Teledermatology – Promising Technique for Improving Access to Care
Telecommunication in dermatology, known as teledermatology, can provide geographically isolated patients access to dermatology care and may be used to triage cases and limit unnecessary referrals to dermatologists. Teledermatology uses two different modalities: live interactive teledermatology, utilizing video-conference equipment, and store-and-forward teledermatology that sends still images to a dermatologist, who reviews and later provides recommendations. This article summarizes the published literature on the reliability and accuracy of teledermatology.
Teledermatology demonstrated good performance in comparison to clinic-based consultation for diagnostic agreement and diagnostic accuracy. Regarding diagnosis, teledermatologists agreed with each other and with clinic-based dermatologists at a rate comparable to group agreement among clinic dermatologists. Regarding accuracy, when compared to the gold standard of histology, rates ranged from 30% to 92% for clinic dermatologists and from 19% to 95% for teledermatologists. The authors suggest that before the widespread implementation of teledermatology, large randomized controlled trials using consistent measures of diagnostic agreement and accuracy for a wide range of skin problems and conditions are necessary to more rigorously quantify its benefits.
Levin Y and Warshaw E. Teledermatology: A review of reliability and accuracy of diagnosis and management. Dermatologic Clinics April 2009;27(2):163-176.
Dr. Warshaw is part of HSR&D’s Center for Chronic Disease Outcomes Research in Minneapolis, MN.