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Teledermatology Has Good Concordance for Diagnosis, Management

Agreement was almost perfect for imaging decisions and for treatment, but no agreement seen for follow-up planning

By Dermsquared Editorial Team | May 19, 2021

Teledermatology seems to be effective in the inpatient setting, with good concordance for diagnosis, evaluation, and management decisions, according to a study published in the June issue of the Journal of the American Academy of Dermatology.

Colleen K. Gabel, from Massachusetts General Hospital in Boston, and colleagues conducted a prospective study using internal medicine referral documentation and photographs to examine the ability of teledermatology to help diagnose disease and manage 41 dermatology consultations from a large urban tertiary care center.

The researchers found considerable agreement between in-person and teledermatology assessment of the diagnosis with differential diagnosis, substantial agreement in pursuing additional laboratory evaluation, near-perfect agreement for imaging decisions, and moderate agreement for the decision to biopsy (median κ = 0.830.67, 1.0, and 0.43, respectively). For treatment, agreement was almost perfect (median κ = 1.0), but follow-up planning showed no agreement (median κ = 0.0). No correlation was seen between raw photograph quality and the primary plus differential diagnosis or primary diagnosis alone.

"Teledermatology may be effective for managing dermatologic disease in the inpatient setting and leads to highly concordant diagnostic, evaluation, and management decisions when performed by experienced inpatient dermatologists," the authors write. "This may represent a novel and effective option for community hospitals and may be particularly applicable during times of concern for spread of infectious disease."

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