title: Clinical course outcomes for store and forward teledermatology versus conventional consultation: a randomized trial.
abstract: We assessed the clinical course of patients after store and forward teledermatology in comparison with conventional consultations. Patients being referred from primary care to dermatology clinics were randomly assigned to teledermatology or a conventional consultation. A total of 392 patients were randomized; 261 patients completed the study and were included in the analysis. Their clinical course was rated on a five-point scale by a panel of three dermatologists, blinded to study assignment, who reviewed serial digital image sets. The clinical course was assessed by comparing images sets between baseline and first clinic visit (if one occurred) and between baseline and nine months. There was no evidence to suggest a difference between the two groups in either clinical course between baseline and nine months post-referral (P = 0.88) or between baseline and the first dermatology clinic visit (P = 0.65). Among teledermatology referrals, subsequent presentation for an in-person dermatology clinic visit was significantly correlated with clinical course (P = 0.023). Store and forward teledermatology did not result in a significant difference in clinical course at either of two post-referral time periods.
authors.affiliation: Durham Veterans Affairs Medical Center, Durham, North Carolina, USA (current affiliation).
authors.forename: John D
authors.initials: JD
authors.lastname: Whited
authors.forename: Erin M
authors.initials: EM
authors.lastname: Warshaw
authors.forename: Kush
authors.initials: K
authors.lastname: Kapur
authors.forename: Karen E
authors.initials: KE
authors.lastname: Edison
authors.forename: Lizy
authors.initials: L
authors.lastname: Thottapurathu
authors.forename: Srihari
authors.initials: S
authors.lastname: Raju
authors.forename: Bethany
authors.initials: B
authors.lastname: Cook
authors.forename: Holly
authors.initials: H
authors.lastname: Engasser
authors.forename: Samantha
authors.initials: S
authors.lastname: Pullen
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Moritz
authors.forename: Santanu K
authors.initials: SK
authors.lastname: Datta
authors.forename: Lucinda
authors.initials: L
authors.lastname: Marty
authors.forename: Neal A
authors.initials: NA
authors.lastname: Foman
authors.forename: Pitiporn
authors.initials: P
authors.lastname: Suwattee
authors.forename: Dana S
authors.initials: DS
authors.lastname: Ward
authors.forename: Domenic J
authors.initials: DJ
authors.lastname: Reda
mesh_terms: D006801:Humans; D015588:Observer Variation; D010781:Photography; D011320:Primary Health Care; D012017:Referral and Consultation; D019114:Remote Consultation; D015203:Reproducibility of Results; D012871:Skin Diseases / Q000473:pathology / Q000628:therapy*; D017216:Telemedicine; D016896:Treatment Outcome; D014481:United States