Diagnosis, Diagnostic Confidence, and Management Concordance in Live-Interactive and Store-and-Forward Teledermatology Compared to In-Person Examination
| Autor: | Karen E. Edison, Whitney Lane, Dana S. Ward, Louanne Chance, Lanis L. Hicks, Jonathan A. Dyer |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Teledermatology Adolescent Concordance Diagnostic concordance Health Informatics Physical examination Dermatology Diagnosis Differential Young Adult Health Information Management Internal medicine medicine Humans Medical diagnosis Young adult Child Psychiatry Physical Examination Aged Aged 80 and over Observer Variation Modalities medicine.diagnostic_test business.industry Remote Consultation Reproducibility of Results General Medicine Middle Aged Female Differential diagnosis business |
| Zdroj: | Telemedicine and e-Health. 14:889-895 |
| ISSN: | 1556-3669 1530-5627 |
| DOI: | 10.1089/tmj.2008.0001 |
| Popis: | Teledermatology studies have examined diagnostic concordance between live-interactive (LI) and in-person examinations (IP); and between store-and-forward (SF) and IP examinations. However, no studies have looked simultaneously across all three care delivery modalities, and few have measured management concordance and diagnostic confidence of the dermatologist. The purpose of this study was to compare LI and SF modalities with IP with respect to diagnostic and management concordance and to compare physician diagnostic confidence across the three modalities. Four dermatologists, in random rotation among all three care modalities, examined 110 new patients. Confidence was rated on a Likert scale from 1 to 5 (5 = total confidence; 1 = no confidence). Identical diagnoses were given to the patient by examiners from all three examination modalities in 70/110 patients (64%). More identical diagnoses were given for IP and LI examinations than for IP and SF examinations (80% vs. 73%); however, the difference was not statistically significant (p = 0.13). The highest self-reported confidence rating was given for 87% of IP examinations, 59% for LI, and 54% for SF. Diagnostic confidence ratings for SF and LI were not significantly different from each other (p = 0.50); however, diagnostic confidence ratings for LI and SF were both statistically lower than IP (p < 0.0001). Dermatologists were more confident with IP examination than either form of teledermatology. The percent of diagnostic and management agreement among IP, LI, and SF modalities was high. |
| Databáze: | OpenAIRE |
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