Use of teledermatology by dermatology hospitalists is effective in the diagnosis and management of inpatient disease
Copyright © 2020. Published by Elsevier Inc..
BACKGROUND: Patient outcomes are improved when dermatologists provide inpatient consultations. Inpatient access to dermatologists is limited, illustrating an opportunity to use teledermatology. Little is known about the ability of dermatologists to accurately diagnose disease and manage inpatients with teledermatology, particularly when using nondermatologist-generated clinical data.
METHODS: This prospective study assessed the ability of teledermatology to diagnose disease and manage 41 dermatology consultations from a large urban tertiary care center, using internal medicine referral documentation and photographs. Twenty-seven dermatology hospitalists were surveyed. Interrater agreement was assessed by the κ statistic.
RESULTS: There was substantial agreement between in-person and teledermatology assessment of the diagnosis with differential diagnosis (median κ = 0.83), substantial agreement in laboratory evaluation decisions (median κ = 0.67), almost perfect agreement in imaging decisions (median κ = 1.0), and moderate agreement in biopsy decisions (median κ = 0.43). There was almost perfect agreement in treatment (median κ = 1.0), but no agreement in follow-up planning (median κ = 0.0). There was no association between raw photograph quality and the primary plus differential diagnosis or primary diagnosis alone.
LIMITATIONS: Selection bias and single-center nature.
CONCLUSIONS: Teledermatology may be effective in the inpatient setting, with concordant diagnosis, evaluation, and management decisions.
| Errataetall: |
CommentIn: J Am Acad Dermatol. 2021 Oct;85(4):e253-e254. - PMID 34314747 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:84 |
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| Enthalten in: |
Journal of the American Academy of Dermatology - 84(2021), 6 vom: 15. Juni, Seite 1547-1553 |
| Sprache: |
Englisch |
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| Links: |
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| Themen: |
Dermatology consultations |
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| Anmerkungen: |
Date Completed 30.08.2021 Date Revised 04.03.2022 published: Print-Electronic CommentIn: J Am Acad Dermatol. 2021 Oct;85(4):e253-e254. - PMID 34314747 Citation Status MEDLINE |
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| doi: |
10.1016/j.jaad.2020.04.171 |
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| 500 | |a CommentIn: J Am Acad Dermatol. 2021 Oct;85(4):e253-e254. - PMID 34314747 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020. Published by Elsevier Inc. | ||
| 520 | |a BACKGROUND: Patient outcomes are improved when dermatologists provide inpatient consultations. Inpatient access to dermatologists is limited, illustrating an opportunity to use teledermatology. Little is known about the ability of dermatologists to accurately diagnose disease and manage inpatients with teledermatology, particularly when using nondermatologist-generated clinical data | ||
| 520 | |a METHODS: This prospective study assessed the ability of teledermatology to diagnose disease and manage 41 dermatology consultations from a large urban tertiary care center, using internal medicine referral documentation and photographs. Twenty-seven dermatology hospitalists were surveyed. Interrater agreement was assessed by the κ statistic | ||
| 520 | |a RESULTS: There was substantial agreement between in-person and teledermatology assessment of the diagnosis with differential diagnosis (median κ = 0.83), substantial agreement in laboratory evaluation decisions (median κ = 0.67), almost perfect agreement in imaging decisions (median κ = 1.0), and moderate agreement in biopsy decisions (median κ = 0.43). There was almost perfect agreement in treatment (median κ = 1.0), but no agreement in follow-up planning (median κ = 0.0). There was no association between raw photograph quality and the primary plus differential diagnosis or primary diagnosis alone | ||
| 520 | |a LIMITATIONS: Selection bias and single-center nature | ||
| 520 | |a CONCLUSIONS: Teledermatology may be effective in the inpatient setting, with concordant diagnosis, evaluation, and management decisions | ||
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| 650 | 4 | |a teledermatology | |
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