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

Abstract

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.