title: Reliability of the MDi Psoriasis®Application to Aid Therapeutic Decision-Making in Psoriasis.
abstract: BACKGROUND
  Therapeutic decisions in psoriasis are influenced by disease factors (e.g., severity or location), comorbidity, and demographic and clinical features.
  
  
  OBJECTIVE
  We aimed to assess the reliability of a mobile telephone application (MDi-Psoriasis) designed to help the dermatologist make decisions on how to treat patients with moderate to severe psoriasis.
  
  
  METHODS
  We analyzed interobserver agreement between the advice given by an expert panel and the recommendations of the MDi-Psoriasis application in 10 complex cases of moderate to severe psoriasis. The experts were asked their opinion on which treatments were most appropriate, possible, or inappropriate. Data from the same 10 cases were entered into the MDi-Psoriasis application. Agreement was analyzed in 3 ways: paired interobserver concordance (Cohen's κ), multiple interobserver concordance (Fleiss's κ), and percent agreement between recommendations.
  
  
  RESULTS
  The mean percent agreement between the total of 1210 observations was 51.3% (95% CI, 48.5-54.1%). Cohen's κ statistic was 0.29 and Fleiss's κ was 0.28. Mean agreement between pairs of human observers only, excluding the MDi-Psoriasis recommendations, was 50.5% (95% CI, 47.6-53.5%). Paired agreement between the recommendations of the MDi-Psoriasis tool and the majority opinion of the expert panel (Cohen's κ) was 0.44 (68.2% agreement).
  
  
  CONCLUSIONS
  The MDi-Psoriasis tool can generate recommendations that are comparable to those of experts in psoriasis.
authors.affiliation: Unidad de Gestión Clínica de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, España. Electronic address: david.moreno.ramirez.sspa@juntadeandalucia.es.
authors.forename: D
authors.initials: D
authors.lastname: Moreno-Ramírez
authors.affiliation: Subdirección de Tecnologías de Información y Comunicaciones, Consejería de Salud, Sevilla, España.
authors.forename: J M
authors.initials: JM
authors.lastname: Herrerías-Esteban
authors.affiliation: Unidad de Gestión Clínica de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, España.
authors.forename: T
authors.initials: T
authors.lastname: Ojeda-Vila
authors.affiliation: Servicio de Dermatología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España.
authors.forename: J M
authors.initials: JM
authors.lastname: Carrascosa
authors.affiliation: Servicio de Dermatología, Hospital Universitario Germans Trias i Pujol, Badalona, España.
authors.forename: G
authors.initials: G
authors.lastname: Carretero
authors.affiliation: Servicio de Dermatología, Hospital Universitario Infanta Leonor, Madrid, España.
authors.forename: P
authors.initials: P
authors.lastname: de la Cueva
authors.affiliation: Servicio de Dermatología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España.
authors.forename: C
authors.initials: C
authors.lastname: Ferrándiz
authors.affiliation: Unidad de Gestión Clínica de Dermatología, Hospital Universitario Reina Sofía, Córdoba, España.
authors.forename: M
authors.initials: M
authors.lastname: Galán
authors.affiliation: Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: Rivera
authors.affiliation: Unidad de Gestión Clínica de Dermatología, Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: L
authors.initials: L
authors.lastname: Rodríguez-Fernández
authors.affiliation: Unidad de Gestión Clínica de Dermatología, Complejo Hospitalario Universitario de Granada, Granada, España.
authors.forename: R
authors.initials: R
authors.lastname: Ruiz-Villaverde
authors.affiliation: Unidad de Gestión Clínica de Dermatología, Hospital Universitario Virgen Macarena, Sevilla, España.
authors.forename: L
authors.initials: L
authors.lastname: Ferrándiz
mesh_terms: D000328:Adult; D040421:Cell Phone; D000066491:Clinical Decision-Making; D000075203:Contraindications, Drug; D003430:Cross-Sectional Studies; D003879:Dermatologic Agents / Q000627:therapeutic use*; D003880:Dermatology / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D015588:Observer Variation; D011701:PUVA Therapy; D011565:Psoriasis / Q000188:drug therapy* / Q000532:radiotherapy; D015203:Reproducibility of Results; D014467:Ultraviolet Therapy
chemical_list: D003879:Dermatologic Agents
keywords: Apps; Biologics; Biológicos; Comorbidity; Comorbilidad; Health applications; Psoriasis; Reproducibilidad; Reproducibility; eHealth; eSalud