Reliability and accuracy of dermatologists' clinic-based and digital image consultations.

Abstract:

BACKGROUND:Telemedicine technology holds great promise for dermatologic health care delivery. However, the clinical outcomes of digital image consultations (teledermatology) must be compared with traditional clinic-based consultations. OBJECTIVE:Our purpose was to assess and compare the reliability and accuracy of dermatologists' diagnoses and management recommendations for clinic-based and digital image consultations. METHODS:One hundred sixty-eight lesions found among 129 patients were independently examined by 2 clinic-based dermatologists and 3 different digital image dermatologist consultants. The reliability and accuracy of the examiners' diagnoses and the reliability of their management recommendations were compared. RESULTS:Proportion agreement among clinic-based examiners for their single most likely diagnosis was 0. 54 (95% confidence interval [CI], 0.46-0.61) and was 0.92 (95% CI, 0. 88-0.96) when ratings included differential diagnoses. Digital image consultants provided diagnoses that were comparably reliable to the clinic-based examiners. Agreement on management recommendations was variable. Digital image and clinic-based consultants displayed similar diagnostic accuracy. CONCLUSION:Digital image consultations result in reliable and accurate diagnostic outcomes when compared with traditional clinic-based consultations.

journal_name

J Am Acad Dermatol

authors

Whited JD,Hall RP,Simel DL,Foy ME,Stechuchak KM,Drugge RJ,Grichnik JM,Myers SA,Horner RD

doi

10.1016/s0190-9622(99)70003-4

subject

Has Abstract

pub_date

1999-11-01 00:00:00

pages

693-702

issue

5 Pt 1

eissn

0190-9622

issn

1097-6787

pii

S0190-9622(99)70003-4

journal_volume

41

pub_type

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