TY  - JOUR
T1  - Potential effect of patient-assisted teledermatology on outpatient referral rates
A1  - Eminović,N.
A1  - Witkamp,L.
A1  - Ravelli,A. C. J.
A1  - Bos,J. D.
A1  - van den Akker,Th. W.
A1  - Bousema,M. T.
A1  - Henquet,C. J. M.
A1  - Koopman,R. J. J.
A1  - Zeegelaar,J. E.
A1  - Wyatt,J. C.
AU  - Eminović,N.
AU  - Witkamp,L.
AU  - Ravelli,A. C. J.
AU  - Bos,J. D.
AU  - van den Akker,Th. W.
AU  - Bousema,M. T.
AU  - Henquet,C. J. M.
AU  - Koopman,R. J. J.
AU  - Zeegelaar,J. E.
AU  - Wyatt,J. C.
PY  - 2003/12
Y1  - 2003/12
N2  - We carried out a pilot study on the feasibility and accuracy of store-and-forward teledermatology based on patient-provided images and history as a triage tool for outpatient consultation. Patients referred by their general practitioner provided a history and images via the Internet. The information was reviewed by one of 12 teledermatologists and the patient then visited a different dermatologist in person within two days. Three independent dermatologists compared the remote and in-person diagnoses in random order to determine diagnostic agreement. Broader agreement was also measured, by comparing the main disease groups into which the two diagnoses fell. The teledermatologists indicated whether an in-person consultation or further investigations were necessary. There were 105 eligible patients, aged four months to 72 years, who were willing to participate. For the 96 cases included in the analysis, complete diagnostic agreement was found in 41% (n = 39), partial diagnostic agreement in 10% (n = 10) and no agreement in 49% (n = 47). There was disease group agreement in 66% of cases (n = 63). Nearly a quarter (23%) of participating patients could have safely been managed without an in-person visit to a dermatologist.
AB  - We carried out a pilot study on the feasibility and accuracy of store-and-forward teledermatology based on patient-provided images and history as a triage tool for outpatient consultation. Patients referred by their general practitioner provided a history and images via the Internet. The information was reviewed by one of 12 teledermatologists and the patient then visited a different dermatologist in person within two days. Three independent dermatologists compared the remote and in-person diagnoses in random order to determine diagnostic agreement. Broader agreement was also measured, by comparing the main disease groups into which the two diagnoses fell. The teledermatologists indicated whether an in-person consultation or further investigations were necessary. There were 105 eligible patients, aged four months to 72 years, who were willing to participate. For the 96 cases included in the analysis, complete diagnostic agreement was found in 41% (n = 39), partial diagnostic agreement in 10% (n = 10) and no agreement in 49% (n = 47). There was disease group agreement in 66% of cases (n = 63). Nearly a quarter (23%) of participating patients could have safely been managed without an in-person visit to a dermatologist.
U2  - 10.1258/135763303771005216
DO  - 10.1258/135763303771005216
M1  - Article
JO  - Journal of Telemedicine and Telecare
JF  - Journal of Telemedicine and Telecare
SN  - 1357-633X
IS  - 6
VL  - 9
SP  - 321
EP  - 327
ER  -