Reliability of telemedicine in evaluating skin tumors.
OBJECTIVE
To determine the reliability of videoconferencing technology in evaluating skin tumors, the impact of the technology on the clinicians' degree of suspicion that a skin tumor is malignant, and the recommendation to do a biopsy.


METHODS
Four skin cancer screenings were conducted at rural health care facilities in eastern North Carolina that were connected to East Carolina University School of Medicine. A dermatologist saw the patients in person at the local facility, and the same patient was seen by a dermatologist via a T-1 connection to Greenville, North Carolina.


RESULTS
The two physicians were in absolute agreement on 59% of the 107 skin tumors evaluated. There were five lesions identified by the on-site dermatologist as a probable or definite malignancy. The degree of concern about a lesion being malignant and the decision whether to do a biopsy were not significantly different, as shown by kappa analysis.


CONCLUSIONS
The concern about the malignancy of a particular skin lesion and the recommendation whether to do a biopsy were not significantly affected by telemedicine technology.
Phillips
C M
CM
Section of Dermatology, East Carolina University School of Medicine, Greenville, NC, USA.
Burke
W A
WA
Allen
M H
MH
Stone
D
D
Wilson
J L
JL
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D003880:Dermatology / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009657:North Carolina; D015203:Reproducibility of Results; D012424:Rural Population; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000473:pathology* / Q000517:prevention & control*; D013685:Telecommunications; D019113:Telepathology / Q000379:methods*