title: Teledermatology: an intraobserver diagnostic correlation study, Part II.
abstract: This is part II of an intraobserver diagnostic correlation study comparing teledermatology with traditional face-to-face evaluation. Part I discussed the methodology and diagnostic correlation results between teledermatology and in-person consultation (Cutis. 2003;71:399-403). This second part reports the diagnostic certainty level between the 2 groups, which are shown to be significantly different (teledermatology, 7/10; in-person, 9/10). This difference held true in every category of skin condition evaluated (P < or = .0065). Unlike other studies, we found that teledermatologists recommended biopsies 10% more frequently than clinic-based evaluators. We discuss the reasons for the lower diagnostic certainty level of teledermatologists, as well as the limitations of this study. Despite the limitations, we conclude that teledermatology appears to be an effective method of delivering dermatologic care in the appropriate setting.
authors.affiliation: Department of Dermatology, Brooke Army Medical Center, 3851 Roger Brooke Dr, Bldg 3600, San Antonio, TX 78258, USA. hon.pak@amedd.army.mil
authors.forename: Hon S
authors.initials: HS
authors.lastname: Pak
authors.forename: David
authors.initials: D
authors.lastname: Harden
authors.forename: David
authors.initials: D
authors.lastname: Cruess
authors.forename: Mark L
authors.initials: ML
authors.lastname: Welch
authors.forename: Ronald
authors.initials: R
authors.lastname: Poropatich
mesh_terms: D001706:Biopsy; D003880:Dermatology / Q000458:organization & administration*; D006801:Humans; D015588:Observer Variation; D005791:Patient Care / Q000592:standards*; D012867:Skin / Q000473:pathology*; D012871:Skin Diseases / Q000175:diagnosis* / Q000453:epidemiology; D017216:Telemedicine / Q000379:methods*