The reliability of diagnosis using store-and-forward teledermatology.
We compared diagnoses made by a teledermatologist from digital photographs and patient histories sent from general practitioners using a store-and-forward technique and those made by another dermatologist in a face-to-face consultation with the same patients. A total of 117 patients (mean age 47 years) were referred by 18 general practitioners for diagnosis of a skin condition. Between one and seven digital images were transmitted per case. In 31% of the cases, three images were transmitted. There was full concordance between store-and-forward and face-to-face diagnoses in 57 of 106 cases (54%); in 10 cases (9%) there was overlap between the differential diagnoses provided by the teledermatologist and the face-to-face consultant. Diagnostic categories with relatively high concordances were eczema and follicular eruptions. General practitioners need to be trained in the making of digital images and in giving a good patient history.
Transmural Care Unit (Bze VII), University Hospital Maastricht, The Netherlands. m.dumoulin@zw.unimaas.nl
M F M T
MF
Du Moulin
Y I J M
YI
Bullens-Goessens
C J M
CJ
Henquet
D E M
DE
Brunenberg
D P
DP
de Bruyn-Geraerds
R A G
RA
Winkens
C D
CD
Dirksen
W P M
WP
Vierhout
H A M
HA
Neumann
D003937:Diagnosis, Differential; D004485:Eczema / Q000175:diagnosis; D005194:Family Practice; D006801:Humans; D008875:Middle Aged; D019114:Remote Consultation / Q000379:methods; D015203:Reproducibility of Results; D012871:Skin Diseases / Q000175:diagnosis*; D017216:Telemedicine / Q000379:methods*