title: Reliability of telemedicine in evaluating skin tumors.
abstract: 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.
authors.affiliation: Section of Dermatology, East Carolina University School of Medicine, Greenville, NC, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Phillips
authors.forename: W A
authors.initials: WA
authors.lastname: Burke
authors.forename: M H
authors.initials: MH
authors.lastname: Allen
authors.forename: D
authors.initials: D
authors.lastname: Stone
authors.forename: J L
authors.initials: JL
authors.lastname: Wilson
mesh_terms: 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*