Teledermatoscopy as a triage system for pigmented lesions: a pilot study.
- 1 January 2006
- journal article
- Published by Oxford University Press (OUP) in Clinical and Experimental Dermatology
- Vol. 31 (1), 13-18
- https://doi.org/10.1111/j.1365-2230.2005.02000.x
Abstract
Skin-cancer screening should rely on simple, low-cost and high-sensitivity diagnostic procedures. To compare diagnosis and management options after the evaluation of clinical and dermatoscopic teleconsultations with a store-and-forward teledermatology screening system for pigmented lesions. Kappa values between telediagnoses and the gold standard (histological examination) were assessed. Referral rates, diagnostic confidence level (DCL), sensitivity and specificity were evaluated in both approaches. Picture quality and time and cost investments were also measured. In total, 61 teleconsultations were evaluated. Sensitivity of the clinical and dermatoscopic teleconsultations was 1 for both, whereas specificities were 0.65 and 0.78, respectively (P < 0.05). DCL was higher for the dermatoscopic teleconsultations (4.75 vs. 4.14, P < 0.05). Agreement between the clinical and dermatoscopic teleconsultation was kappa = 0.89 (95% CI 0.81-0.97). Agreement with the gold standard was 0.91 (95% CI 0.82-1.00) for the clinical teleconsultation and 0.94 (95% CI 0.88-1.00) for teledermatoscopy (P > 0.05). Teledermatoscopy increased the economic investment of a teledermatology facility by 2.4 times. The GP spent 1.5 times longer on dermatoscopic teleconsultations. Teledermatoscopy has improved the DCL, specificity and referral rates of a teledermatology-based screening system for pigmented lesions. A more detailed economic analysis remains to be performed before recommending teledermatoscopy as a routine screening procedure in pigmented-lesion clinics.Keywords
This publication has 16 references indexed in Scilit:
- Teledermatology as a filtering system in pigmented lesion clinicsJournal of Telemedicine and Telecare, 2005
- Comparison of Skin Biopsy Triage Decisions in 49 Patients With Pigmented Lesions and Skin NeoplasmsArchives of Dermatology, 2004
- Improvement of malignant/benign ratio in excised melanocytic lesions in the 'dermoscopy era': a retrospective study 1997-2001British Journal of Dermatology, 2004
- Teleconsulta de lesiones pigmentadasPiel, 2004
- Risk factors for the development of primary cutaneous malignant melanoma.Dermatologic Clinics, 2002
- 5.3.2. Teledermatoscopy in Daily Routine - Results of the First 100 CasesPublished by S. Karger AG ,2002
- Teledermatology: a reviewBritish Journal of Dermatology, 2001
- Evaluating a telemedicine system to assist in the management of dermatology referralsBritish Journal of Dermatology, 2001
- Teledermatoscopy in Switzerland: A preliminary evaluationJournal of the American Academy of Dermatology, 2000
- Comparison of Conventional Photographs and Telephonically Transmitted Compressed Digitized Images of Melanomas and Dysplastic NeviDermatology, 1998