title: Teledermatology as a filtering system in pigmented lesion clinics.
abstract: Teledermatology was evaluated as a filtering system for a pigmented lesion clinic (PLC). A total of 219 teleconsultations were received at the PLC in a 12-week period. The outcome of the teleconsultation was that 49% of patients were referred to the face-to-face clinic. Teleconsultation reports were available to the general practitioner (GP) in a mean time of 44 h and patients attended the face-to-face clinic within the following two weeks. Agreement between different dermatologists was almost perfect, with k =0.91 (95% confidence interval [CI] 0.87-0.96) for diagnosis and kappa =0.92 (95% CI 0.86-0.98) for management options ("referral" or "non- referral"). Agreement within observers was excellent, with kappa =0.93 (95% CI 0.87-0.98). The accuracy of diagnosis, as judged by the histology, was less good, with kappa =0.79 (95% CI 0.70-0.89). In all, 86% of patients and 97% of GPs stated that they were "very satisfied" with the new system. Teledermatology performed well as a filtering system for the PLC. However, more experience is needed to detect the real effect, if any, of teleconsultation on the early diagnosis and prognosis of melanoma.
authors.affiliation: Pigmented Lesion and Teledermatology Clinic of the Dermatology Department, University Hospital Virgen Macarena, Avda. Dr. Fedriani s/n, 41073 Seville, Spain. dmoreno@e-derma.org
authors.forename: D
authors.initials: D
authors.lastname: Moreno-Ramirez
authors.forename: L
authors.initials: L
authors.lastname: Ferrandiz
authors.forename: A Perez
authors.initials: AP
authors.lastname: Bernal
authors.forename: R Carrasco
authors.initials: RC
authors.lastname: Duran
authors.forename: J J Rios
authors.initials: JJ
authors.lastname: Martín
authors.forename: F
authors.initials: F
authors.lastname: Camacho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D003880:Dermatology / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration; D017060:Patient Satisfaction; D012017:Referral and Consultation; D019114:Remote Consultation / Q000592:standards / Q000706:statistics & numerical data*; D012878:Skin Neoplasms / Q000175:diagnosis*