BACKGROUND: Studies on the reliability of teledermatology have shown considerable variability in results. Only one study has compared asynchronous and synchronous methods. OBJECTIVES: This report describes DERMATEL, a prospective, randomized diagnostic-concordance study that sought to evaluate the relative advantages, in terms of reliability, of two remote consultation techniques. METHODS:Patients referred by 18 general practitioners were randomized (4 : 4 : 2) to three study groups: store and forward (SF), hybrid videoconferencing-SF (VC-SF), and a control group. In total, 457 patients were assigned: 192 to the SF group, 176 to the VC-SF group and 89 to the control group. High-quality still images were used throughout, with additional use of standard web-camera (webcam) videoconferencing in the VC-SF group. All patients were also seen by the same dermatologist in a face-to-face (FTF) consultation, considered the practical reference standard. Two different dermatologists assessed concordances between the teledermatology and FTF consultations. RESULTS: There were no significant differences in age, gender or diagnostic category between the three groups, and the images (82%), clinical history (91%) and diagnostic confidence (89%) were high-quality. Online management was possible for 70% of cases. Agreement between teledermatology and the FTF consultation was high for both diagnosis (> 0.85) and treatment (> 0.78). Concordance in diagnosis was influenced by image quality (P < 0.001), confidence in diagnosis (P < 0.001) and need for conventional consultation (P < 0.001), rather than by quality of clinical history (P = 0.58) or method of teleconsultation (P = 0.340). CONCLUSIONS:Intraobserver reliability is very high in teledermatology. When history taking and training in digital photography are standardised, a hybrid system with audio is no better than SF alone.
RCT Entities:
BACKGROUND: Studies on the reliability of teledermatology have shown considerable variability in results. Only one study has compared asynchronous and synchronous methods. OBJECTIVES: This report describes DERMATEL, a prospective, randomized diagnostic-concordance study that sought to evaluate the relative advantages, in terms of reliability, of two remote consultation techniques. METHODS:Patients referred by 18 general practitioners were randomized (4 : 4 : 2) to three study groups: store and forward (SF), hybrid videoconferencing-SF (VC-SF), and a control group. In total, 457 patients were assigned: 192 to the SF group, 176 to the VC-SF group and 89 to the control group. High-quality still images were used throughout, with additional use of standard web-camera (webcam) videoconferencing in the VC-SF group. All patients were also seen by the same dermatologist in a face-to-face (FTF) consultation, considered the practical reference standard. Two different dermatologists assessed concordances between the teledermatology and FTF consultations. RESULTS: There were no significant differences in age, gender or diagnostic category between the three groups, and the images (82%), clinical history (91%) and diagnostic confidence (89%) were high-quality. Online management was possible for 70% of cases. Agreement between teledermatology and the FTF consultation was high for both diagnosis (> 0.85) and treatment (> 0.78). Concordance in diagnosis was influenced by image quality (P < 0.001), confidence in diagnosis (P < 0.001) and need for conventional consultation (P < 0.001), rather than by quality of clinical history (P = 0.58) or method of teleconsultation (P = 0.340). CONCLUSIONS: Intraobserver reliability is very high in teledermatology. When history taking and training in digital photography are standardised, a hybrid system with audio is no better than SF alone.
Authors: Rashid L Bashshur; Gary W Shannon; Trilokraj Tejasvi; Joseph C Kvedar; Michael Gates Journal: Telemed J E Health Date: 2015-09-22 Impact factor: 3.536
Authors: Naomi Chuchu; Jacqueline Dinnes; Yemisi Takwoingi; Rubeta N Matin; Susan E Bayliss; Clare Davenport; Jacqueline F Moreau; Oliver Bassett; Kathie Godfrey; Colette O'Sullivan; Fiona M Walter; Richard Motley; Jonathan J Deeks; Hywel C Williams Journal: Cochrane Database Syst Rev Date: 2018-12-04
Authors: Cesar Leal-Costa; Antonio Lopez-Villegas; Mercedes Perez-Heredia; Miguel Angel Baena-Lopez; Carlos Javier Hernandez-Montoya; Remedios Lopez-Liria Journal: J Clin Med Date: 2022-09-21 Impact factor: 4.964
Authors: Daniela C Gonçalves-Bradley; Ana Rita J Maria; Ignacio Ricci-Cabello; Gemma Villanueva; Marita S Fønhus; Claire Glenton; Simon Lewin; Nicholas Henschke; Brian S Buckley; Garrett L Mehl; Tigest Tamrat; Sasha Shepperd Journal: Cochrane Database Syst Rev Date: 2020-08-18