title: Diagnostic accuracy and image quality using a digital camera for teledermatology.
abstract: OBJECTIVE
  The study was designed to evaluate the effectiveness of digital photography for dermatologic diagnoses and compare it with in-person diagnoses.
  
  
  METHODS
  Patients referred for specialty consultations (n = 308) were recruited from a university dermatology clinic. Patients were examined in-person by one of three board-certified dermatologists who provided clinical diagnoses. Digital photos were obtained on all patients and were evaluated as computer images by a panel of dermatologists.
  
  
  RESULTS
  There was 83% concordance between in-person versus digital photo diagnoses. Intradermatologist concordance averaged 84%, and interdermatologist concordance averaged 81%. Decision confidence was rated as "very definite" to "definite" 62% of the time. Concordance with biopsy results was achieved in 76% of the cases. Image sharpness and color quality were rated "good" to "excellent" 83% and 93% of the time, respectively.
  
  
  CONCLUSIONS
  Digital photography for store-and-forward teledermatology produces high-quality images and diagnostic concordance rates that compare favorably with in-person clinical diagnoses.
authors.affiliation: Telemedicine Program, University of Arizona, University of Arizona College of Medicine, Tucson, AZ, USA.
authors.forename: E A
authors.initials: EA
authors.lastname: Krupinski
authors.forename: B
authors.initials: B
authors.lastname: LeSueur
authors.forename: L
authors.initials: L
authors.lastname: Ellsworth
authors.forename: N
authors.initials: N
authors.lastname: Levine
authors.forename: R
authors.initials: R
authors.lastname: Hansen
authors.forename: N
authors.initials: N
authors.lastname: Silvis
authors.forename: P
authors.initials: P
authors.lastname: Sarantopoulos
authors.forename: P
authors.initials: P
authors.lastname: Hite
authors.forename: J
authors.initials: J
authors.lastname: Wurzel
authors.forename: R S
authors.initials: RS
authors.lastname: Weinstein
authors.forename: A M
authors.initials: AM
authors.lastname: Lopez
mesh_terms: D001130:Arizona; D003880:Dermatology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D010781:Photography; D019114:Remote Consultation; D012871:Skin Diseases / Q000175:diagnosis