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Cited by 44Telemedicine and Telehealth ImplementationHealthcare Systems and TechnologyCutaneous Melanoma Detection and Management

Potential effect of patient-assisted teledermatology on outpatient referral rates

Eminović, N, Witkamp, L, Ravelli, A C J, Bos, J D, Van Den Akker, Th W, Bousema, M T, Henquet, C J M, Koopman, R J J +2 more·2003·Journal of Telemedicine and Telecare
DOI 10.1258/135763303771005216
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Abstract

We carried out a pilot study on the feasibility and accuracy of store-and-forward teledermatology based on patient-provided images and history as a triage tool for outpatient consultation. Patients referred by their general practitioner provided a history and images via the Internet. The information was reviewed by one of 12 teledermatologists and the patient then visited a different dermatologist in person within two days. Three independent dermatologists compared the remote and in-person diagnoses in random order to determine diagnostic agreement. Broader agreement was also measured, by comparing the main disease groups into which the two diagnoses fell. The teledermatologists indicated whether an in-person consultation or further investigations were necessary. There were 105 eligible patients, aged four months to 72 years, who were willing to participate. For the 96 cases included in the analysis, complete diagnostic agreement was found in 41% ( n= 39), partial diagnostic agreement in 10% ( n= 10) and no agreement in 49% ( n= 47). There was disease group agreement in 66% of cases ( n= 63). Nearly a quarter (23%) of participating patients could have safely been managed without an in-person visit to a dermatologist.

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  • Image quality and diagnostic concordance are generally lower and more variable with patient-submitted images, which may impact their decision-making utility.

    “Image quality and diagnostic concordance are generally lower and more variable with patient-submitted images, which may impact their decision-making utility.”

    From Store-and-Forward Images in Teledermatology: Narrative Literature Review (2022) · cites this paper as [17]

  • Diagnostic concordance rates between dermatologists evaluating patient-generated SAF images and dermatologists evaluating patients at a face-to-face visit range from approximately 40% to 80%.

    “Several studies indicate that diagnostic concordance rates between dermatologists evaluating patient-generated SAF images and dermatologists evaluating patients at a FTF visit range from approximately 40% to 80% [5,8,16,17] (Table 1).”

    From Store-and-Forward Images in Teledermatology: Narrative Literature Review (2022) · cites this paper as [17]

  • 23% of patients could have avoided face-to-face appointments when SAF teledermatology was used as a triage tool based on patient-submitted images collected by their primary care physicians.

    “The authors found that 23% of patients could have avoided FTF appointments, as determined by a panel of 3 dermatologists [17] (Table 2).”

    From Store-and-Forward Images in Teledermatology: Narrative Literature Review (2022) · cites this paper as [17]

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Authors
Eminović, N., Witkamp, L., Ravelli, A. C. J., Bos, J. D., Van Den Akker, T. W., Bousema, M. T., Henquet, C. J. M., Koopman, R. J. J., Zeegelaar, J. E., & Wyatt, J. C.
Affiliations
  • Amsterdam UMC Location University of Amsterdam (NL)
  • KSYOS TeleMedical Centre (NL)
  • Dermatology Department, Medical Centre Haaglanden, The Hague
  • Meander Medisch Centrum (NL)
  • Maastricht University Medical Centre (NL)
  • Medisch Spectrum Twente (NL)
  • Flevoziekenhuis (NL)
Corresponding author
Eminović, N
ORCID
Venue
Journal of Telemedicine and Telecare
Publisher
SAGE Publications
Published
2003-12
Volume
9
Issue
6
Pages
321-327
ISSN
  • 1357-633X (ISSN-L)
  • 1758-1109
DOI
10.1258/135763303771005216
OpenAlex
W2103510276
Cited by
44
References
0
Citations by year
2026: 1 · 2023: 2 · 2022: 2 · 2020: 1 · 2018: 1 · 2017: 1 · 2016: 1 · 2015: 2 · 2014: 2 · 2013: 3 · 2012: 1
FWCI
2.37
Type
journal article
Language
en
Open access
closed
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Journal of Telemedicine and Telecare (publishedVersion)
  • PubMed (publishedVersion)
  • Discovery Research Portal (University of Dundee) (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
  • Health Sciences › Medicine › Oncology › Cutaneous Melanoma Detection and Management
Keywords
teledermatology, store-and-forward telemedicine, outpatient referral, triage, diagnostic agreement, dermatology, general practitioner referral, remote diagnosis
MeSH terms
Adolescent, Adult, Aged, Ambulatory Care, Child, Child, Preschool, Dermatology, Feasibility Studies, Humans, Infant, Middle Aged, Netherlands, Pilot Projects, Referral and Consultation, Skin Diseases, Reproducibility of Results, Observer Variation, Telemedicine, Remote Consultation

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