Diagnostic agreement between face-to- face dermatologic exam and asynchronious teledermatology evaluations - a pilot study - Hospital de San José, Bogotá DC
Acuerdo entre el examen dermatológico directo y teledermatología asincrónica prueba piloto, hospital de San José, Bogotá DC, Colombia
Show authors biography
Introduction: skin diseases are common and access to specialists is limited in remote locations as well as in large cities. The use of teledermatology allows a prompt diagnosis and treatment. Objective: to determine the intra and interobserver diagnostic agreement between traditional dermatologic examination (face-to-face physical exam) and asynchronous teledermatology evaluations. Methods: a pilot study was conducted prior to the teledermatology plat form implementation. Two expert dermatologists examined 39 first-time patients attended at Hospital de San José, Bogotá DC dermatology service. They providedtheir own independent diagnosisin order to conduct the interobserver diagnostic correlation evaluation. The asynchronous teledermatology platform was used to show photographs of the lesions two months later. This phase describes the intra and interobserver agreement and satisfaction among derma tologists regarding the platform. Results: the rate of intraobserver agreement between face-to-face physical exam and teledermatology evaluations was 51 and 59% (examiners 1 and 2) and greater for tumoral lesions (68% and 74%). The rate of interobserver agreement was 64% for direct physical exam and declined to 46% when using telemedicine. Conclusions: the correlation rate between direct dermatologic exam and teledermatology evaluations was acceptable and improves in tumoral pathology. These results match those reported in the literature regarding greater series.
Article visits 339 | PDF visits 227
Downloads
1. Whited J. Teledermatology research review. Int J Dermatol. 2006 Mar;45(3):220- 9
2. Freiburger G, Holcomb M, Piper D. The STARPAHC collection: part of an ar chive of the history of telemedicine. J TelemedTelecare. 2007;13(5):221-3.
3. KindelánBaró M. La Telemedicina, su estructura, objetivo y ventajas[monografía en Internet]. Santiago de Cuba: Instituto Superior de Ciencias Médicas; 2005 [citado 23 Mar 2012). Disponible en:http://www.ilustrados.com/tema/69!2/ Telemedicina-estructura-objetivo-ventajas.html
4. Finch TL, Mai FS, May CR. Teledermatology in the U.K.: lessons in service innovation. Br J Dermatol. 2007 Mar;l56(3):521-7.
5. Argila D. Reflexiones sobre el futuro y la utilidad de la teledermatología. Actas Dermosifiliogr. 2008; 99 (7): 503-5.
6. Romero G, Cortina P, Vera E. Telemedicina y teledermatología (Il): estado actual de la investigación en teleconsulta dermatológica. Actas Dermosifiliogr. 2008; 99(8): 586-97.
7. Romero G, Garrido JA y García-Arpa M. Telemedicina y teledermatología (]): concepto y aplicaciones. Actas Dermosifiliogr. 2008; 99(7): 506-522.
8. Van der Heijden JP, Keizer NF, Bos JO, Spuls PL, Witkamp L. Teledermato logy applied following patient selection by general practitiooer in daily practi ce improves efficiency and quality of care at lower cost. Br J Dermatol. 2011 Nov;l 65(5):1058-65.
9. Romero G, García M, Vera E, Martínez C, Cortina P, Sánchez P, Guerra A. Resultados preliminares de DERMATEL: estudio aleatorizado prospectivo com parando modalidades de teledermatología síncrona y asíncrona. Actas Dermosi filiogr. 2006; 97(10): 630-36.
10. Tabemer Ferrer R, Pareja Bezares A. Fiabilidad diagnóstica de una consulta de teledermatología asincrónica. Aten Primaria. 2009; 41(10): 552-57
11. Kanthraj GR. Newer insights in teledermatology practice. lndian J DermatolVe oereolLeprol.2011 May-Jun; (77): 276-87.
12. Warshaw EM, Hillman YJ, Greer NL, et al. Teledermatology for diagnosis and management of skin conditions: a systematic review. J Am AcadDermatol. 2011 Apr; (64): 759-72.
13. Eminovié N, Dijkgraaf MG, Berghout RM, Prins AH, Bindels PJ, de Keizer NF. A cost minimisation analysis in teledermatology: model-based approach.BMC HealthServ Res. 201O Aug 25;10:251.
14. Withed JO, Hall RP, Simel DL, Foy ME, Stechuchak KM, Drugee RJ, et al. Reliability and accuracy of dermatologists clinic-based and digital image consultations.J Am AcadDermatol.1999 Nov;41(5 Pt 1):693-702.