A Comparison of the Concordance of Digital Images, Live Examinations, and Skin Biopsies for the Diagnosis of Hospitalized Dermatology Consultation Patients
- 1 January 2003
- journal article
- research article
- Published by Wiley in SKINmed: Dermatology for the Clinician
- Vol. 2 (1), 14-19
- https://doi.org/10.1111/j.1540-9740.2003.01866.x
Abstract
Objective. The goal of this study was to compare live and digital image examination of hospitalized dermatology consultation patients. Design. A medical student digitally imaged patients with a Nikon Coolpix 950 digital camera (Nikon Corp., Tokyo, Japan). A resident reviewed these images and the student recorded the differential diagnosis. Digital examination was followed by live dermatologic examination by the dermatology resident and then by a supervising board certified dermatologist. The diagnoses in 29 of these cases were compared with definitive diagnostic tests (e.g., skin biopsy). Setting. Montefiore Hospital, Bronx, NY Patients. In March, 2000, 48 of 58 consecutive hospitalized patients for whom dermatology consultations were requested and from whom consent for photographs could be obtained. Main Outcome Measures. The accuracy and consistency of the examiners' top (up to three) digital diagnoses, (up to three) live diagnoses, and histopathologic diagnoses were compared. Results. Eighty‐one percent (38/47) of resident digital consult diagnoses agreed with live resident diagnoses. Live resident diagnosis agreement with live supervising board certified dermatologist's diagnosis was 90% (18/20). Resident digital image diagnosis correlation with definitive diagnostic test results was 76% (22/29). Live supervising board certified dermatologist diagnosis correlation with definitive diagnostic test results was 73% (14/19). Conclusions. Digital image review results in reliable and accurate diagnosis compared to live consultations. For inpatient consultations, three‐dimensional lesions are more amenable to digital diagnosis than flat, generalized rashes.Keywords
This publication has 17 references indexed in Scilit:
- Comparing the diagnostic accuracy of dermatologists and nondermatologists.Archives of Dermatology, 2001
- A cost study of teleconsultation for primary-care ophthalmology and dermatologyJournal of Telemedicine and Telecare, 2001
- Compact storage of medical images with patient informationIEEE Transactions on Information Technology in Biomedicine, 2001
- Teledermatology and In-Person ExaminationsArchives of Dermatology, 1998
- The substitution of digital images for dermatologic physical examinationArchives of Dermatology, 1997
- The influence of history on interobserver agreement for diagnosing actinic keratoses and malignant skin lesionsJournal of the American Academy of Dermatology, 1995
- Comparison of the clinical informativeness of photographs and digital imaging media with multiple-choice receiver operating characteristic analysisArchives of Dermatology, 1995
- A comparison of JPEG and FIF compression of color medical images for dermatologyComputerized Medical Imaging and Graphics, 1994
- Dermatologic consultations in the hospital settingArchives of Dermatology, 1994
- Texture in skin images: Comparison of three methods to determine smoothnessComputerized Medical Imaging and Graphics, 1992