title: [Diagnostic reliability of an asynchronous teledermatology consultation].
abstract: 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...).
authors.affiliation: Servicio de Dermatología, Hospital Son Llàtzer, Palma de Mallorca, España. rtaberner@comib.com
authors.forename: Rosa Taberner
authors.initials: RT
authors.lastname: Ferrer
authors.forename: Antonio Pareja
authors.initials: AP
authors.lastname: Bezares
authors.forename: Alex Llambrich
authors.initials: AL
authors.lastname: Mañes
authors.forename: Antonia Vila
authors.initials: AV
authors.lastname: Mas
authors.forename: Ignacio Torné
authors.initials: IT
authors.lastname: Gutiérrez
authors.forename: Cristina Nadal
authors.initials: CN
authors.lastname: Lladó
authors.forename: Guillermo Mas
authors.initials: GM
authors.lastname: Estaràs
mesh_terms: 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