title: [Four years of quality assurance of dermatologic procedures: report from the ABD clearing institution].
abstract: BACKGROUND
  Expert dermatologic evaluation is the most relevant tool for secondary prevention in occupational dermatology in Germany. If there is a possibility of a work-related skin disorder in an employee, dermatologists may conduct the relevant diagnostic procedures (e.g. patch-and prick-tests, serology) at the expenses of the public employers' liability insurance fund (UVT). Most dermatologists make careful use of this unparalleled privilege, which is also an obligation. However, recently, with an increasing number of dermatologist's reports submitted, there have been occasional complaints by the UVT concerning overly extensive testing. In 1999 the Task Force on Occupational and Environmental Dermatology (ABD) of the German Dermatological Society established a clearing procedure. Two experienced occupational dermatologists will--separately--give their expert opinion on dermatologist's reports which have been forwarded anonymously by the UVT for expert review.
  
  
  RESULTS
  Thus far, from May 1999 to May 2003 155 dermatologist's reports have been submitted to the clearing procedure. The complaints were in > 95% of cases considered justified by the experts. Their criticism was primarily directed towards excessive testing procedures and failure to provide sufficient clinical information.
  
  
  CONCLUSIONS
  The UVT does not undertake such extensive preventive efforts for any other occupational disease. Therefore, quality management of the dermatologist's procedure--conducted by dermatologists and providing transparency--is essential to maintain and develop this effective tool of secondary prevention for the benefit of workers and employers.
authors.affiliation: Fachgebiet Dermatologie, Umweltmedizin und Gesundheitstheorie, Universität Osnabrück. sjohn@uos.de
authors.forename: Swen Malte
authors.initials: SM
authors.lastname: John
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Diepgen
authors.forename: Peter
authors.initials: P
authors.lastname: Elsner
authors.forename: Arno
authors.initials: A
authors.lastname: Köllner
authors.forename: Gerhard
authors.initials: G
authors.lastname: Richter
authors.forename: Axel
authors.initials: A
authors.lastname: Rothe
authors.forename: Ingo
authors.initials: I
authors.lastname: Schindera
authors.forename: Alois
authors.initials: A
authors.lastname: Stary
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Wehrmann
authors.forename: Hans Joachim
authors.initials: HJ
authors.lastname: Schwanitz
mesh_terms: D005858:Germany / Q000453:epidemiology; D006801:Humans; D009784:Occupational Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D011785:Quality Assurance, Health Care / Q000379:methods*; D012871:Skin Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D016896:Treatment Outcome