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Dermatopathology via a still-image telemedicine system: diagnostic concordance with direct microscopy
B Berman1, G W Elgart, A E Burdick
1Dept. of Dermatology, University of Miami School of Medicine, FL 33136, USA.
Objective:
To determine the concordance of dermatopathology diagnosis by still-image telemedicine technology and direct microscopy.
Materials And Methods:
Skin specimens (N = 79) were examined by a dermatopathologist using a still-image phone system, and the diagnoses were compared with those made by the same dermatopathologist 1 year earlier by direct microscopy. The telemedical diagnoses were reached first without, and then with, patient histories.
Results:
When the patient history was available, identical diagnoses were made in 66 of the 79 cases (84% concordance rate). Without patient history, the concordance rate was 80%. The diagnostic concordance rate for the diagnosis of benign nevocytic nevi, inflammatory diseases, and benign and malignant non-squamous cell carcinoma neoplasms was statistically significantly greater than the concordance rate for the diagnosis of squamous cell carcinoma and squamous cell carcinoma in situ (P = 0.005).
Conclusions:
The diagnostic concordance rate achieved by teledermatopathology using a still-image phone system fell short of the 99% intraobserver diagnostic concordance rate using direct microscopy.