The Reliability of Teledermatology to Triage Inpatient Dermatology Consultations

Abstract

Teledermatology is reliable for the triage of inpatient dermatology consultations and has the potential to improve efficiency.

Postoperative care using a secure online patient portal: changing the (inter) face of general surgery

“…[19][20][21][22][23][24]26 As a result of smartphone-based digital cameras, most people now have basic familiarity with image capture and sharing. 41 Prior survey-based work suggested that most patients would be willing to use smartphones for wound surveillance after vascular surgery procedures.…”

“…Classically known as "store-and-forward" telemedicine, this approach has been used successfully to provide clinical assessments and follow-up care in dermatology, plastic surgery, and burn care. [19][20][21][22][23][24][25] Often, these images are captured by a clinician in one setting and shared with another clinician elsewhere. To date, there has been minimal incorporation of these new care delivery modalities into general surgical care, and patients have been less frequently relied upon to generate their own data in the form of digital images.…”

Teledermatology: current perspectives

“…There was a predominance of female sex in six studies, 5,36,40,45,46,50 male predominance in two studies, 41,43 and no information about sex in nine studies. Participants' age also varied, ranging from infants to elderly patients.…”

“…42 The remaining studies encompassed multiple skin conditions. 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.…”

“…Teledermatology showed an agreement higher than FTF diagnosis, achieving an almost perfect level (kappa 0.95 vs 0.60). 40 Of studies that compared telediagnosis to only FTF diagnosis, using kappa statistics, the overall diagnostic agreement between teledermatologists and FTF dermatologists showed high variability, from fair (kappa 0.35) 36 to almost perfect (kappa 0.91), 46 even though the majority of them (eight studies from 10) achieved substantial to almost perfect agreement. 5,38,41,42,[44][45][46]48,50 The agreement of management or therapy plan between both groups was only assessed by two studies, varying from moderate (kappa 0.57) 45 to almost perfect (kappa 0.86).…”