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Luo J, Yang Z, Xie Y, He Y, Wu M, Fang X, Liao X. Emerging Trends in Teledermatology Research: A Scientometric Analysis from 2002 to 2021. Telemed J E Health 2024; 30:393-403. [PMID: 37449779 DOI: 10.1089/tmj.2023.0101] [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] [Indexed: 07/15/2023] Open
Abstract
Background: With advances in technology, teledermatology (TD) research has increased. However, an updated comprehensive quantitative analysis of TD research, especially one that identifies emerging trends of TD research in the coronavirus disease 2019 (COVID-19) era, is lacking. Objective: To conduct a scientometric analysis of TD research documents between 2002 and 2021 and explore the emerging trends. Methods: CiteSpace was used to perform scientometric analysis and yielded visualized network maps with corresponding metric values. Emerging trends were identified mainly through burst detection of keywords/terms, co-cited reference clustering analysis, and structural variability analysis (SVA). Results: A total of 932 documents, containing 27,958 cited references were identified from 2002 to 2021. Most TD research was published in journals from the "Dermatology" and "Health Care Sciences & Services" categories. American, Australian, and European researchers contributed the most research and formed close collaborations. Keywords/terms with strong burst values to date were "primary care," "historical perspective," "emerging technique," "improve access," "mobile teledermoscopy (TDS)," "access," "skin cancer," "telehealth," "recent finding," "artificial intelligence (AI)," "dermatological care," and "dermatological condition." Co-cited reference clustering analysis showed that the recently active cluster labels included "COVID-19 pandemic," "skin cancer," "deep neural network," and "underserved population." The SVA identified two reviews (Tognetti et al. and Mckoy et al.) that may be highly cited in the future. Conclusion: During and after the COVID-19 era, emerging trends in research on TD (especially mobile TDS) may be related to skin cancer and AI as well as further exploration of primary care in underserved areas.
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Affiliation(s)
- Jianzhao Luo
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ziyu Yang
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yao Xie
- Department of Dermatovenerology, West China Hospital, Sichuan University, Chengdu, China
| | - Yang He
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Miaomiao Wu
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiang Fang
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoyang Liao
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
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Abeck F, Kött J, Bertlich M, Wiesenhütter I, Schröder F, Hansen I, Schneider SW, von Büren J. Direct-to-Consumer Teledermatology in Germany: A Retrospective Analysis of 1,999 Teleconsultations Suggests Positive Impact on Patient Care. Telemed J E Health 2023; 29:1484-1491. [PMID: 36862525 DOI: 10.1089/tmj.2022.0472] [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] [Indexed: 03/03/2023] Open
Abstract
Background: There is a high demand for dermatological care in Germany. As use of teledermatology has increased significantly, this study aimed to investigate the impact of teledermatology on patient care. Methods: This retrospective cross-sectional study used data from a direct-to-consumer teledermatology platform using store-and-forward technology available in Germany between July 2021 and April 2022. Additional patient characteristics were collected using a voluntary follow-up questionnaire, 28 days after teleconsultation. Results: Data of 1,999 enrolled patients were evaluated. Patients had a mean age of 36 years, and 61.2% (1,223/1,999) lived in a rural residence. The most common diagnoses included eczema (36.0%, 701/1,946), fungal diseases (15.4%, 299/1,946), and acne (12.5%, 243/1,946). The follow-up questionnaire was answered by 166 patients (8.3%, 166/1,999). In total, 42.8% (71/166) of patients had undergone no previous medical consultation. The most frequent reason for using teledermatology was the waiting time for a dermatology outpatient appointment (62.0%, 103/166). A total of 62.0% (103/166) participants rated the treatment success as good or very good, while 86.1% (143/166) rated the quality of telemedical care as equal or better to that of an outpatient visit. Conclusion: This study showed that patients often use teledermatology because of functional barriers (waiting times). In this cohort, the diagnoses strongly corresponded to reasons for outpatient presentation. Most patients rated the quality of teledermatology service as at least equivalent to that of outpatient physician visits and reported treatment success. Thus, teledermatology can relieve the burden of outpatient care while providing high benefits from the patient's perspective.
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Affiliation(s)
- Finn Abeck
- Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julian Kött
- Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mattis Bertlich
- Department of Dermatology and Allergology, Ludwig Maximilian University of Munich, Munich, Germany
| | - Isabell Wiesenhütter
- Munich University Institute for Psychotherapy Training (MUNIP), Munich, Germany
- Wellster Healthtech Group, Munich, Germany
| | | | - Inga Hansen
- Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan W Schneider
- Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Drabarek D, Ackermann D, Medcalf E, Bell KJL. Acceptability of a Hypothetical Reduction in Routinely Scheduled Clinic Visits Among Patients With History of a Localized Melanoma (MEL-SELF): Pilot Randomized Clinical Trial. JMIR DERMATOLOGY 2023; 6:e45865. [PMID: 37632976 PMCID: PMC10335154 DOI: 10.2196/45865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/23/2023] [Accepted: 03/31/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND After treatment for a localized melanoma, patients attend routinely scheduled clinics to monitor for new primary or recurrent melanoma. Patient-led surveillance (skin self-examination with patient-performed teledermoscopy) is an alternative model of follow-up that could replace some routinely scheduled visits. OBJECTIVE This study aims to assess the acceptability of a hypothetical reduction in routinely scheduled visits among participants of the Melanoma Self Surveillance (MEL-SELF) pilot randomized clinical trial of patient-led surveillance (intervention) versus usual care (control). METHODS Patients previously treated for localized melanoma in New South Wales who were participating in the MEL-SELF pilot randomized clinical trial were asked to respond to a web-based questionnaire at baseline and after 6 months on trial. We used mixed methods to analyze the data. The main outcome of interest was the acceptability of a hypothetical reduction in routinely scheduled visits for melanoma surveillance. RESULTS Of 100 randomized participants, 87 answered the questionnaire at baseline, 66 answered the questionnaire at 6 months, and 79 provided a free-text explanation at either time point. At 6 months, 33% (17/51) of the control group and 35% (17/49) of the intervention group indicated that a hypothetical reduction in routinely scheduled visits with all melanoma doctors was at least slightly acceptable (difference in proportions -1%, 95% CI -20% to 17%; P=.89). Participants suggested that prerequisites for a reduction in routinely scheduled visits would include that sufficient time had elapsed since the previous diagnosis without a new primary melanoma or recurrence, an unscheduled appointment could be made at short notice if the patient noticed something concerning, their melanoma doctor had suggested reducing their clinic visit frequency, and patients had confidence that patient-led surveillance was a safe and effective alternative. Participants suggested that a reduction in routinely scheduled visits would not be acceptable where they perceived a very high risk of new or recurrent melanoma, low self-efficacy in skin self-examination and in the use of technologies for the patient-led surveillance intervention, and where they had a preference for clinician-led surveillance. Some patients said that a partial reduction to once a year may be acceptable. CONCLUSIONS Some patients may be receptive to a reduction in routinely scheduled visits if they are assured that patient-led surveillance is safe and effective. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12616001716459; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371865&isReview=true; ClinicalTrials.gov NCT03581188; https://clinicaltrials.gov/ct2/show/NCT03581188. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1001/jamadermatol.2021.4704.
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Affiliation(s)
- Dorothy Drabarek
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Deonna Ackermann
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Ellie Medcalf
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Katy J L Bell
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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4
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Mannino RG, Arconada Alvarez SJ, Greenleaf M, Parsell M, Mwalija C, Lam WA. Navigating the complexities of mobile medical app development from idea to launch, a guide for clinicians and biomedical researchers. BMC Med 2023; 21:109. [PMID: 36959646 PMCID: PMC10035117 DOI: 10.1186/s12916-023-02833-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 03/13/2023] [Indexed: 03/25/2023] Open
Abstract
With today’s pace of rapid technological advancement, many patient issues in modern medicine are increasingly solvable by mobile app solutions, which also have the potential to transform how clinical research is conducted. However, many critical challenges in the app development process impede bringing these translational technologies to patients, caused in large part by the lack of knowledge among clinicians and biomedical researchers of “what it takes” to design, develop, and maintain a successful medical app. Indeed, problems requiring mobile app solutions are often nuanced, requiring more than just clinical expertise, and issues such as the cost and effort required to develop and maintain a well-designed, sustainable, and scalable mobile app are frequently underestimated. To bridge this skill set gap, we established an academic unit of designers, software engineers, and scientists that leverage human-centered design methodologies and multi-disciplinary collaboration to develop clinically viable smartphone apps. In this report, we discuss major misconceptions clinicians and biomedical researchers often hold regarding medical app development, the steps we took to establish this unit to address these issues and the best practices and lessons learned from successfully ideating, developing, and launching medical apps. Overall, this report will serve as a blueprint for clinicians and biomedical researchers looking to better benefit their patients or colleagues via medical mobile apps.
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Affiliation(s)
- Robert G. Mannino
- Georgia Clinical Translational Science Alliance, Atlanta, USA
- grid.189967.80000 0001 0941 6502Emory University School of Medicine, Atlanta, USA
| | - Santiago J. Arconada Alvarez
- Georgia Clinical Translational Science Alliance, Atlanta, USA
- grid.213917.f0000 0001 2097 4943School of Interactive Computing, Georgia Institute of Technology, Atlanta, USA
| | - Morgan Greenleaf
- Georgia Clinical Translational Science Alliance, Atlanta, USA
- grid.189967.80000 0001 0941 6502Emory University School of Medicine, Atlanta, USA
| | - Maren Parsell
- Georgia Clinical Translational Science Alliance, Atlanta, USA
- grid.189967.80000 0001 0941 6502Emory University School of Medicine, Atlanta, USA
| | | | - Wilbur A. Lam
- Georgia Clinical Translational Science Alliance, Atlanta, USA
- grid.189967.80000 0001 0941 6502Emory University School of Medicine, Atlanta, USA
- grid.213917.f0000 0001 2097 4943Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, USA
- grid.428158.20000 0004 0371 6071Aflac Cancer and Blood Disorders Center of Children’s Healthcare of Atlanta, Atlanta, USA
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5
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Lee C, Witkowski A, Żychowska M, Ludzik J. The role of mobile teledermoscopy in skin cancer triage and management during the COVID-19 pandemic. Indian J Dermatol Venereol Leprol 2022; 89:347-352. [PMID: 36688890 DOI: 10.25259/ijdvl_118_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 04/01/2022] [Indexed: 12/13/2022]
Abstract
The unprecedented onset of the COVID-19 crisis poses a significant challenge to all fields of medicine, including dermatology. Since the start of the coronavirus outbreak, a stark decline in new skin cancer diagnoses has been reported by countries worldwide. One of the greatest challenges during the pandemic has been the reduced access to face-to-face dermatologic evaluation and non-urgent procedures, such as biopsies or surgical excisions. Teledermatology is a well-integrated alternative when face-to-face dermatological assistance is not available. Teledermoscopy, an extension of teledermatology, comprises consulting dermoscopic images to improve the remote assessment of pigmented and non-pigmented lesions when direct visualisation of lesions is difficult. One of teledermoscopy's greatest strengths may be its utility as a triage and monitoring tool, which is critical in the early detection of skin cancer, as it can reduce the number of unnecessary referrals, wait times, and the cost of providing and receiving dermatological care. Mobile teledermoscopy may act as a communication tool between medical practitioners and patients. By using their smartphone (mobile phone) patients can monitor a suspicious skin lesion identified by their medical practitioner, or alternatively self-detect concerning lesions and forward valuable dermoscopic images for remote medical evaluation. Several mobile applications that allow users to photograph suspicious lesions with their smartphones and have them evaluated using artificial intelligence technology have recently emerged. With the growing popularity of mobile apps and consumer-involved healthcare, this will likely be a key component of skin cancer screening in the years to come. However, most of these applications apply artificial intelligence technology to assess clinical images rather than dermoscopic images, which may lead to lower diagnostic accuracy. Incorporating the direct-to-consumer mobile dermoscopy model in combination with mole-scanning artificial intelligence as a mobile app may be the future of skin cancer detection.
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Affiliation(s)
- Claudia Lee
- Department of Medicine, University of California Riverside, Riverside, California, United States
| | - Alexander Witkowski
- Department of Dermatology, Oregon Health and Sciences University, Portland, Oregon, United States
| | - Magdalena Żychowska
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | - Joanna Ludzik
- Department of Dermatology, Oregon Health and Sciences University, Portland, Oregon, United States
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6
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Owida HA. Developments and Clinical Applications of Noninvasive Optical Technologies for Skin Cancer Diagnosis. J Skin Cancer 2022; 2022:9218847. [PMID: 36437851 PMCID: PMC9699785 DOI: 10.1155/2022/9218847] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/29/2022] [Accepted: 11/09/2022] [Indexed: 04/03/2024] Open
Abstract
Skin cancer has shown a sharp increase in prevalence over the past few decades and currently accounts for one-third of all cancers diagnosed. The most lethal form of skin cancer is melanoma, which develops in 4% of individuals. The rising prevalence and increased number of fatalities of skin cancer put a significant burden on healthcare resources and the economy. However, early detection and treatment greatly improve survival rates for patients with skin cancer. Since the rising rates of both the incidence and mortality have been particularly noticeable with melanoma, significant resources have been allocated to research aimed at earlier diagnosis and a deeper knowledge of the disease. Dermoscopy, reflectance confocal microscopy, optical coherence tomography, multiphoton-excited fluorescence imaging, and dermatofluorescence are only a few of the optical modalities reviewed here that have been employed to enhance noninvasive diagnosis of skin cancer in recent years. This review article discusses the methodology behind newly emerging noninvasive optical diagnostic technologies, their clinical applications, and advantages and disadvantages of these techniques, as well as the potential for their further advancement in the future.
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Affiliation(s)
- Hamza Abu Owida
- Medical Engineering Department, Faculty of Engineering, Al Ahliyya Amman University, Amman 19328, Jordan
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7
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Glenister K, Witherspoon S, Crouch A. A qualitative descriptive study of a novel nurse-led skin cancer screening model in rural Australia. BMC Health Serv Res 2022; 22:1019. [PMID: 35948920 PMCID: PMC9365213 DOI: 10.1186/s12913-022-08411-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/30/2022] [Indexed: 11/10/2022] Open
Abstract
Background People residing in rural areas have higher rates of skin cancer and face barriers to accessing care. Models of skin cancer care addressing the specific needs of rural communities and overcoming specific challenges are required, but literature is scarce. This study aimed to describe the elements of a nurse-led skin cancer model in rural Victoria using qualitative methodology and programme logic to inform implementation and ongoing sustainability. Methods Qualitative descriptive design. Semi-structured interviews were conducted with key stakeholders involved in the skin cancer model, namely health service executive management, clinical staff, and administration staff. Interviews were audio-recorded and transcribed verbatim. Transcripts were thematically analysed independently by two researchers before themes were compared and refined. A programme logic model was developed to organise themes into contextual elements, inputs, activities and anticipated outcomes; it was also used as a visual tool to aid discussions with key stakeholders. Member checking of the logic model occurred to verify interpretation. This programme logic model will be refined throughout the implementation phase, and again after three years of service delivery. Results Eight stakeholders participated in interviews. Thematic analysis identified three major themes: the influence of the local rural context, the elements of the model, and “making it happen’. These major themes and accompanying sub-themes were mapped to the programme logic model by contextual elements (rural locale, health service access barriers, burden of disease), key inputs (promotion, human resources including appropriate nurse training and leadership) and ‘making it happen’ (governance including referral pathways, flexible and sustained funding, and partnerships). The anticipated outcomes identified include skin cancer care delivered locally, timely access, career development for nurses, and decreased skin cancer burden. Conclusion An initiative that is place-based and community driven in response to consumer demand addresses key system barriers to earlier detection of skin cancers. It is anticipated to result in flow-on reductions in skin cancer disease burden. Programme logic was useful to both describe the initiative and as a visual tool for discussions, with the potential to inform wider health service efforts to address system barriers and bottlenecks. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08411-6.
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Affiliation(s)
- Kristen Glenister
- Department of Rural Health, 'The Chalet', University of Melbourne, Docker Street, Wangaratta 3677, Victoria, Australia.
| | - Sophie Witherspoon
- Department of Rural Health, 'The Chalet', University of Melbourne, Docker Street, Wangaratta 3677, Victoria, Australia
| | - Alan Crouch
- Department of Rural Health, 'Dunvegan', University of Melbourne, 806 Mair Street, Ballarat, VIC, 3350, Australia
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Rogers T, McCrary MR, Yeung H, Krueger L, Chen SC. Dermoscopic Photographs Impact Confidence and Management of Remotely Triaged Skin Lesions. Dermatol Pract Concept 2022; 12:e2022129. [PMID: 36159122 PMCID: PMC9464534 DOI: 10.5826/dpc.1203a129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2021] [Indexed: 12/14/2022] Open
Abstract
Introduction Improving remote triage is crucial given expansions in tele-dermatology and with limited in-person care during COVID-19. In addition to clinical pictures, dermoscopic images may provide utility for triage. Objectives To determine if dermoscopic images enhance confidence, triage accuracy, and triage prioritization for tele-dermatology. Methods In this preliminary parallel convergent mixed-methods study, a cohort of dermatologists and residents assessed skin lesions using clinical and dermoscopic images. For each case, participants viewed a clinical image and determined diagnostic category, management, urgency, and decision-making confidence. They subsequently viewed the associated dermoscopy and answered the same questions. A moderated focus group discussion followed to explore perceptions on the role of dermoscopy in tele-dermatology. Results Dermoscopy improved recognition of malignancies by 23% and significantly reduced triage urgency measures for non-malignant lesions. Participants endorsed specific utilities of tele-dermoscopy, such as for evaluating pigmented lesions, with limitations including poor image quality. Conclusions Dermoscopic images may be useful when remotely triaging skin lesions. Standardized imaging protocols are needed.
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Affiliation(s)
- Tova Rogers
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia, USA
| | | | - Howa Yeung
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia, USA,Regional Telehealth Service, VISN 7, Duluth, Georgia, USA
| | - Loren Krueger
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Suephy C Chen
- Regional Telehealth Service, VISN 7, Duluth, Georgia, USA,Department of Dermatology, Duke University, Durham, North Carolina, USA
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Drabarek D, Habgood E, Janda M, Hersch J, Ackermann D, Low D, Low C, Morton RL, Dieng M, Cust AE, Morgan A, Smith E, Bell KLJ. Experiences of Patient-Led Surveillance, Including Patient-Performed Teledermoscopy, in the MEL-SELF Pilot Randomized Controlled Trial: Qualitative Interview Study. JMIR DERMATOLOGY 2022; 5:e35916. [PMID: 37632893 PMCID: PMC10334928 DOI: 10.2196/35916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/05/2022] [Accepted: 04/18/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Current clinician-led melanoma surveillance models require frequent routinely scheduled clinic visits, with associated travel, cost, and time burden for patients. Patient-led surveillance is a new model of follow-up care that could reduce health care use such as clinic visits and medical procedures and their associated costs, increase access to care, and promote early diagnosis of a subsequent new melanoma after treatment of a primary melanoma. Understanding patient experiences may allow improvements in implementation. OBJECTIVE This study aims to explore patients' experiences and perceptions of patient-led surveillance during the 6 months of participation in the MEL-SELF pilot randomized controlled trial. Patient-led surveillance comprised regular skin self-examination, use of a mobile dermatoscope to image lesions of concern, and a smartphone app to track and send images to a teledermatologist for review, in addition to usual care. METHODS Semistructured interviews were conducted with patients previously treated for melanoma localized to the skin in New South Wales, Australia, who were randomized to the patient-led surveillance (intervention group) in the trial. Thematic analysis was used to analyze the data with reference to the technology acceptance model. RESULTS We interviewed 20 patients (n=8, 40% women and n=12, 60% men; median age 62 years). Patients who were more adherent experienced benefits such as increased awareness of their skin and improved skin self-examination practice, early detection of melanomas, and opportunities to be proactive in managing their clinical follow-up. Most participants experienced difficulty in obtaining clear images and technical problems with the app. These barriers were overcome or persevered by participants with previous experience with digital technology and with effective help from a skin check partner (such as a spouse, sibling, or friend). Having too many or too few moles decreased perceived usefulness. CONCLUSIONS Patients with melanoma are receptive to and experience benefits from patient-led surveillance using teledermoscopy. Increased provision of training and technical support to patients and their skin check partners may help to realize the full potential benefits of this new model of melanoma surveillance.
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Affiliation(s)
- Dorothy Drabarek
- Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Emily Habgood
- Centre for Cancer Research and Department of General Practice, University of Melbourne, Melbourne, Australia
| | - Monika Janda
- Centre for Health Services Research, University of Queensland, Brisbane, Australia
| | - Jolyn Hersch
- Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Deonna Ackermann
- Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Don Low
- Cancer Voices NSW, Sydney, Australia
| | | | - Rachael L Morton
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, Australia
| | - Mbathio Dieng
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, Australia
| | - Anne E Cust
- Sydney School of Public Health, University of Sydney, Sydney, Australia
- The Daffodil Centre, The University of Sydney Cancer Council NSW, Sydney, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia
| | - Adelaide Morgan
- Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Elloise Smith
- Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Katy L J Bell
- Sydney School of Public Health, University of Sydney, Sydney, Australia
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10
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Marchetti MA, Sar-Graycar L, Dusza SW, Nanda JK, Kurtansky N, Rotemberg VM, Hay JL. Prevalence and Age-Related Patterns in Health Information-Seeking Behaviors and Technology Use Among Skin Cancer Survivors: Survey Study. JMIR DERMATOLOGY 2022; 5:e36256. [PMID: 36776536 PMCID: PMC9910806 DOI: 10.2196/36256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Information is an unmet need among cancer survivors. There is a paucity of population-based data examining the health information-seeking behaviors and attitudes of skin cancer survivors. Objective We aimed to identify the prevalence and patterns of health information-seeking behaviors and attitudes among skin cancer survivors across age groups. Methods We analyzed population-based data from the 2019 Health Information National Trends Survey 5 (Cycle 3). Results The 5438 respondents included 346 (6.4%) skin cancer survivors (mean age 65.8 years); of the 346 skin cancer survivors, the majority were White (96.4% [weighted percentages]), and 171 (47.8%) were men. Most reported having ever looked for health- (86.1%) or cancer-related (76.5%) information; 28.2% stated their last search took a lot of effort, and 21.6% were frustrated. The internet was most often cited as being the first source that was recently used for health or medical information (45.6%). Compared to skin cancer survivors younger than 65 years old, those 65 years of age or older were more likely to see a doctor first for important health information (≥65 years: 68.3%;<65 years: 36.2%; P<.001) and less likely to have health and wellness apps (≥65 years: 26.4%; <65 years: 54.0%, P=.10), to have watched a health-related YouTube video (≥65 years: 13.3%; <65 years: 27.4%; P=.02), and to have used electronic means to look for information (≥65 years: 61.4%;<65 years: 82.3%, P<.001). Conclusions Searches for health information are common among skin cancer survivors, but behaviors and attitudes are associated with age, which highlights the importance of access to doctors and personalized information sources.
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Affiliation(s)
| | | | - Stephen W Dusza
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Japbani K Nanda
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
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11
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Ibrahim AE, Magdy M, Khalaf EM, Mostafa A, Arafa A. Teledermatology in the time of COVID-19. Int J Clin Pract 2021; 75:e15000. [PMID: 34714575 PMCID: PMC8646275 DOI: 10.1111/ijcp.15000] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 09/20/2021] [Accepted: 10/27/2021] [Indexed: 12/11/2022] Open
Abstract
AIMS The enormous spread of the novel Corona virus disease (COVID-19) represents a challenge to dermatological practice. Accumulating evidence has suggested a possible role of teledermatology in facing this challenge. In this article, we aimed to give a general overview of teledermatology in terms of models of practice, modes of delivery, advantages, limitations, ethical considerations and legislative challenges as well as discussing, using examples from literature, how dermatological practice can benefit from teledermatology during the time of the COVID-19 pandemic. DISCUSSION AND CONCLUSION Teledermatology could be an accessible, accurate and cost-effective substitute for conventional face-to-face dermatological consultations during the COVID-19 pandemic. However, teledermatology practice needs updated legislation and guidelines. More efforts should be done to encourage dermatologists, especially in underserved communities, to provide teledermatology services. Ethical issues and data security related to teledermatology have to be considered.
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Affiliation(s)
- Ahmed Elsayed Ibrahim
- Department of NeuropsychiatryFaculty of MedicineAlexandria UniversityAlexandriaEgypt
| | - Mayar Magdy
- Barnet HospitalThe Royal Free London NHS Foundation TrustLondonUK
| | - Eslam M. Khalaf
- Department of Critical MedicineFaculty of MedicineAlexandria UniversityAlexandriaEgypt
| | - Alshimaa Mostafa
- Department of DermatologyGraduate School of MedicineKyoto UniversityKyotoJapan
- Department of DermatologyFaculty of MedicineBeni‐Suef UniversityBeni‐SuefEgypt
| | - Ahmed Arafa
- Department of Public HealthGraduate School of MedicineOsaka UniversitySuitaJapan
- Department of Public HealthFaculty of MedicineBeni‐Suef UniversityBeni‐SuefEgypt
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12
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Meng X, Chen J, Zhang Z, Li K, Li J, Yu Z, Zhang Y. Non-invasive optical methods for melanoma diagnosis. Photodiagnosis Photodyn Ther 2021; 34:102266. [PMID: 33785441 DOI: 10.1016/j.pdpdt.2021.102266] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/09/2021] [Accepted: 03/22/2021] [Indexed: 02/07/2023]
Abstract
Cutaneous melanoma is one of the most common malignancies with increased incidence in the past few decades, making it a significant public health problem. The early diagnosis of melanoma is a major factor in improving patient's survival. The traditional pathway to melanoma diagnosis starts with a visual diagnosis, followed by subsequent biopsy and histopathologic evaluation. Recently, multiple innovative optical technology-based methods, including dermoscopy, reflectance confocal microscopy, optical coherence tomography, multiphoton excited fluorescence imaging and stepwise two-photon excited fluorescence (dermatofluoroscopy), have been developed to increase the diagnostic accuracy for the non-invasive melanoma diagnosis. Some of them have already been applied to real-life clinical settings, others require more research and development. These technologies show promise in facilitating the diagnosis of melanoma since they are non-invasive, sensitive, objective and easy to apply. Diagnostic accuracy, detection time, portability and the cost-effectiveness of the device are all aspects that need to be improved. This article reviews the method of these emerging optical non-invasive diagnostic technologies, their clinical application, their benefits and limitations, as well as their possible future development.
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Affiliation(s)
- Xinxian Meng
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Jun Chen
- Department of Dermatology and Dermatologic Surgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Zheng Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Ke Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Jie Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Zhixi Yu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yixin Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China; Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China.
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13
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Alakeel A. Acceptance of Teledermatological Practices: A Cross-Sectional Study of Practicing Saudi Dermatologists. Cureus 2021; 13:e13710. [PMID: 33824842 PMCID: PMC8016530 DOI: 10.7759/cureus.13710] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: The increase in demand for Telemedicine globally has continued to rise in recent months, showing remarkable success in a variety of medical fields. As dermatology shows one of the most prolific rates of success, having a clear national picture of practitioner opinion on the subject is important. In this study we aimed to quantify the overall level of acceptance and satisfaction of Saudi dermatologists towards the practice of teledermatology. Design and setting: Data was collected by means of a survey which included demographic data and level of exposure and overall satisfaction towards Telemedicine in their field. Results: A total of 102 questionnaires were returned of which 57.8% had engaged in at least one teleconsultation. Of these, 71.2% showed support for the technology, with negative responses being associated with poor infrastructure or implementation in the workplace. Conclusion: The acceptance of dermatologists to teledermatology consultations in Saudi Arabia shows a positive tendency, with the majority of those who engaged in the practice saying they would do so again and find it satisfactory. Creating more reliable and robust tools and greater training in their use would be beneficial for its further incorporation.
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Affiliation(s)
- Abdullah Alakeel
- Dermatology Department, College of Medicine, King Saud University, Riyadh, SAU
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14
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Lee KJ, Janda M, Stark MS, Sturm RA, Soyer HP. On Naevi and Melanomas: Two Sides of the Same Coin? Front Med (Lausanne) 2021; 8:635316. [PMID: 33681261 PMCID: PMC7933521 DOI: 10.3389/fmed.2021.635316] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/01/2021] [Indexed: 12/13/2022] Open
Abstract
Benign naevi are closely linked to melanoma, as risk factors, simulators, or sites of melanoma formation. There is a heavy genetic overlap between the two lesions, a shared environmental influence of ultraviolet radiation, and many similar cellular features, yet naevi remain locally situated while melanomas spread from their primary site and may progress systemically to distal organs. Untangling the overlapping contributors and predictors of naevi and melanoma is an ongoing area of research and should eventually lead to more personalized prevention and treatment strategies, through the development of melanoma risk stratification tools and early detection of evolving melanomas. This will be achieved through a range of complementary strategies: risk-adjusted primary prevention counseling; the use of lesion imaging technologies such as sequential 3D total body photography and consumer-performed lesion imaging; artificial intelligence deep phenotyping and clinical assistance; a better understanding of genetic drivers of malignancy, risk variants, clinical genetics, and polygenic effects; and the interplay between genetics, phenotype and the environment.
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Affiliation(s)
- Katie J Lee
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Monika Janda
- Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia
| | - Mitchell S Stark
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Richard A Sturm
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
| | - H Peter Soyer
- Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia.,Department of Dermatology, Princess Alexandra Hospital, Brisbane, QLD, Australia
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15
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Dovigi E, Kwok EYL, English JC. A Framework-Driven Systematic Review of the Barriers and Facilitators to Teledermatology Implementation. CURRENT DERMATOLOGY REPORTS 2020; 9:353-361. [PMID: 33200042 PMCID: PMC7658914 DOI: 10.1007/s13671-020-00323-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 01/07/2023]
Abstract
Purpose of Review Telemedicine use in dermatology, termed “teledermatology”, offers a cost-effective model to improve healthcare efficiency and access. Only a minority of dermatology practices has integrated teledermatology into their practice prior to COVID-19. A thorough understanding of the barriers and facilitators may promote teledermatology adoption. Implementation science frameworks offer theoretically driven ways to assess factors affecting teledermatology implementation. This review uses a comprehensive implementation science framework to summarize barriers and facilitators of teledermatology implementation and appraises the quality of existing research. Recent Findings Technological characteristics of teledermatology (e.g., user-friendliness) and factors within the outer setting (e.g., reimbursement and legal considerations) were the most commonly reported barriers. No existing studies use a comprehensive implementation framework to identify factors influencing teledermatology implementation. Many included studies have a risk of bias in at least two of the five study quality indices evaluated. Summary This systematic review is the first study to summarize the existing teledermatology implementation literature into well-defined constructs from a comprehensive implementation science framework. Findings suggest future studies would benefit from the use of an implementation framework to reduce study bias, improve result comprehensiveness, facilitate comparisons across studies, and produce evidence-based resolutions to implementation barriers. Tools, resources, and recommendations to facilitate the use of an implementation framework in future studies are provided. Supplementary Information The online version contains supplementary material available at 10.1007/s13671-020-00323-0.
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Affiliation(s)
- Edwin Dovigi
- Rush University Medical Center, 1620 W Harrison St, Chicago, IL 60612 USA
| | | | - Joseph C. English
- Department of Dermatology, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA USA
- Center for Teledermatology, UPMC North Hills Dermatology, 9000, Brooktree Rd Suite 200, Wexford, PA 15044 USA
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