Accuracy of store-and-forward diagnosis in leprosy.
Telemedicine might increase the speed of diagnosis for leprosy and reduce the development of disabilities. We compared the accuracy of diagnosis made by telemedicine with that made by in-person examination. The cases were patients with suspected leprosy at eight public health clinics in outlying areas of the city of São Paulo. The case history and clinical examination data, and at least two clinical images for each patient, were stored in a web-based system developed for teledermatology. After the examination in the public clinic, patients then attended a teaching hospital for an in-person examination. The benchmark was the clinical examination of two dermatologists at the university hospital. From August 2005 to April 2006, 142 suspected cases of leprosy were forwarded to the website by the doctors at the clinics. Of these, 36 cases were excluded. There was overall agreement in the diagnosis of leprosy in 74% of the 106 remaining cases. The sensitivity was 78% and the specificity was 31%. Although the specificity was low, the study suggests that telemedicine may be a useful low-cost method for obtaining second opinions in programmes to control leprosy.
Medicine Faculty, University of São Paulo, São Paulo, Brazil. angelatrindade@uol.com.br
Maria Angela Bianconcini
MA
Trindade
Chao Lung
CL
Wen
Cyro Festa
CF
Neto
Maria Mercedes
MM
Escuder
Vera Lúcia G
VL
Andrade
Tânia Mara T
TM
Yamashitafuji
Vânia Lúcia S
VL
Manso
D001938:Brazil / Q000453:epidemiology; D006801:Humans; D007918:Leprosy / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D011787:Quality of Health Care / Q000592:standards*; D012017:Referral and Consultation; D012680:Sensitivity and Specificity; D012874:Skin Diseases, Infectious / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D017216:Telemedicine / Q000592:standards*