Teledermatology protocol for screening of Skin Cancer

Piccoli, Maria Fernanda; Amorim, Bruna Dücker Bastos; Wagner, Harley Miguel; Nunes, Daniel Holthausen

doi:10.1590/abd1806-4841.20153163

Cited by 26 publications

(17 citation statements)

References 21 publications

(31 reference statements)

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“…Twenty-eight articles met inclusion criteria but 7 of 28 were excluded owing to insufficient reporting of methods to enable quality assessment. [19][20][21][22][23][24][25] Characteristics of the 21 included studies are presented in Table 3.…”

Section: Resultsmentioning

confidence: 99%

Teledermatology for the Diagnosis and Management of Skin Cancer

et al. 2017

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IMPORTANCE As technology becomes more commonplace in dermatological practice, it is essential to continuously review the accuracy of teledermatology devices and services compared with in-person care. The last systematic review was conducted over 5 years ago. OBJECTIVE To synthesize and assess the quality of the evidence to address 3 research questions: (1) How accurate is teledermatology for skin cancer diagnosis compared with usual care (face-to-face [FTF] diagnosis)? (2) Does teledermatology save clinician and/or patient time, compared with usual care? (3) What are the enablers and barriers to adoption of teledermatology in clinical practice for the diagnosis of skin cancer? EVIDENCE REVIEW The review protocol was registered in the PROSPERO database. Six databases (Cochrane, PubMed, Medline, Science Direct, Embase, and Web of Science) were searched for studies investigating the diagnostic accuracy and concordance, management accuracy and concordance, measures of time (waiting times, delay to diagnosis), and enablers and barriers to implementation. Potentially eligible articles were screened by 2 reviewers. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to evaluate the risk of bias and applicability of individual studies assessing diagnostic accuracy. FINDINGS Twenty-one studies were reviewed. The diagnostic accuracy (defined as agreement with histopathology for excised lesions or clinical diagnosis for nonexcised lesions) of FTF dermatology consultation remains higher (67%-85% agreement with reference standard, Cohen κ, 0.90) when compared with teledermatology (51%-85% agreement with reference standard, κ, 0.41-0.63), for the diagnosis of skin cancer. However, some studies do report high accuracy of teledermatology diagnoses. Most studies of diagnostic accuracy and concordance had significant methodological limitations. Studies of health service outcomes found teledermatology reduced waiting times and could result in earlier assessment and treatment. Patients reported high satisfaction and were willing to pay out of pocket for access to such services. CONCLUSIONS AND RELEVANCE Robust implementation studies of teledermatology are needed, paying careful attention to reducing risk of bias when assessing diagnostic accuracy. Teledermatology services consistently reduced waiting times to assessment and diagnosis, and patient satisfaction was high.

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Section: Resultsmentioning

confidence: 99%

Teledermatology for the Diagnosis and Management of Skin Cancer

et al. 2017

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“…Effective, outcomes, and communicative were mentioned in 6/60 occurrences (10%). 27,28,30,[37][38][39][40]45,46,48,53,[54][55][56]58 mHealth can change behaviour through feedback. It can mentally stimulate patients to delay the advance of dementia, improve triage decisions and arrangement of transportation through communication channels, increase self-efficacy augmenting existing interventions and thereby outcomes.…”

Section: Facilitatorsmentioning

confidence: 99%

“…The outcomes theme included early diagnosis, mobile interventions to stimulate mental activity, encouraging a more active role of patients in their conditions, and increased medication and therapy adherence, and an enabler to detect falls. 27,39,45,46,56,58 Mobile technology can also serve as a tool of communication to augment existing modalities to provide real-time data and increase the level of communication between patient and provider. 28,30,37,40,45,54 Quality of life was mentioned in 5/60 occurrences (8%), and it encompassed observations that mobile technology can make life easier, convenient and more comfortable for the user.…”

Section: Facilitatorsmentioning

confidence: 99%

Mobile health solutions for the aging population: A systematic narrative analysis

2016

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Introduction: The ubiquitous nature of mobile technology coupled with the acceptance of mobile health (mHealth) among the elderly offers an opportunity to augment the existing medical workforce in long-term care. The objective of this review and narrative analysis is to identify and analyse facilitators and barriers to adoption of mHealth for the elderly. Methods: Studies over the last year were identified in multiple database indices, and three reviewers examined abstracts (k ¼ 0.82) and analysed articles for themes which were tallied in affinity diagrams to identify frequency of occurrence in the literature (n ¼ 36). Results: The three facilitators mentioned most often were independence (18%), understanding (13%), and visibility (13%). The three barriers mentioned most often were complexity (21%), limited by users (12%) and ineffective (12%). Discussion and conclusions: The reviewers concluded that the work done so far illustrates that mHealth enables a perception of independence. Future research should focus on the barriers of complexity of technology and improving existing medical literacy in order to facilitate further adoption.

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“…This research demonstrates the importance of using telemedicine, since it is a diagnostic method that allows for the early detection of oral pre-malignancy lesions, thus decreasing the number of unnecessary referrals to general dentists. 22 Therefore, it helps to reduce not only wait times for face-to-face consultations, but also the costs associated with this process.…”

Section: Actual Diagnosismentioning

confidence: 99%