title: Mobile teledermatology--patient satisfaction, diagnostic and management concordance, and factors affecting patient refusal to participate in Saudi Arabia.
abstract: We evaluated the use of a 4G smart phone for mobile teledermatology. A dermatologist took pictures of skin images with a mobile phone (8 Mpixel camera resolution) and made a face-to-face diagnosis. The images were transmitted to a second dermatologist who viewed them on a similar mobile phone and made an independent diagnosis for comparison. Images were taken and transmitted only after receiving informed consent from the patients. A total of 166 consecutive patients were included in the study (97 male and 69 female). A questionnaire to assess patient satisfaction was administered to each patient. Most of the responders were highly satisfied with teledermatology. However, 23 patients (14%) refused photography of the skin lesions (21 female and 2 males). The main reasons for refusal to be photographed were stated as social or religious. The broad categorical diagnostic and management concordance (i.e. when considering at least one of the diagnoses to be similar) was 95%. Specific diagnostic concordance varied according to the disease. The average kappa coefficient was 0.66 for diagnostic concordance and 0.82 for management concordance. Refusal to be photographed--a problem not limited to teledermatology--needs to be considered when designing teledermatology protocols for larger scale implementation in areas like the Middle East.
authors.affiliation: Faculty of Dermatology, College of Medicine, King Faisal University, Al Ahsa, Saudi Arabia.
authors.forename: Feroze
authors.initials: F
authors.lastname: Kaliyadan
authors.forename: Tarek Tawfik
authors.initials: TT
authors.lastname: Amin
authors.forename: Joel
authors.initials: J
authors.lastname: Kuruvilla
authors.forename: Waleed Hamad Al Bu
authors.initials: WH
authors.lastname: Ali
mesh_terms: D000293:Adolescent; D000328:Adult; D040421:Cell Phone / Q000295:instrumentation*; D003880:Dermatology / Q000379:methods* / Q000458:organization & administration; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D045808:Refusal to Participate; D019114:Remote Consultation / Q000379:methods; D012529:Saudi Arabia; D012871:Skin Diseases / Q000175:diagnosis*; D017216:Telemedicine / Q000379:methods*; D055815:Young Adult