Diagnostic value and cost-effectiveness of good quality digital images accompanying electronic referrals for suspected skin malignancies.
OBJECTIVE
The aim of this study was to investigate the outcome and cost-effectiveness of good and poor quality photographs accompanying the electronic referrals for suspected skin malignancies.


METHODS
A retrospective study of 100 patients, divided into 2 groups, 50 with good quality photographs and 50 with poor quality photographs. Patients with no digital images, or who failed to attend, or patients with incomplete notes were excluded from the study. The treatment pathway, waiting times, and estimated cost between the 2 groups were compared.


RESULTS
Good photographs were more likely to be treated at the 1-Stop Clinic (P = 0.05). Good images had a better positive predictive value than poor quality images (62.55% vs. 42.86%).


CONCLUSIONS
Good quality images are more accurate than poor quality images in triaging of patients, and thus more effective in facilitating the treatment of malignant lesions timely. Good quality photographs allow a delayed appropriate treatment of benign lesions. This increases the safety for patients in a queue in a rationed health care system, and improves patient flow.
Department of Plastic Surgery, Ninewells Hospital, Dundee, United Kingdom. mng@nhs.net
Michael F Y
MF
Ng
J Howard
JH
Stevenson
D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer / Q000191:economics* / Q000379:methods; D006801:Humans; D016522:Oncology Service, Hospital / Q000458:organization & administration; D010781:Photography / Q000191:economics* / Q000379:methods; D011787:Quality of Health Care / Q000458:organization & administration; D012017:Referral and Consultation / Q000191:economics* / Q000458:organization & administration; D019114:Remote Consultation / Q000191:economics* / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000191:economics; D013222:State Medicine / Q000458:organization & administration; D006113:United Kingdom