Diagnostic Reliability of In-Person Versus Remote Dermatology: A Meta-Analysis.

Area of Science:

• Dermatology
• Medical Informatics
• Health Services Research

Background:

• Existing studies report variable diagnostic agreement between teledermatology and in-person dermatology consultations.
• A robust comparison requires baseline diagnoses from multiple independent in-person consultations.

Purpose of the Study:

• To conduct a meta-analysis comparing diagnostic agreement in teledermatology versus in-person consultations.
• To evaluate studies with at least two in-person dermatologists and one remote dermatologist examining the same patients.

Main Methods:

• Systematic literature search for studies comparing teledermatology and in-person diagnoses.
• Inclusion of studies with two independent in-person diagnosticians.
• Meta-analysis of data from six identified studies.

Main Results:

• Significant differences in diagnostic concordance rates were found between teledermatology and in-person consultations (OR = 0.55, 95% CI = 0.42-0.72).
• Diagnostic agreement varied widely across the included studies.

Conclusions:

• Teledermatology diagnoses may be less reliable than in-person assessments, particularly for high-risk skin conditions.
• Teledermatology remains valuable for improving access, reducing costs, and patient triage.
• Increased caution is warranted in teledermatology for diagnosing potentially serious skin conditions.