[Diagnostic reliability of an asynchronous teledermatology consultation].
OBJECTIVE
To analyze the diagnostic agreement rate between primary care, an asynchronous teledermatology consultation, and a conventional dermatology consultation.


METHODS
Prospective non-randomized concordance study.


METHODS
Dermatology Service in Hospital Son Llàtzer (Palma de Mallorca) and primary care centers of Sóller and Arenal (Mallorca).


METHODS
Patients have been included from December 2005 to July 2008, sent by teleconsultation (n=158).


METHODS
Analysis of primary care, teledermatology consultation and face-to-face consultation diagnosis, in mentioned period of time. Calculation of kappa index of concordance.


RESULTS
158 teleconsultations have been made from December 2005 to July 2008, 94 (59,5%) women, and 64 (40,5%) men, aged from 9 to 96 years old (average, 55 years old). After grouping the diagnosis in categories, the distribution was: 48 (37,2%) benign tumours, 39 (30,2%) inflammatory and appendages diseases, 15 (11,6%) infectious diseases, 14 (10,9%) malignant tumours, and 13 (10,1%) premalignant tumours. In grouped diagnosis, concordance was 59,8% (CI 95%, 50-70%) (P<.0001) for general practitioner and 94,7% (CI 95%, 90-99%) (P<.0001) for teledermatologist.


CONCLUSIONS
The main advantage of asynchronous teledermatology is the improvement of the quality triage, allowing the detection of malignant or suspicious lesions. However, we need more comparable studies on a larger scale to evaluate the disadvantages (photographic technique limitation, evaluation of other lesions, legal aspects, professional motivation...).
Ferrer
Rosa Taberner
RT
Servicio de Dermatología, Hospital Son Llàtzer, Palma de Mallorca, España. rtaberner@comib.com
Bezares
Antonio Pareja
AP
Mañes
Alex Llambrich
AL
Mas
Antonia Vila
AV
Gutiérrez
Ignacio Torné
IT
Lladó
Cristina Nadal
CN
Estaràs
Guillermo Mas
GM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003880:Dermatology / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011446:Prospective Studies; D019114:Remote Consultation; D015203:Reproducibility of Results; D012871:Skin Diseases / Q000175:diagnosis*; D055815:Young Adult