title: Authors' willingness for second-opinion teledermatology in difficult-to-manage cases: 'an online survey'.
abstract: BACKGROUND
  Expert non-availability for an instant difficult-to-manage case may limit the online discussion group to provide second-opinion teledermatology for registered dermatologists. Author-based second-opinion teledermatology (AST) is proposed and assessment of authors' response to answer queries and their willingness to participate in teledermatology consultation is analysed.
  
  
  METHODS
  Authors of 292 articles from seven non-open access dermatology and three general medical journals addressing difficult-to-manage cases from June 2007 to December 2008 participated in this online dermatology authors' survey. Authors' response to reprint requests, answer literature queries and willingness to offer second-opinion teledermatology were the main outcome measures. Perceived views were also documented.
  
  
  RESULTS
  The scores for reprints requests vs. received were (chi(2) = 13.57, n = 292), P = 0.000. The scores for articles read, analysed and literature queries sent vs. authors answered were (chi(2) = 11.09, n = 190), P = 0.001. The scores for authors responded to reprints vs. willing to offer second-opinion teledermatology consultation were (chi(2) = 5.65, n = 190), P = 0.017 and authors responded to reprint requests, answered queries and willing to offer second-opinion (chi(2) = 5.65, n = 190), P = 0.017.
  
  
  CONCLUSIONS
  A dermatologist obtains literature, answered queries and constructive suggestions with additional informative material and pools second-opinions from the authors using their e-mail to deliver quality health care. AST is an alternative to online discussion group for second-opinion teledermatology practice in difficult-to-manage cases. Uniform international laws are to be framed to facilitate telemedicine care for a difficult-to-manage case.
authors.affiliation: Department of Dermatology, Jagadguru Sri Shivarathreshwara University Medical College Hospital, Ramanuja Road, Mysore, Karnataka, India. kanthacad@yahoo.com
authors.forename: G R
authors.initials: GR
authors.lastname: Kanthraj
mesh_terms: D003299:Cooperative Behavior; D003625:Data Collection; D003880:Dermatology / Q000639:trends*; D034742:Electronic Mail; D006801:Humans; D011787:Quality of Health Care / Q000639:trends; D012017:Referral and Consultation / Q000639:trends*; D019114:Remote Consultation / Q000639:trends; D012189:Retrospective Studies; D017216:Telemedicine / Q000639:trends*