Diagnostic accuracy and image quality using a digital camera for teledermatology.

OBJECTIVE The study was designed to evaluate the effectiveness of digital photography for dermatologic diagnoses and compare it with in-person diagnoses. MATERIALS AND METHODS Patients referred for specialty consultations (n = 308) were recruited from a university dermatology clinic. Patients were examined in-person by one of three board-certified dermatologists who provided clinical diagnoses. Digital photos were obtained on all patients and were evaluated as computer images by a panel of dermatologists. RESULTS There was 83% concordance between in-person versus digital photo diagnoses. Intradermatologist concordance averaged 84%, and interdermatologist concordance averaged 81%. Decision confidence was rated as "very definite" to "definite" 62% of the time. Concordance with biopsy results was achieved in 76% of the cases. Image sharpness and color quality were rated "good" to "excellent" 83% and 93% of the time, respectively. CONCLUSION Digital photography for store-and-forward teledermatology produces high-quality images and diagnostic concordance rates that compare favorably with in-person clinical diagnoses.

[1]  J W Burnett,et al.  Teledermatology and in-person examinations: a comparison of patient and physician perceptions and diagnostic agreement. , 1998, Archives of dermatology.

[2]  P. Weary,et al.  Patients' opinions regarding direct access to dermatologic specialty care. , 1997, Journal of the American Academy of Dermatology.

[3]  J. Bamford.  Interobserver variation in the assessment of rosacea. , 1998, Archives of dermatology.

[4]  B Gerbert,et al.  Primary care physicians as gatekeepers in managed care. Primary care physicians' and dermatologists' skills at secondary prevention of skin cancer. , 1996, Archives of dermatology.

[5]  C. Sneiderman,et al.  A comparison of video and photographic display of skin lesions for morphology recognition. , 1991, The Journal of biocommunication.

[6]  S Gustke,et al.  Reliability of dermatology teleconsultations with the use of teleconferencing technology. , 1997, Journal of the American Academy of Dermatology.

[7]  E Krupinski,et al.  Evaluation of a digital camera for acquiring radiographic images for telemedicine applications. , 2000, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[8]  C Sneiderman,et al.  A comparison of JPEG and FIF compression of color medical images for dermatology. , 1994, Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society.

[9]  Perednia Da,et al.  Teledermatology: one application of telemedicine. , 1995 .

[10]  D. Eedy,et al.  Effect of camera performance on diagnostic accuracy: preliminary results from the Northern Ireland arms of the UK Multicentre Teledermatology Trial , 1997, Journal of telemedicine and telecare.

[11]  P V Harrison,et al.  A portable digital imaging system in dermatology: Diagnostic and educational applications , 1997, Journal of telemedicine and telecare.

[12]  D A Perednia,et al.  Variability in physician assessment of lesions in cutaneous images and its implications for skin screening and computer-assisted diagnosis. , 1992, Archives of dermatology.

[13]  R S Weinstein,et al.  Static image telepathology in perspective. , 1996, Human pathology.

[14]  T. Fitzpatrick,et al.  Accuracy of dermatologic diagnosis by television. , 1972, Archives of dermatology.

[15]  R S Weinstein,et al.  Diagnostic accuracy of an international static-imaging telepathology consultation service. , 1997, Human pathology.

[16]  Jacob Cohen.  A Coefficient of Agreement for Nominal Scales , 1960 .

[17]  Elizabeth A. Krupinski,et al.  Teleradiology in rural Arizona: user's perspective , 1997, Medical Imaging.

[18]  M Rademaker,et al.  Diagnostic accuracy of teledermatology: results of a preliminary study in New Zealand. , 1997, The New Zealand medical journal.

[19]  J. Dover,et al.  The substitution of digital images for dermatologic physical examination. , 1997, Archives of dermatology.

[20]  C A Sneiderman,et al.  How dermatologists perceive CRT displays and silver halide prints of transparency-based images: a comparison study. , 1994, Journal of biological photography.

[21]  S. Burgiss,et al.  Telemedicine for dermatology care in rural patients. , 1997, Telemedicine journal : the official journal of the American Telemedicine Association.

[22]  M. Goldyne,et al.  Evaluation of an asynchronous teleconsultation system for diagnosis of skin cancer and other skin diseases. , 2000, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[23]  D A Perednia,et al.  Comparison of the clinical informativeness of photographs and digital imaging media with multiple-choice receiver operating characteristic analysis. , 1995, Archives of dermatology.

[24]  R. M. Strickland,et al.  Dermatology screening with telemedicine. , 1996, The Journal of family practice.

[25]  E G Tangalos,et al.  Delivery of health care to the underserved: potential contributions of telecommunications technology. Consensus conference entitled "Telemedicine and Access to Care.". , 1994, Mayo Clinic proceedings.

[26]  D. Perednia.  Fear, loathing, dermatology, and telemedicine. , 1997, Archives of dermatology.

[27]  R. Weinstein,et al.  Telepathology: a ten-year progress report. , 1997, Human pathology.

[28]  D. Eedy,et al.  Preliminary results from the Northern Ireland arms of the UK Multicentre Teledermatology Trial: Effect of camera performance on diagnostic accuracy , 1997, Journal of telemedicine and telecare.

[29]  B. Berman,et al.  Teledermatology and underserved populations. , 1997, Archives of dermatology.