title: Feasibility and Efficacy of Patient-Initiated Mobile Teledermoscopy for Short-term Monitoring of Clinically Atypical Nevi.
abstract: OBJECTIVE
  Patient-driven mobile teledermoscopy may be applicable for monitoring of skin lesions.
  
  
  OBJECTIVE
  To assess the feasibility, efficacy, and patient receptivity of teledermoscopy for short-term monitoring of clinically atypical nevi.
  
  
  METHODS
  This was a prospective cohort study performed at an institutional referral center in New York. Consecutive patients 18 years or older, with 1 or more clinically atypical nevi that required short-term monitoring and were accessible by a mobile imaging device were recruited for the study. All 34 patients consented to the study, and 29 completed follow-up. Dermoscopic images were obtained in the office-based setting by a dermatologist and with an iPhone by the patient at baseline and follow-up (3-4 months). Patients completed surveys that included questions about skincare awareness and attitudes toward teledermoscopy. Standard dermoscopic images were evaluated by the office-based dermatologist, and mobile dermoscopic images were sent via the Internet to a teledermatologist to evaluate image quality and presence of significant clinical lesion change. The decisions of the teledermatologist and office-based dermatologist were compared.
  
  
  METHODS
  (1) Feasibility of using mobile dermatoscope by patients, (2) diagnostic concordance of teledermoscopy vs conventional office-based visit, and (3) patient receptivity to teledermoscopy for short-term monitoring of nevi.
  
  
  RESULTS
  Of the 29 patients who completed the study, 28 (97%) were able to acquire baseline and follow-up images that were subsequently deemed evaluable by the teledermatologist. The diagnostic concordance between conventional office-based visits and teledermoscopy encounters was 0.87 (SE, 0.13) (κ statistic). In addition, patients reported high receptivity to teledermoscopy for short-term monitoring of nevi.
  
  
  CONCLUSIONS
  Results from this pilot study suggest that teledermoscopy is feasible and effective as a method for short-term monitoring of clinically atypical nevi. The implementation of teledermoscopy can potentially enhance patient convenience, optimize physician scheduling, and promote efficiency.
authors: Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
authors: Xinyuan
authors: X
authors: Wu
authors: Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
authors: Susan A
authors: SA
authors: Oliveria
authors: Weill Cornell Medical College, New York, New York.
authors: Sarah
authors: S
authors: Yagerman
authors: Memorial Sloan Kettering Cancer Center, New York, New York.
authors: Lucy
authors: L
authors: Chen
authors: Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
authors: Jennifer
authors: J
authors: DeFazio
authors: University Hospital Zürich, Zürich, Switzerland.
authors: Ralph
authors: R
authors: Braun
authors: Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
authors: Ashfaq A
authors: AA
authors: Marghoob
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001292:Attitude to Computers; D015331:Cohort Studies; D046169:Dermoscopy / Q000379:methods* / Q000523:psychology / Q000706:statistics & numerical data; D003937:Diagnosis, Differential; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology; D008875:Middle Aged; D063731:Mobile Applications / Q000706:statistics & numerical data*; D009506:Nevus / Q000473:pathology*; D009508:Nevus, Pigmented / Q000473:pathology; D010358:Patient Participation / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010865:Pilot Projects; D011159:Population Surveillance; D011446:Prospective Studies; D015203:Reproducibility of Results; D012871:Skin Diseases / Q000473:pathology; D012878:Skin Neoplasms / Q000473:pathology*; D019113:Telepathology / Q000379:methods* / Q000706:statistics & numerical data; D055815:Young Adult