OBJECTIVE: To investigate the diagnostic accuracy of clinicians viewing a patient's history and static digital image set compared with clinicians who conducted office-based physical examinations of the same patients. DESIGN: Observational study. SETTING AND PATIENTS: One hundred sixteen adult patients presenting with dermatologic symptoms in a university-based practice who consented to have their skin conditions documented with a still digital camera according to a standardized protocol. MAIN OUTCOME MEASURES: Concordance between office-based dermatologists' diagnoses and 2 remote clinicians' diagnoses using still digital images (resolution, 92 dots per inch) and identical medical history data to render diagnoses. RESULTS: When photographic quality was high and office-based clinician certainty was high, remote clinicians were in agreement more than 75% of the time. Office-based and remote clinicians were in agreement 61% to 64% of the time for all cases. No specific disease category appeared to be more or less amenable to diagnosis based on still digital imagery. The diagnostic certainty of the office-based clinician (reported from 0-10) had the most impact on agreement. When cases with office-based clinician certainty of no more than 7 were compared with cases with certainty of at least 9, agreement increased 54% for remote clinician 1 and 111% for remote clinician 2. As an isolated variable, photographic quality had a modest impact on agreement. CONCLUSIONS: Still digital images can substitute for the dermatologic physical examination in up to 83% of cases. This study provides validation of the store-and-forward concept of telemedicine as applied to dermatology. These results serve as the foundation for field testing of the concept in primary care settings.
OBJECTIVE: To investigate the diagnostic accuracy of clinicians viewing a patient's history and static digital image set compared with clinicians who conducted office-based physical examinations of the same patients. DESIGN: Observational study. SETTING AND PATIENTS: One hundred sixteen adult patients presenting with dermatologic symptoms in a university-based practice who consented to have their skin conditions documented with a still digital camera according to a standardized protocol. MAIN OUTCOME MEASURES: Concordance between office-based dermatologists' diagnoses and 2 remote clinicians' diagnoses using still digital images (resolution, 92 dots per inch) and identical medical history data to render diagnoses. RESULTS: When photographic quality was high and office-based clinician certainty was high, remote clinicians were in agreement more than 75% of the time. Office-based and remote clinicians were in agreement 61% to 64% of the time for all cases. No specific disease category appeared to be more or less amenable to diagnosis based on still digital imagery. The diagnostic certainty of the office-based clinician (reported from 0-10) had the most impact on agreement. When cases with office-based clinician certainty of no more than 7 were compared with cases with certainty of at least 9, agreement increased 54% for remote clinician 1 and 111% for remote clinician 2. As an isolated variable, photographic quality had a modest impact on agreement. CONCLUSIONS: Still digital images can substitute for the dermatologic physical examination in up to 83% of cases. This study provides validation of the store-and-forward concept of telemedicine as applied to dermatology. These results serve as the foundation for field testing of the concept in primary care settings.
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: Jason T Wiseman; Sara Fernandes-Taylor; Rebecca Gunter; Maggie L Barnes; Richard Scott Saunders; Paul J Rathouz; Dai Yamanouchi; K Craig Kent Journal: J Vasc Surg Venous Lymphat Disord Date: 2016-03-26
Authors: Inge C Gyssens; Matthew Dryden; Peter Kujath; Dilip Nathwani; Nicolaas Schaper; Barbara Hampel; Peter Reimnitz; Jeff Alder; Pierre Arvis Journal: J Antimicrob Chemother Date: 2011-09-06 Impact factor: 5.790
Authors: Jacqueline Dinnes; Jonathan J Deeks; Naomi Chuchu; Rubeta N Matin; Kai Yuen Wong; Roger Benjamin Aldridge; Alana Durack; Abha Gulati; Sue Ann Chan; Louise Johnston; Susan E Bayliss; Jo Leonardi-Bee; Yemisi Takwoingi; Clare Davenport; Colette O'Sullivan; Hamid Tehrani; Hywel C Williams Journal: Cochrane Database Syst Rev Date: 2018-12-04
Authors: Jacqueline Dinnes; Jonathan J Deeks; Matthew J Grainge; Naomi Chuchu; Lavinia Ferrante di Ruffano; Rubeta N Matin; David R Thomson; Kai Yuen Wong; Roger Benjamin Aldridge; Rachel Abbott; Monica Fawzy; Susan E Bayliss; Yemisi Takwoingi; Clare Davenport; Kathie Godfrey; Fiona M Walter; Hywel C Williams Journal: Cochrane Database Syst Rev Date: 2018-12-04