J Telemed Telecare - Accuracy and reliability of teledermatoscopy with images taken by general practitioners during everyday practice.

Tópicos

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Resumo

We assessed the accuracy and reliability of teledermatoscopy with images taken by a general practitioner (GP) compared to face-to-face dermatological examination. GPs selected patients for teledermatoscopy and took both macro and dermatoscopic photographs. Patients were then referred to the local dermatologist for face-to-face examination. Accuracy and inter-observer reliability were calculated for the diagnosis and management plan. Image quality was rated by two observers on a three-point scale. A total of 108 teledermatoscopy consultations sent by 13 GPs were assessed by four dermatologists. Agreement was 0.61 (kappa) on diagnostic group and 0.23 on management plan. The inter-observer reliability was 0.65 on diagnostic group and 0.36 on management plan. The image quality was reported as bad in 36% of cases, reasonable in 28% and good in 36%. Agreement for cases with good quality images was 0.66 on diagnostic group and 0.42 on management plan. Teledermatoscopy in general practice had overall a lower accuracy and reliability than face-to-face consultation. In cases where a good quality image was reported, the accuracy increased, which emphasises that teledermatoscopy is highly dependent on a good quality images.

Resumo Limpo

assess accuraci reliabl teledermatoscopi imag taken general practition gp compar facetofac dermatolog examin gps select patient teledermatoscopi took macro dermatoscop photograph patient refer local dermatologist facetofac examin accuraci interobserv reliabl calcul diagnosi manag plan imag qualiti rate two observ threepoint scale total teledermatoscopi consult sent gps assess four dermatologist agreement kappa diagnost group manag plan interobserv reliabl diagnost group manag plan imag qualiti report bad case reason good agreement case good qualiti imag diagnost group manag plan teledermatoscopi general practic overal lower accuraci reliabl facetofac consult case good qualiti imag report accuraci increas emphasis teledermatoscopi high depend good qualiti imag

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