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Cited by 81Cutaneous Melanoma Detection and ManagementTelemedicine and Telehealth ImplementationDigital Imaging in Medicine

Mobile teledermoscopy—there’s an app for that!

Open access
Börve, Alexander, Terstappen, Karin, Sandberg, Carin, Paoli, John·2013·Dermatology Practical & Conceptual
DOI 10.5826/dpc.0302a05PMC PMC3663402
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Abstract

Background: The introduction of the smartphone with high-quality, built-in digital cameras and easy-to-install software may make it more convenient to perform teledermatology. In this study we looked at the feasibility of using a smartphone (iPhone 4®) with an installed application especially developed for teledermatology (iDoc24®) and a dermoscope (FotoFinder Handyscope®) that is customized to attach to the smartphone to be able to carry out mobile teledermoscopy. Objectives: To study the diagnostic accuracy of this mobile teledermoscopy solution, to determine the interobserver concordance between teledermoscopists (TDs) and a dermatologist meeting the patient face-to-face (FTF), and to assess the adequacy of the TDs’ management decisions and to evaluate the image quality obtained. Patients/Methods: During a 16-week period, patients with one or more suspicious skin lesions deemed to need a biopsy or excision were included. The smartphone app was used to send a clinical image, a dermoscopy image and relevant clinical information to a secure Internet platform (Tele-Dermis®). Two TDs assessed the incoming cases, providing a specific primary diagnosis and a management decision. They also graded the image quality. The histopathological diagnosis was used as the gold standard. Results: Sixty-nine lesions were included. The FTF dermatologist’s diagnostic accuracy was 66.7%, which was statistically higher than TD 1 (50.7%, P=0.04) but similar to TD 2 (60.9%, P=0.52). The interobserver concordances between the FTF dermatologist and the two TDs and between the respective TDs showed moderate to substantial agreement. The TDs provided adequate management decisions for 68 (98.6%) and 69 (100%) lesions, respectively. The image quality was rated as excellent or sufficient in 94% and 84% of the cases by the respective TDs. Conclusion: This novel mobile teledermoscopy solution may be useful as a triage tool for patients referred to dermatologists for suspicious skin lesions.

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Crossref · 10.5826/dpc.0302a05

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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 [29]

    The Results report poor image quality in 4 of 69 cases (5.8%) for one teledermatologist and 11 of 69 (15.9%) for the other; the Discussion says these were 14 different cases, approximately 20% of cases. The paper rates cases rather than individual photographs, and says no images needed to be excluded because of poor quality, so it does not establish that 20% of transmitted photographs were insufficient for use. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • 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 [29]

    The Results (page not provided) compare teledermoscopists’ diagnoses with a face-to-face dermatologist’s and report Cohen’s κ values of 0.47 and 0.48 for the specific primary diagnosis. The paper supports the subject of diagnostic concordance, but the passages do not report a range across studies of 0.20–0.84 or a median of 0.60. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • 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 [29]

    The Results (page not available) report moderate-to-substantial concordance between the face-to-face dermatologist and teledermoscopists, supporting the general point about agreement. They report κ values of 0.47 and 0.48 for specific primary diagnoses and 0.49–0.82 across lesion-classification categories, not the claimed range of 0.29–0.87 or median of 0.74. The paper also does not compare concordance with and without a dermoscope to show an improvement. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • To give an opinion solely based on photographs, whatever their quality, is a challenge for dermatologists.

    “This review recalls that to give an opinion solely based on photographs, whatever their quality, is a challenge for dermatologists [29,41,63].”

    From Use of Smartphones for Early Detection of Melanoma: Systematic Review (2018) · cites this paper as [29]

    The Results report that the remote dermatologists rated many lesions as highly difficult to diagnose, even though most images were rated sufficient or excellent. But the Materials and methods say they received clinical information alongside the photographs, so the study does not establish the challenge of giving an opinion solely from photographs. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

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Authors
Börve, A., Terstappen, K., Sandberg, C., & Paoli, J.
Affiliations
  • Sahlgrenska University Hospital (SE)
  • Skaraborg Hospital (SE)
Corresponding author
Paoli, John
ORCID
Venue
Dermatology Practical & Conceptual
Publisher
Mattioli1885
Published
2013-04-30
Volume
3
Issue
2
Pages
41-48
ISSN
2160-9381 (ISSN-L)
DOI
10.5826/dpc.0302a05
PMC
PMC3663402
OpenAlex
W2083825608
Cited by
81
References
18
Citations by year
2026: 4 · 2025: 1 · 2024: 5 · 2023: 6 · 2022: 6 · 2021: 6 · 2020: 9 · 2019: 3 · 2018: 7 · 2017: 10 · 2016: 12 · 2015: 9 · 2014: 3
FWCI
4.29
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Dermatology Practical & Conceptual (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
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
teledermatology, mobile application, dermoscopy, diagnostic accuracy, interobserver concordance, suspicious skin lesions, triage, image quality, management decision-making, histopathological diagnosis

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