远程皮肤病学的诊断可靠性:系统性审查和元分析
Adrienn N Bourkas1, Natasha Barone2, Matthew E C Bourkas3
1Queen's University School of Medicine, Kingston, Ontario, Canada.
BMJ open
|August 11, 2023
概括
远程皮肤病学显示出与面对面 (F2F) 咨询的良好诊断协议,特别是当由专家进行时. 图像采集培训和质量技术提高了准确性,使得远程皮肤学成为一种有价值的工具,特别是在服务不足的地区.
科学领域:
- 皮肤病学 皮肤病学
- 医疗信息学 医疗信息学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 远程皮肤病学为皮肤病学咨询提供了一个可扩展的解决方案.
- 评估远程皮肤病与传统面对面 (F2F) 咨询之间的诊断一致性对于其临床采用至关重要.
- 诊断准确度可能存在变化,这取决于提供者的专业知识和使用的技术.
研究的目的:
- 系统地审查和元分析皮肤病的远程皮肤病学和F2F咨询之间的诊断协议.
- 确定影响远程皮肤病学诊断一致性的因素.
主要方法:
- 2010年1月至2022年5月期间发表的观察性研究和随机临床试验的系统综述和元分析.
- 在 MEDLINE,Embase,Cochrane 图书馆,CINAHL 和 medRxiv 进行了搜索.
- 计算了百分比一致性和kappa一致性的聚合估计.
主要成果:
- 远程皮肤学和F2F之间的综合诊断一致率为68.9% (kappa = 0.67).
- 专业皮肤科医生获得的同意率高于非专业医生 (44%),高于非专业医生 (71%).
- 图像采集培训和数字摄影与改善的诊断协议有关.
结论:
- 远程皮肤病学表明与F2F咨询有相当大的诊断一致性,支持其实用性.
- 提供者专业化和优化的成像实践提高了远程皮肤病学的诊断准确度.
- 远程皮肤科是一个有前途的选择,特别是在资源有限的环境中,需要改进培训和技术.
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