Healing from a Distance: A Cross-Sectional Study on the Diagnostic Reliability of Store-and-Forward Teledermatology
ABSTRACT
Background:
Telemedicine delivers health care services between two distant locations through the use of information and communication technology. Several medical specializations, such as dermatology, have incorporated telemedicine into their practice. Since dermatologists are trained to diagnose skin, hair and nail conditions with a clinical eye, teledermatology may be an alternative when a traditional face-to-face clinic visit is not feasible.
Objective:
The purpose of this study is to evaluate the diagnostic reliability of teledermatology.
Methods:
A cross-sectional study was conducted among patients from two government hospitals. Thirty-nine patients were seen face-to-face and diagnosed by a consultant dermatologist. A written history of their present illness and accompanying photographs were taken, and were shown to three consultant teledermatologists who then diagnosed their condition. Two senior dermatology residents then rated the face-to-face and teledermatology diagnoses as either complete agreement, partial agreement, or no agreement. Descriptive statistics was used to summarize the general and clinical characteristics of the participants. Cohen’s Kappa was used to determine the agreement of the evaluations between the teledermatology and face to face diagnoses by senior residents 1 and 2.
Results:
Over 70% of the diagnoses were deemed as either partial or in complete agreement with the face-to-face diagnosis for senior resident rater 1. Similarly, over 80% of the diagnoses were deemed as either partial or in complete agreement with the face-to-face diagnosis for senior resident rater 2. The agreement between the agreement ratings of senior residents 1 and 2 were fair to substantial.
Conclusions:
The findings of the study show that the diagnostic concordance of in-person clinicians and teledermatologists are fair to substantial, with over 70% of the diagnoses in partial or complete agreement. Though face-to-face consultations remain the gold standard, teledermatology is an important alternative where dermatologic care is not accessible.
Citation

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