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Randomized controlled trial comparing store-and-forward teledermatology alone and in combination with web-camera

G Romero1, P Sánchez, M García

  • 1Dermatology Unit, Ciudad Real General Hospital, Ciudad Real, Spain. gromeroa@meditex.es

Clinical and Experimental Dermatology
|October 31, 2009
PubMed
Summary

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Teledermatology offers high diagnostic reliability, comparable to in-person visits. Standardizing image quality and history taking is key for accurate remote consultations.

Area of Science:

  • Dermatology
  • Medical Informatics
  • Health Services Research

Background:

  • Teledermatology reliability studies show variable results.
  • Few studies compare asynchronous and synchronous teledermatology methods.

Purpose of the Study:

  • Evaluate the reliability of two remote teledermatology consultation techniques.
  • Compare store-and-forward (SF) with hybrid videoconferencing-SF (VC-SF) methods.

Main Methods:

  • Prospective, randomized diagnostic-concordance study (DERMATEL).
  • 457 patients randomized to SF, VC-SF, or control groups.
  • Compared teledermatology consultations with face-to-face (FTF) consultations.

Main Results:

  • High-quality images (82%) and diagnostic confidence (89%) were achieved.

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  • High agreement between teledermatology and FTF for diagnosis (>0.85) and treatment (>0.78).
  • Image quality and diagnostic confidence influenced concordance, not the teleconsultation method.

    • Conclusions:

    • Intraobserver reliability in teledermatology is very high.
    • Hybrid systems offer no advantage over SF alone when history and photography are standardized.