Background: Studies comparing teledermatology with in-person dermatologists report wide variations in diagnostic agreement. Teledermatology studies should have two independent in-person consultations establishing a baseline for comparing diagnoses made face-to-face and those made remotely. Objective: To perform a meta-analysis of comparison studies having two in-person dermatologists and at least one remote dermatologist examining the same patients to determine the overall preponderance of agreement. Method: Studies having two in-person diagnosticians were identified from previous teledermatology research reviews and independent searches of PubMed and other databases. Data from six studies identified were meta-analyzed. Results: Some studies showed high levels of diagnostic concordance, while others did not. Meta-analysis revealed that concordance rates reported in the teledermatology and clinical (in-person) consultations were significantly different (odds ratio = 0.55 [Mantel-Haenszel, fixed effect model, 95% confidence interval = 0.42-0.72], χ2 = 11.87, p < 0.05, I2 = 58%). Overall results showed that in-person primary diagnoses are significantly more concordant than remote. The results also suggest that diagnoses made in-person and teledermatology were marginally but significantly different than remote. Conclusion: Although the results of this study suggest teledermatology diagnoses are less reliable than those in-person, there are still valid reasons for using teledermatology to improve access, reduce costs, and triage patients to determine those warranting further in-person consultation and/or laboratory tests. More caution should be exercised in teledermatology when diagnoses involve risky skin conditions. There is evidence that this happens in practice.
Background: Studies comparing teledermatology with in-person dermatologists report wide variations in diagnostic agreement. Teledermatology studies should have two independent in-person consultations establishing a baseline for comparing diagnoses made face-to-face and those made remotely. Objective: To perform a meta-analysis of comparison studies having two in-person dermatologists and at least one remote dermatologist examining the same patients to determine the overall preponderance of agreement. Method: Studies having two in-person diagnosticians were identified from previous teledermatology research reviews and independent searches of PubMed and other databases. Data from six studies identified were meta-analyzed. Results: Some studies showed high levels of diagnostic concordance, while others did not. Meta-analysis revealed that concordance rates reported in the teledermatology and clinical (in-person) consultations were significantly different (odds ratio = 0.55 [Mantel-Haenszel, fixed effect model, 95% confidence interval = 0.42-0.72], χ2 = 11.87, p < 0.05, I2 = 58%). Overall results showed that in-person primary diagnoses are significantly more concordant than remote. The results also suggest that diagnoses made in-person and teledermatology were marginally but significantly different than remote. Conclusion: Although the results of this study suggest teledermatology diagnoses are less reliable than those in-person, there are still valid reasons for using teledermatology to improve access, reduce costs, and triage patients to determine those warranting further in-person consultation and/or laboratory tests. More caution should be exercised in teledermatology when diagnoses involve risky skin conditions. There is evidence that this happens in practice.
Authors: E A Krupinski; B LeSueur; L Ellsworth; N Levine; R Hansen; N Silvis; P Sarantopoulos; P Hite; J Wurzel; R S Weinstein; A M Lopez Journal: Telemed J Date: 1999
Authors: Richard Marchell; Craig Locatis; Gene Burges; Richard Maisiak; Wei-Li Liu; Michael Ackerman Journal: Telemed J E Health Date: 2016-10-05 Impact factor: 3.536
Authors: David Moreno-Ramirez; Lara Ferrandiz; Adoracion Nieto-Garcia; Rafael Carrasco; Pedro Moreno-Alvarez; Rafael Galdeano; Esther Bidegain; Juan J Rios-Martin; Francisco M Camacho Journal: Arch Dermatol Date: 2007-04
Authors: Urszula Grata-Borkowska; Mateusz Sobieski; Jarosław Drobnik; Ewa Fabich; Maria Magdalena Bujnowska-Fedak Journal: Int J Environ Res Public Health Date: 2022-09-13 Impact factor: 4.614