title: Reliability of dermatology teleconsultations with the use of teleconferencing technology.
abstract: BACKGROUND
  Recent advances in telecommunications technology allow physicians to consult on patients at a distance via an interactive video format. Few data exist as to the reliability of this form of consultation.
  
  
  OBJECTIVE
  Our purpose was to measure the degree of concordance between a dermatologist seeing a patient in a clinic and another dermatologist seeing the same patient over a commercially available videoconferencing system.
  
  
  METHODS
  Patients referred to a general dermatology clinic were seen by both a "live" dermatologist and a "teledermatologist" via a T1 connection. Diagnosis and recommendations were recorded by both physicians and compared. The physicians were also asked to rate the degree of confidence they had in their diagnosis.
  
  
  RESULTS
  Seventy-nine diagnoses were made on 60 patients. The two physicians were in absolute agreement on 61 of the diagnoses (77.2%). Race or sex of the patient, nature of the skin problems, or which of the two physicians was the teledermatologist did not statistically correlate with the concordance of the two physicians.
  
  
  CONCLUSIONS
  There was a reasonable degree of agreement between the two examining physicians. Despite the relatively high degree of concordance the teledermatologist had a significantly lower degree of confidence in his diagnoses.
authors.affiliation: Section of Dermatology, East Carolina University, School of Medicine, Greenville, NC 27858-4354, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Phillips
authors.forename: W A
authors.initials: WA
authors.lastname: Burke
authors.forename: A
authors.initials: A
authors.lastname: Shechter
authors.forename: D
authors.initials: D
authors.lastname: Stone
authors.forename: D
authors.initials: D
authors.lastname: Balch
authors.forename: S
authors.initials: S
authors.lastname: Gustke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003880:Dermatology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D019114:Remote Consultation; D015203:Reproducibility of Results; D012871:Skin Diseases / Q000175:diagnosis*