Reliability and Accuracy of Inpatient Teledermatology in Asian Patients

Previous studies demonstrated the reliability and accuracy of teledermatology in outpatient settings. It is cost effective and can enhance accessibility to specialist care, leading to better patient outcomes. Few studies have investigated inpatient teledermatology, and local data are lacking. This study aimed to determine whether store-and-forward teledermatology is accurate and reliable for inpatient dermatology consultations in Asians.

During the study period from April to June 2022, consecutive inpatient dermatology consultations were collected at a tertiary referral center in Hong Kong. For each recruited patient, after assessment by an in-house dermatologist, another dermatologist who would practice store-and-forward teledermatology would assess the same patient separately. The primary outcome measured was the concordance of the preferred diagnoses. Factors affecting concordance were evaluated.

A total of 190 Asian patients were recruited. The concordance between the teledermatologist and inpatient dermatologists was 80% for the preferred diagnosis, with a kappa coefficient of 0.75 (95% confidence interval (CI) 0.71-0.78). The concordance of differential diagnoses was 97.4%, with a kappa coefficient of 0.76 (95% CI 0.73-0.8). The diagnostic accuracy rates were 68.8% (53/77) for inpatient dermatologists and 59.7% (46/77) for the teledermatologist. Better quality of clinical photographs (p < 0.001) was associated with agreement on the preferred diagnosis.

Inpatient teledermatology in real-world settings has been found to be reliable and accurate in Asians. Its utilization should be encouraged to enhance specialist accessibility and improve patient care.