Perception and Acceptability of Medical Photography in Chinese Dermatologic Patients: A Questionnaire Survey

Perception and acceptance of medical photography among Arab dermatology patients: a cross-sectional analysis

Medical photography has been utilized in clinical, academic, and research settings. In conservative countries, such as Saudi Arabia, limited data reflect patients' viewpoints on medical photography. The aim of this paper was to assess patients' opinions on medical photography and the factors influencing its acceptability. A cross-sectional study utilizing a self-distributed paper-based questionnaire was performed in the dermatology clinics at King Abdulaziz Medical City (Riyadh, Saudi Arabia) between February 2020 and January 2021. The response rate is 100% as only willing participants were handed a hard-copy survey and then retrieved once completed. A total of 414 Saudi adults were enrolled. Medical photography was highly acceptable, fairly acceptable, and poorly acceptable in 36.7%, 11.6%, and 14.3% of the patients, respectively. Females were more accepting of medical photography than males (p=0.041). Physicians were the most preferred choice as photographers (83%). Stating all intended use of the photographs was favored by most patients. Using a department-owned camera was essential to 84%. Patients who never had their photographs taken previously were more unaccepting of medical photography than those with prior experience (p=0.037). The main limitation of the study was that it was conducted at a single center; therefore, it may not represent the entire population. Medical photography is acceptable to the majority of patients. Meeting popular preferences, including physicians as photographers, using department-owned cameras, and stating all possible uses of the photographs may enhance patients' experience. The findings offer insight for developing a standardized framework that is suitable for both patients and physicians.

Patient Comfort with Before and After Photography at Plastic Surgery Offices

BACKGROUND

Before and after (B&A) photographs are a sensitive part of patients' medical records, and the use of smartphones may pose risks to confidentiality and comfort. The purpose of this study was to assess patient comfort depending on the circumstances under which these photographs being taken.

METHODS

Amazon's Mechanical Turk crowdsourcing service and REDCap's survey manager were used to recruit survey participants. An anonymous survey was distributed to ascertain demographics and comfort in various B&A scenarios using a five-point Likert scale. T tests and ANOVA testing were used to compare groups.

RESULTS

There were 411 respondents with an average age of 36.1 years old. Of them, 46% were female and the majority were White (90%) and non-Hispanic (64%). Nearly one-third had previously undergone plastic surgery, with 80% receiving B&A photography. Surgeons took these photographs 51% of the time with similar rates of smartphone cameras use (47%) versus professional cameras (52%). The public had similar levels of comfort when a nurse or a surgeon took the clinical photographs (p = 0.08). Patients were significantly less comfortable when non-medically trained office staff captured their photographs (p = 0.0041). The public had similar comfort levels with the use of smartphones and professional cameras when dressed but were significantly less comfortable with the use of a smartphone when unclothed (p = < 0.001).

CONCLUSION

To ensure the best patient experience, B&A photography should be taken by a medical professional. If photographs are to be taken when the patient is unclothed, the use of a professional-grade camera may help ease patient discomfort.

LEVEL OF EVIDENCE III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Fotografie in der Dermatologie - ein Scoping Review: Praktiken, Skin of Color, Patientenpräferenzen und medizinisch-rechtliche Überlegungen

Die klinische Fotografie ist essentiell für die Dermatologie. Es gibt jedoch keine umfassende Aufarbeitung der Literatur zur Fotografie in der Dermatologie. Dieser Scoping Review soll die Literatur zu fotografischen Praktiken in der Dermatologie, der Fotografie stark pigmentierter Haut (Skin of Color), Patientenpräferenzen und medizinisch‐rechtlichen Überlegungen zusammenfassen. Die Datenbanken Embase, MEDLINE, PubMed und Evidence Based Medicine wurden im Einklang mit der PRISMA‐Erweiterung für Scoping Reviews durchsucht. Insgesamt wurden 33 Studien zusammengefasst. Die klinische Fotografie wird häufig für die Markierung von Biospiestellen, Beurteilung, Diagnostik, Krankheitsüberwachung, Bewertung des Ansprechens auf die Behandlung, medizinische Ausbildung, Forschung, das Einholen kollegialer Ratschläge und in der Teledermatologie eingesetzt. Obwohl es in der dermatologischen Fotografie weiterhin kaum Darstellungen von Skin of Color gibt, sind fotografische Überlegungen für dunklere Hauttypen verfügbar. Die meisten Patienten unterstützen die medizinische Fotografie. Dabei besteht der Wunsch, dass klinische Fotografien vom eigenen Arzt aufgenommen und bevorzugt klinikeigene Kameras und keine persönlichen Geräte verwendet werden. Relevante medizinisch‐rechtliche Fragestellungen umfassen Bedenken hinsichtlich des Datenschutzes, der Verwendung persönlicher Geräte und der Dokumentation der Einwilligung. Die Fotografie in der Dermatologie entwickelt sich ständig weiter und findet immer breitere Anwendung. Verbesserte Verfahren und Innovationen werden Menschen aller Hautfarben zugute kommen. Die Einhaltung der Zustimmung und des Datenschutzes muss gewährleistet werden, um die zunehmende Einfachheit der Bildaufnahme und ‐freigabe aufrechtzuerhalten.

Photography in dermatology - a scoping review: Practices, skin of color, patient preferences, and medical-legal considerations

Clinical photography is essential in dermatology. However, a comprehensive literature review of photography in dermatology is lacking. This scoping review aims to summarize the literature regarding photography practices in dermatology, photography of skin of color, patient preferences, and medical-legal considerations. A search was conducted utilizing Embase, MEDLINE, PubMed, and Evidence Based Medicine databases in accordance with the PRISMA extension for Scoping Reviews. In total, 33 studies were summarized. Clinical photography is commonly used in biopsy site marking, assessment, diagnosis, disease monitoring, evaluation of treatment response, medical education, research, seeking advice from colleagues, and teledermatology. Although dermatologic photography remains devoid of skin of color representation, photographic considerations for darker skin are available. Most patients support medical photography, with a preference for clinical photographs to be taken by their own physicians, and for use of clinic/hospital-owned cameras over personal devices. Pertinent medical-legal issues include concerns around privacy, personal device use, and documentation of consent. Photography in dermatology is continuously evolving with broader applications. Improved practices and innovations will benefit individuals of various skin tones. Management of consent and privacy must be upheld to sustain the increasing ease of image capture and sharing.

Parents' perspectives on the use of children's facial images for research and diagnosis: a survey

Computer-aided facial diagnostic tools are valuable emerging technologies for the early detection and initial diagnosis of congenital disorders. These tools require large datasets of facial photographs, especially of infants and children, to identify these disorders and improve classification accuracies. Researchers need to balance this need for larger datasets with patients' privacy rights, needs and preferences. This study aimed to investigate parents' views regarding the collection, storage, use and publication of their children's facial images for research and diagnostic purposes. A total of 151 parents of children with and without congenital disorders completed an online survey evaluating their views on the collection, storage, use and publication of children's facial images for research and diagnosis. Overall, 72.5% of parents would allow researchers to take facial photographs of their children, preferring the images to be stored in a secure database that is not available to the public. Parents of children with congenital disorders were more accepting of researchers taking facial photographs of their children, compared to parents of children without these conditions. Half of the respondents would allow facial photographs of their children to be published in academic journals, without their eyes covered, and this acceptance increased as the proportion of the child's face covered increased. Parents also indicated specific requirements to allow the use of these images in other similar research studies which need to be taken into consideration when planning studies that involve facial analysis research.

Publishing Identifiable Patient Photographs in Scientific Journals: Scoping Review of Policies and Practices

BACKGROUND

Publishing identifiable patient data in scientific journals may jeopardize patient privacy and confidentiality if best ethical practices are not followed. Current journal practices show considerable diversity in the publication of identifiable patient photographs, and different stakeholders may have different opinions of and practices in publishing patient photographs.

OBJECTIVE

This scoping review aimed to identify existing evidence and map knowledge gaps in medical research on the policies and practices of publishing identifiable photographs in scientific articles.

METHODS

We performed a comprehensive search of the Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, CINAHL with Full Text, Database of Abstracts of Reviews of Effects, Ovid MEDLINE, and Scopus. The Open Science Framework, PROSPERO, BASE, Google Scholar, OpenGrey, ClinicalTrials.gov, the Campbell Collaboration Library, and Science.gov were also searched.

RESULTS

After screening the initial 15,949 titles and abstracts, 98 (0.61%) publications were assessed for eligibility at the full-text level, and 30 (0.19%) publications were included in this review. The studies were published between 1994 and 2020; most had a cross-sectional design and were published in journals covering different medical disciplines. We identified 3 main topics. The first included ethical aspects of the use of facial photographs in publications. In different clinical settings, the consent process was not conducted properly, and health professionals did not recognize the importance of obtaining written patient consent for taking and using patient medical photographs. They often considered verbal consent sufficient or even used the photographs without consent. The second topic included studies that investigated the practices and use of medical photography in publishing. Both patients and doctors asked for confidential storage and maintenance of medical photographs. Patients preferred to be photographed by their physicians using an institutional camera and preferred nonidentifiable medical photographs not only for publication but also in general. Conventional methods of deidentification of facial photographs concealing the eye area were recognized as unsuccessful in protecting patient privacy. The third topic emerged from studies investigating medical photography in journal articles. These studies showed great diversity in publishing practices regarding consent for publication of medical photographs. Journal policies regarding the consent process and consent forms were insufficient, and existing ethical professional guidelines were not fully implemented in actual practices. Patients' photographs from open-access medical journals were found on public web-based platforms.

CONCLUSIONS

This scoping review showed a diversity of practices in publishing identifiable patient photographs and an unsatisfactory level of knowledge of this issue among different stakeholders despite existing standards. Emerging issues include the availability of patients' photographs from open-access journals or preprints in the digital environment. There is a need to improve standards and processes to obtain proper consent to fully protect the privacy of patients in published articles.

Patient Perceptions of Dermatologic Photography: Scoping Review

BACKGROUND

Medical photography is used extensively in dermatology to record disease progression, measure treatment response, and help teach patients about skin disease; such photos are also commonly utilized in teledermatology, medical education, research, and medical reference websites. Understanding patient perceptions of medical photographs obtained during dermatologic care in the clinic or hospital setting is critical to enable the delivery of high-quality, patient-centered medical care.

OBJECTIVE

The aims of this study were to elucidate patient perceptions of skin photos in dermatology and to explore possible next steps in improving the patient experience with medical photography in the hospital or clinic setting.

METHODS

A scoping review of the literature was performed using the PubMed database, with clinic- or hospital-based full-text publications in English spanning the last 10 years considered for inclusion.

RESULTS

The majority of included studies (10/11, 91%) found positive patient attitudes toward medical photographs. The majority of patients (1197/1511, 79.2%) felt that medical photographs could improve medical care in the clinic setting. Written consent detailing all photo uses, including secondary uses (such as research or teaching), was preferred, apart from in 1 study. Patients preferred or found it acceptable for the photographer of their medical photos to be a physician (1301/1444, 90.1%). Clinic-owned cameras with departmental record storage were the preferred modality. Latinx and African American patients expressed less trust in the utility of medical photographs to improve care, compared with Asian and White patients. The minimal number of available publications on this topic and the inclusion of articles older than 5 years are limitations, since patient perceptions of medical photography may have rapidly changed during this time span, particularly in light of the COVID-19 pandemic and the subsequent increase in teledermatology visits.

CONCLUSIONS

Patients reported positive perceptions of dermatologic photography for improving their medical care. Ethnic disparities in patient perceptions require further exploration to better elucidate nuances and develop interventions to improve the experience of marginalized patients. Building patient trust in nonphysician photographers may enhance clinic efficiency. Although clinic-owned cameras are well-accepted by patients, improved patient education surrounding the safety of electronic medical record phone applications is needed.