title: Accuracy and reliability of teledermatoscopy with images taken by general practitioners during everyday practice.
abstract: We assessed the accuracy and reliability of teledermatoscopy with images taken by a general practitioner (GP) compared to face-to-face dermatological examination. GPs selected patients for teledermatoscopy and took both macro and dermatoscopic photographs. Patients were then referred to the local dermatologist for face-to-face examination. Accuracy and inter-observer reliability were calculated for the diagnosis and management plan. Image quality was rated by two observers on a three-point scale. A total of 108 teledermatoscopy consultations sent by 13 GPs were assessed by four dermatologists. Agreement was 0.61 (kappa) on diagnostic group and 0.23 on management plan. The inter-observer reliability was 0.65 on diagnostic group and 0.36 on management plan. The image quality was reported as bad in 36% of cases, reasonable in 28% and good in 36%. Agreement for cases with good quality images was 0.66 on diagnostic group and 0.42 on management plan. Teledermatoscopy in general practice had overall a lower accuracy and reliability than face-to-face consultation. In cases where a good quality image was reported, the accuracy increased, which emphasises that teledermatoscopy is highly dependent on a good quality images.
authors.affiliation: Department of Dermatology, Academic Medical Centre, University of Amsterdam, The Netherlands.
authors.forename: Job P
authors.initials: JP
authors.lastname: van der Heijden
authors.forename: Leonie
authors.initials: L
authors.lastname: Thijssing
authors.forename: Leonard
authors.initials: L
authors.lastname: Witkamp
authors.forename: Phyllis I
authors.initials: PI
authors.lastname: Spuls
authors.forename: Nicolette F
authors.initials: NF
authors.lastname: de Keizer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D046169:Dermoscopy / Q000193:education* / Q000295:instrumentation / Q000592:standards*; D005194:Family Practice; D005260:Female; D058005:General Practitioners / Q000193:education; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012017:Referral and Consultation; D019114:Remote Consultation / Q000379:methods / Q000592:standards; D015203:Reproducibility of Results; D012878:Skin Neoplasms / Q000175:diagnosis*; D017216:Telemedicine / Q000379:methods* / Q000592:standards; D013997:Time Factors; D055815:Young Adult