To analyze the diagnostic agreement rate between primary care, an asynchronous teledermatology consultation, and a conventional dermatology consultation. DESIGN Prospective non-randomized concordance study. SETTING Dermatology Service in Hospital Son Llàtzer (Palma de Mallorca) and primary care centers of Sóller and Arenal (Mallorca). PARTICIPANTS Patients have been included from December 2005 to July 2008, sent by teleconsultation (n=158). MAIN MEASUREMENTS Analysis of primary care, teledermatology consultation and face-to-face consultation diagnosis, in mentioned period of time. Calculation of kappa index of concordance. RESULTS 158 teleconsultations have been made from December 2005 to July 2008, 94 (59,5%) women, and 64 (40,5%) men, aged from 9 to 96 years old (average, 55 years old). After grouping the diagnosis in categories, the distribution was: 48 (37,2%) benign tumours, 39 (30,2%) inflammatory and appendages diseases, 15 (11,6%) infectious diseases, 14 (10,9%) malignant tumours, and 13 (10,1%) premalignant tumours. In grouped diagnosis, concordance was 59,8% (CI 95%, 50-70%) (P<.0001) for general practitioner and 94,7% (CI 95%, 90-99%) (P<.0001) for teledermatologist. CONCLUSIONS The main advantage of asynchronous teledermatology is the improvement of the quality triage, allowing the detection of malignant or suspicious lesions. However, we need more comparable studies on a larger scale to evaluate the disadvantages (photographic technique limitation, evaluation of other lesions, legal aspects, professional motivation...).
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Kanthraj GR. Classification and design of teledermatology practice: What dermatoses? Which technology to apply? J Eur Acad Dermatol Venereol 2009; 23:865-75. [DOI: 10.1111/j.1468-3083.2009.03136.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Romero G, Garrido J, García-Arpa M. Telemedicina y teledermatología (I): concepto y aplicaciones. ACTAS DERMO-SIFILIOGRAFICAS 2008. [DOI: 10.1016/s0001-7310(08)74735-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Schreier G, Hayn D, Kastner P, Koller S, Salmhofer W, Hofmann-Wellenhof R. A mobile-phone based teledermatology system to support self-management of patients suffering from psoriasis. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2008; 2008:5338-5341. [PMID: 19163923 DOI: 10.1109/iembs.2008.4650420] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Psoriasis is one of the most common chronic skin diseases, affecting about 2% of the population world wide. Continuous clinical monitoring with periodic assessment of the state of the disease is essential for long-term therapy optimization. We present a mobile phone based telemedical compliance management system for psoriasis-patients. Using special software, patients can acquire health parameters such as their body weight, take photos of their psoriasis lesions, and report adverse effects. The data are automatically sent to a monitoring centre, where they are provided to the patient's physician via the use of a web-browser. In case of therapy relevant events, email or SMS notifications can be sent to the physician. If necessary, the physician can send feedback messages to the patient, e.g. for admitting the patient to the clinic for further examinations. The system has been implemented and functional tests have proven its functionality. Currently, the system is used in the course of a medical case series.
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Affiliation(s)
- Günter Schreier
- Austrian Research Centers GmbH-ARC/eHealth Systems, Austria.
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Romero G, Garrido J, García-Arpa M. Telemedicine and Teledermatology (I): Concepts and Applications. ACTAS DERMO-SIFILIOGRAFICAS 2008. [DOI: 10.1016/s1578-2190(08)70307-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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