Feasibility and Efficacy of Patient-Initiated Mobile Teledermoscopy for Short-term Monitoring of Clinically Atypical Nevi
Open accessAbstract
IMPORTANCE: 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. DESIGN, SETTING, AND PARTICIPANTS: 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. MAIN OUTCOMES AND MEASURES: (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 AND RELEVANCE: 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.
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Up to 20% of the photographs transmitted were of insufficient quality.
“In this literature review, up to 20% of the photographs transmitted were of insufficient quality.”
From Use of Smartphones for Early Detection of Melanoma: Systematic Review (2018) · cites this paper as [42]
The diagnostic concordance between the conclusion of a teledermatologist and the conclusion of a dermatologist who conducted a face-to-face examination varied across studies, with a kappa coefficient range of .20 to .84 and a median of .60.
“However, the concordance between the conclusion of a teledermatologist and the conclusion of a dermatologist who conducts a face-to-face examination depended on the study (the kappa coefficient range was .20 to .84, median κ=.60).”
From Use of Smartphones for Early Detection of Melanoma: Systematic Review (2018) · cites this paper as [42]
The use of a dermoscope may improve concordance between the teledermatologist and the face-to-face dermatologist, with a kappa coefficient range of .29 to .87 and a median of .74.
“The use of a dermoscope may improve the concordance (the kappa coefficient range was .29 to .87, median κ=.74).”
From Use of Smartphones for Early Detection of Melanoma: Systematic Review (2018) · cites this paper as [42]
Many of the results supporting the importance of particular attributes in this study are in concordance with previous literature on consumer satisfaction with teledermoscopy or teledermatology.
“Many of the results found supporting the importance of particular attributes in this study are in concordance with the previous literature focusing on consumer satisfaction with teledermoscopy or teledermatology more broadly [14,18,19,27,28].”
From Consumer preferences for teledermoscopy screening to detect melanoma early (2016) · cites this paper as [14]
The screening alternatives and attribute levels were chosen based on results of three previous surveys in the target group, a literature review, and included important screening outcome, financial and convenience considerations.
“These alternatives, and the different attribute levels over which they vary, were chosen based on the results of three previous surveys undertaken in the target group [11], as well as a literature review [14, 16-22, 27, 28] and included important screening outcome, financial and convenience considerations.”
From Consumer preferences for teledermoscopy screening to detect melanoma early (2016) · cites this paper as [14]
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References 25 · Cited by 67
- Authors
- Wu, X., Oliveria, S. A., Yagerman, S., Chen, L., DeFazio, J., Braun, R., & Marghoob, A. A.
- Affiliations
- Memorial Sloan Kettering Cancer Center (US)
- Weill Cornell Medicine (US)
- University Hospital Zurich (CH)
- Corresponding author
- Marghoob, Ashfaq A.
- Venue
- JAMA Dermatology
- Publisher
- American Medical Association (AMA)
- Published
- 2015-05-01
- Volume
- 151
- Issue
- 5
- Pages
- 489
- ISSN
- 2168-6068 (ISSN-L)
- OpenAlex
- W2023034403
- Cited by
- 67
- References
- 25
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 6 · 2020: 13 · 2019: 7 · 2018: 11 · 2017: 8 · 2016: 5 · 2015: 5 · 2013: 1
- FWCI
- 4.22
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- JAMA Dermatology (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich)
- Topics
- Health Sciences › Medicine › Oncology › Cutaneous Melanoma Detection and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Digital Imaging in Medicine
- Keywords
- teledermoscopy, dysplastic nevi, skin lesion monitoring, teledermatology, smartphone imaging, diagnostic agreement, patient receptivity, feasibility
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Attitude to Computers, Diagnosis, Differential, Feasibility Studies, Female, Humans, Male, Melanoma, Middle Aged, Nevus, Nevus, Pigmented, Patient Participation, Pilot Projects, Population Surveillance, Prospective Studies, Skin Diseases, Skin Neoplasms, Reproducibility of Results, Cohort Studies, Patient Satisfaction, Telepathology, Dermoscopy, Young Adult, Mobile Applications
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