Whatsapp telediagnosis of potentially malignant disorders: a cross-sectional study

Potentially Malignant Disorders (PMD) require early diagnosis and consistent follow-up for effective management, particularly in remote areas with limited access to healthcare facilities. Telemedicine, especially through accessible platforms like WhatsApp, offers a promising solution for bridging these healthcare gaps by enabling timely diagnosis and follow-up of PMD. However, the accuracy and reliability of WhatsApp telediagnosis compared to traditional clinical evaluations require further validation.

This study aimed to assess the feasibility and diagnostic accuracy of WhatsApp-based telediagnosis for PMD in comparison to in-person clinical evaluations. Objectives included evaluating inter-evaluator reliability and agreement between clinical diagnosis and telediagnosis in terms of identifying PMD.

200 oral lesions in 198 patients visiting with a clinical diagnosis of PMDs were recorded. This data along with the image of the lesion was submitted to two Oral Medicine specialists via WhatsApp .The images were viewed and evaluated using smart phones. First evaluator used XIOMI (MI4 ) , the second evaluator used a REDMI Note 3 . Both the evaluators had a minimum of 8 years of experience in Oral Medicine. Clinical diagnosis was compared with WhatsApp telediagnosis. Biopsy of the lesion was performed and sent for histopahological diagnosis Results: :The data was collected, fed into SPSS (IBM version 23) and subjected to descriptive and Kappa statistics.CASES INCLUDED Leukoplakia -102 Lichen planus-50 OSMF-28 Malignancy-20 DEGREE OF DYSPLASIA No dysplasia-55.1% Mild -22.4% Moderate-6.8% Severe -5% Malignancy -10.3% Clinical diagnosis of Evaluator 1 Kappa value-0.844 P value Discussion: The findings highlight the potential of WhatsApp telediagnosis to serve as a reliable and accessible diagnostic tool, especially valuable in remote and underserved areas. High agreement levels suggest that telemedicine platforms like WhatsApp can deliver comparable diagnostic accuracy to in-person evaluations. However, additional studies are needed to explore broader applications of WhatsApp telediagnosis and to refine protocols for various telemedicine practices.

In the present study, clinical diagnosis and WhatsApp telediagonosis showed good agreement( Kappa = 0.844 and 0.891) , between evaluator 1 and 2 also showed good agreement (Kappa value =.891). • Hence Telemedicine using WhatsApp could be a valuable and feasible tool for early diagnosis and follow up of PMD, especially in remote areas where there is lack of access to health care.