Quality and Perceived Usefulness of Patient-Submitted Store-and-Forward Teledermatology Images

Area of Science:

• Dermatology
• Medical Informatics
• Health Services Research

Background:

• Patient-submitted images are crucial for teledermatology but vary in quality and utility.
• Limited real-world data exists on the quality and perceived usefulness of these images.
• Assessing dermatologist agreement on image evaluation is essential for optimizing digital health tools.

Purpose of the Study:

• To evaluate the quality and perceived usefulness of patient-submitted images.
• To characterize dermatologist agreement on image quality and usefulness.
• To identify factors influencing dermatologist comfort with medical decision-making based on submitted images.

Main Methods:

• A survey study involving 10 dermatologists evaluating patient-submitted images.
• Analysis of 3600 unique image evaluations for quality and usefulness.
• Interrater agreement assessed using Fleiss kappa (κ) and logistic regression for influencing factors.

Main Results:

• 55.1% of images were useful for decision-making; 62.2% were of sufficient quality.
• Fair to moderate interrater agreement was observed for quality (κ, 0.35-0.47) and usefulness (κ, 0.29-0.38).
• In-focus images and those reviewed by senior faculty were more likely to be deemed useful.

Conclusions:

• A slight majority of patient-submitted images were adequate in quality and usefulness.
• Fair agreement suggests teledermatology initiatives should account for individual physician experience.
• Optimizing image submission guidelines and physician training is necessary to reduce dermatologist burden.