Telediagnosis and face‐to‐face diagnosis reliability for melanocytic and non‐melanocytic ‘pink’ lesions

Abstract

Our results underline that teledermoscopy of 'pink' lesions does not provide a similar degree of diagnostic accuracy as otherwise in face-to-face diagnosis perhaps due to the absence of typical criteria. Atypical skin lesions are characterized by the absence of typical dermoscopic patterns, and their teleconsultation does not always increase the diagnostic accuracy.

The Remote Assessment of Melanocytic Skin Lesions: A Viable Alternative to Face-to-Face Consultation

“…Motivated by the documented successes of teledermatology [11,14,15,16,17,18,19,20,21,22,23,24], by recent advances in the image quality of mobile-phone cameras, by the high rates of mobile-phone ownership within Australia, and by high rates of melanoma self-detection [25], here we investigate the practicality and utility of a novel clinical tool, the implementation of which has the ultimate aim of increasing the rates of early detection of melanoma: the remote diagnosis of melanocytic lesions using patient-generated clinical images obtained by mobile-phone cameras. Our hypothesis is that patient-motivated remote diagnosis of melanocytic lesions could be a viable alternative to conventional patient-motivated face-to-face (FTF) assessments.…”

Teledermatology in India: Practical implications

“…[16] There have been various studies which have demonstrated the effectiveness of teledermoscopy vis-à-vis face-to-face consultation, especially in the case of melanomas. [17,18] The same applies for the extended use of telepathology in conjunction with teledermatology. [19] The increased and more effective use of mobile devices like cell phones and personal digital assistants (PDAs) is another direction t o w a r d s w h i c h t e l e d e r m a t o l o g y i s expanding.…”

Teledermatology: current perspectives

“…Fabroccini et al 39 investigated the concordance between clinical and dermoscopic diagnosis of teledermatology and FTF consultation to histopathologic diagnosis and found that telediagnosis presented lesser agreement than FTF diagnosis (kappa 0.44-0.45 vs 0.52-0.70). The interobserver agreement between the two teledermatologists was fair for clinical diagnosis (kappa 0.36) and moderate (kappa 0.44) for dermoscopic diagnosis.…”

“…The interobserver agreement between the two teledermatologists was fair for clinical diagnosis (kappa 0.36) and moderate (kappa 0.44) for dermoscopic diagnosis. 39 Ferrer et al compared the concordance of telediagnosis and FTF diagnosis to the final diagnosis, after presential consultation with all complementary examinations. Teledermatology showed an agreement higher than FTF diagnosis, achieving an almost perfect level (kappa 0.95 vs 0.60).…”

“…7,36,37,40,[45][46][47][50][51][52] Twelve studies analyzed the reliability by kappa statistics. 5,36,[38][39][40][41][42][44][45][46]48,50 From these, one study compared teledermatology and FTF diagnosis to histopathological results, 39 one compared both groups to teledermatology and FTF diagnosis to the definitive diagnosis, 40 all the others considered FTF consultation as standard reference without histopathological confirmation for the diagnosis. In two studies focusing on reliability, teledermatology was used for advising another medical provider.…”