Telemedicine evaluation of cutaneous diseases: A blinded comparative study

Lesher, Jack L.; Davis, Loretta S.; Gourdin, Frederick W.; English, Debra; Thompson, William O.

doi:10.1016/s0190-9622(98)70534-1

Cited by 97 publications

(85 citation statements)

References 2 publications

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“…The finding that these variables were significantly different between in-person and all remote exams conforms to two other previous studies having two in-person agreement baselines. 11,12 The mean ratings for uncompressed video were significantly ( p < 0.001) lower than for compressed video for each assessment type, Mann-Whitney test.…”

Section: Discussionmentioning

confidence: 89%

“…10 The other studies had more than one teledermatologist. [14][15][16][17][18][19][20][21] Of the four studies, measuring inter-observational agreement for in-person exams, two showed significantly better agreement among in-person clinicians than distant teledermatologists, 11,12 especially for primary diagnoses, and two did not. 10,13 A PubMed search for teledermatology research done after the latest research reviews published in 2011 9 identified only one additional study having two in-person dermatologists.…”

Section: Introductionmentioning

confidence: 94%

See 1 more Smart Citation

Comparing High Definition Live Interactive and Store-and-Forward Consultations to In-Person Examinations

Marchell

Locatis

Burges

et al. 2017

Telemedicine and e-Health

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Background: There is little teledermatology research directly comparing remote methods, even less research with two inperson dermatologist agreement providing a baseline for comparing remote methods, and no research using high definition video as a live interactive method. Objective: To compare inperson consultations with store-and-forward and live interactive methods, the latter having two levels of image quality. Methods: A controlled study was conducted where patients were examined in-person, by high definition video, and by store-and-forward methods. The order patients experienced methods and residents assigned methods rotated, although an attending always saw patients in-person. The type of high definition video employed, lower resolution compressed or higher resolution uncompressed, was alternated between clinics. Primary and differential diagnoses, biopsy recommendations, and diagnostic and biopsy confidence ratings were recorded. Results: Concordance and confidence were significantly better for in-person versus remote methods and biopsy recommendations were lower. Store-and-forward and higher resolution uncompressed video results were similar and better than those for lower resolution compressed video. Limitations: Dermatology residents took store-and-forward photos and their quality was likely superior to those normally taken in practice. There were variations in expertise between the attending and second and third year residents. Conclusion: The superiority of in-person consultations suggests the tendencies to order more biopsies or still see patients in-person are often

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Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 94%

Comparing High Definition Live Interactive and Store-and-Forward Consultations to In-Person Examinations

Marchell

Locatis

Burges

et al. 2017

Telemedicine and e-Health

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show abstract

“…Interdermatologist agreement varies significantly, from 88% to 91% for actinic keratoses and 0% to 85% for malignancies, 8 59% for a variety of still images, 5 and 61% to 88% for comparisons of still and in-person diagnoses in the same patients. 9 Interphysician agreement between inperson and live 2-way interactive teledermatology examination was 77% in 1 study 10 of 60 patients and 78% complete agreement/14% partial agreement in another study 11 of 60 patients. Agreement in skin cancer screening yielded =0.78 for actinic keratoses, =0.38 for squamous cell carcinomas, 12 =0.44 to 0.76 13 for the extent of cutaneous photodamage, and =0.01 and 0.78 14 for criteria for atopic dermatitis.…”

Section: Diagnostic Agreementmentioning

confidence: 93%

Teledermatology and In-Person Examinations

Lowitt¹,

Kessler²,

Kauffman³

et al. 1998

Arch Dermatol

153

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“…35 These findings highlight a need for real-time interactivity. 54 Finally, an index of patient satisfaction was not included in our project. As mentioned earlier, the responsibility for patient care was exclusively that of the surgical team managing the case.…”

Section: Interactivitymentioning

confidence: 99%

Assessment of Telemedicine in Surgical Education and Patient Care

Demartines

Mutter²,

Vix³

et al. 2000

Annals of Surgery

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ObjectiveTo analyze the value of teleconferencing for patient care and surgical education by assessing the activity of an international academic network. Summary Background DataThe uses of telemedicine include teleeducation, training, and consulting, and surgical teams are now involved, sharing diagnostic information and opinions without the need for travel. However, the value of telematics in surgery remains to be assessed. MethodsDuring a 2-year period, weekly surgical teleconferences were held among six university hospitals in four European countries. To assess the accuracy of telediagnosis for surgical cases, 60 randomly selected cases were analyzed by a panel of surgeons. Participants' opinions were analyzed by questionnaire. ResultsSeventy teleconferences (50 lectures and 271 case presentations) were held. Ninety-five of the 114 participants (83.3%) completed the final questionnaire. Eighty-six percent rated the surgical activity as good or excellent, 75.7% rated the scientific level as good or excellent, 55.8% rated the daily clinical activity as good or excellent, and 28.4% rated the manual surgical technique as good or excellent. The target organ was identified in all the cases; the organ structure and pathology were considered well defined in 93.3%, and the fine structure was considered well defined in 58.3%. Diagnosis was accurate in 17 cases (28.3%), probable in 25 (41.7%), possible but uncertain in 16 (26.7%), and not possible in 2 cases (3.3%). Discussion among the remote sites increased the rate of valuable therapeutic advice from 55% of cases before the discussion to 95% after the discussion. Eighty-six percent of the surgeons expressed satisfaction with telematics for medical education and patient care. ConclusionsParticipant satisfaction was high, transmission of clinical documents was accurate, and the opportunity to discuss case documentation and management significantly improved diagnostic potential, resulting in an accuracy rate of up to 95%. Teleeducation and teleconsultation in surgery appear to be beneficial.In this information age, the new computer-based communication technologies called telematics offer enormous potential for applications in medical and surgical practice and education.1 The introduction of these tools in surgery has attracted much interest; however, the possibilities of combining increasing computing power 2 with surgeons' objectives and needs have not yet been properly analyzed. First, we must assess the results of telematic applications in medicine and surgery. 3,4 The field of telemedicine involves far more than just the transmission of patient files.5 It involves education, 6,7 training, 8 consulting, 9 and mentoring, 10 -12 and in the near future will include accreditation. 13 Currently, surgical teams are involved in teleconferencing, sharing medical advice and offering second opinions without the need to transfer the patient.14 -16 The time and costs of travel on the part of experts are limiting factors to joint consultations or meet- 282ings.17 Telemedicine s...

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Telemedicine evaluation of cutaneous diseases: A blinded comparative study

Cited by 97 publications

References 2 publications

Comparing High Definition Live Interactive and Store-and-Forward Consultations to In-Person Examinations

Comparing High Definition Live Interactive and Store-and-Forward Consultations to In-Person Examinations

Teledermatology and In-Person Examinations

Assessment of Telemedicine in Surgical Education and Patient Care

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