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Unimaged Melanomas in Store-and-Forward Teledermatology
James L Gendreau1, Jordan Gemelas1, Melinda Wang2
11 School of Public Health, University of Washington, Seattle, Washington.
Summary
Primary care providers may miss imaging melanomas in store-and-forward teledermatology (SFT) referrals. This study found a 10.1 per 10,000 consultation rate for unimaged melanomas, suggesting SFT is noninferior to in-person care.
Area of Science:
- Dermatology
- Telemedicine
- Public Health
Background:
- Store-and-forward teledermatology (SFT) relies on captured images for diagnosis.
- Concerns exist about primary care providers (PCPs) accurately imaging melanoma lesions.
- Unimaged melanomas are those not photographed by PCPs.
Purpose of the Study:
- To determine the frequency of unimaged melanomas in Veterans using SFT.
- To assess the diagnostic limitations of SFT in melanoma detection.
Main Methods:
- Retrospective analysis of SFT consultations for melanoma diagnoses.
- Data sourced from VA corporate data warehouse and patient records.
- Inclusion criteria applied to identify relevant melanoma cases.
Main Results:
- 13 out of 69 identified melanomas were unimaged.
- The frequency of unimaged melanoma was 10.1 per 10,000 SFT consultations.
- Study population comprised 7,960 Veterans over a 30-month period.
Conclusions:
- PCPs may fail to image melanomas when referring patients via SFT.
- The rate of unimaged melanomas suggests SFT is comparable to face-to-face care for Veterans.
- Findings are specific to the Veteran population and may not generalize to the public.
