title: Prospective observational comparative study assessing the role of store and forward teledermatology triage in skin cancer.
abstract: In the UK, patients with suspected cancer should be seen within 2 weeks of referral, and treatment commenced within 62 days. We investigated store-and-forward teledermatology triage for melanoma and squamous cell carcinoma (SCC) at a skin-cancer clinic. Electronic referral and digital photography were assessed together to allocate priority. Data were collected prospectively for 1 year and compared with conventional referral. In the photograph group, we upgraded all patients with malignant lesions who were not referred urgently. In the comparison group, seven patients (9%) were not upgraded and six (8%) were downgraded. Median wait to clinic for photographed patients with melanoma was 14 days and 13.5 days for SCC. Without photographs, urgent cases were seen after a median of 24 days. In the photograph group, all but one melanoma and 60% of patients with SCC were treated within 62 days. In the group without photographs, 68% of patients with melanoma and < 50% of patients with SCC were treated within 62 days. These data support photographic triage as a useful tool for improving prioritization and reducing waiting times.
authors.affiliation: Department of Dermatology, Monklands Hospital, Airdrie, Lanarkshire, UK. claremay@doctors.org.uk
authors.forename: C
authors.initials: C
authors.lastname: May
authors.forename: L
authors.initials: L
authors.lastname: Giles
authors.forename: G
authors.initials: G
authors.lastname: Gupta
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D046169:Dermoscopy / Q000592:standards; D006801:Humans; D008545:Melanoma / Q000175:diagnosis*; D010781:Photography; D011446:Prospective Studies; D012017:Referral and Consultation; D012606:Scotland; D012815:Signal Processing, Computer-Assisted; D012878:Skin Neoplasms / Q000175:diagnosis*; D017216:Telemedicine / Q000379:methods / Q000592:standards*; D013997:Time Factors; D014218:Triage / Q000379:methods / Q000592:standards*