Mobile teledermatology – patient satisfaction, diagnostic and management concordance, and factors affecting patient refusal to participate in Saudi Arabia

Abstract

We evaluated the use of a 4G smart phone for mobile teledermatology. A dermatologist took pictures of skin images with a mobile phone (8 Mpixel camera resolution) and made a face-to-face diagnosis. The images were transmitted to a second dermatologist who viewed them on a similar mobile phone and made an independent diagnosis for comparison. Images were taken and transmitted only after receiving informed consent from the patients. A total of 166 consecutive patients were included in the study (97 male and 69 female). A questionnaire to assess patient satisfaction was administered to each patient. Most of the responders were highly satisfied with teledermatology. However, 23 patients (14%) refused photography of the skin lesions (21 female and 2 males). The main reasons for refusal to be photographed were stated as social or religious. The broad categorical diagnostic and management concordance (i.e. when considering at least one of the diagnoses to be similar) was 95%. Specific diagnostic concordance varied according to the disease. The average kappa coefficient was 0.66 for diagnostic concordance and 0.82 for management concordance. Refusal to be photographed--a problem not limited to teledermatology--needs to be considered when designing teledermatology protocols for larger scale implementation in areas like the Middle East.

Perspectives of online surveys in dermatology

“…Fixed lighting and flash can minimize blurring because a blurred photograph is usually useless. Also, maintaining the position of the patient while taking the photograph is important in follow‐up studies …”

“…Also, maintaining the position of the patient while taking the photograph is important in follow-up studies. 72,73 Mobile phones could offer effective communication with patients, provide personalization and serve in online surveying. However, concerns about coverage of smartphones, response rate, confidentiality and ethical issues especially in photographing patients were suggested.…”

A telemedicina alkalmazása a bőrgyógyászatban: a teledermatológia

“…A szakorvos diagnózist készít, kezelési javaslatot nyújt, szükség esetén pedig személyes bőrgyógyászati ellátást javasol [4]. Ilyen jellegű ellátórendszer kiépítéséről számos tanulmány készült, többek között Ausztráliában [16,17], az Egyesült Királyságban [18][19][20][21][22][23], az Egyesült Államokban [24,25], Hollandiában [26,27], Spanyolországban [28], Szaúd-Arábiában [29], Új-Zélandon [30] és a harmadik világbeli országokban [31,32]. A különböző tanulmányok a helyi viszonyoktól is függően különböző kérdésekre keresték a választ, de a legtöbb a gazdasági kérdéseket és kényelmi szempontokat veszi figyelembe.…”

The Empirical Foundations of Teledermatology: A Review of the Research Evidence

“…Attitudinal data were gathered regarding the use of mobile phones with high-resolution cameras for the remote diagnosis and management recommendations of skin disorders, compared with in-person care. 55 Patients were sequentially recruited into the study as they came to the clinic for care. About 14% of patients refused to be photographed for social or religious reasons.…”