Store-and-forward teledermatology versus in-person visits: a comparison in pediatric teledermatology clinic. J Am Acad Dermatol 2009 Jun;60(6):956-61
Date
04/14/2009Pubmed ID
19362751DOI
10.1016/j.jaad.2008.11.026Scopus ID
2-s2.0-67349196747 (requires institutional sign-in at Scopus site) 71 CitationsAbstract
BACKGROUND: The role of teledermatology in the diagnosis of pediatric skin conditions has not been studied exclusively.
OBJECTIVE: To determine the ability of a pediatric dermatologist to correctly diagnose rashes by history and digital images.
METHODS: Consecutive, new referrals to the pediatric dermatology clinic with a rash were enrolled in the study. A history, demographic data, and digital photographs were obtained from each patient. The data were reviewed by a pediatric dermatologist who made a preliminary diagnosis. The child was then seen in person and a final diagnosis was made. Concordance and kappa values were calculated. Cases of diagnostic disagreement were analyzed for their effect on management.
RESULTS: One hundred thirty-five patients were enrolled. Diagnostic concordance was 82% (95% confidence interval [CI], 73%-88%), and the kappa value was 0.80. Clinically relevant disagreement occurred in 12% of cases.
LIMITATIONS: The study was performed at a single site, theoretically limiting generalizability.
CONCLUSION: Teledermatology appears to have a useful role in the care of children with rashes.
Author List
Heffner VA, Lyon VB, Brousseau DC, Holland KE, Yen KAuthors
Viday Heffner MD Associate Professor in the Pediatrics department at Medical College of WisconsinKristen E. Holland MD Associate Professor in the Dermatology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentChild
Child, Preschool
Computers
Exanthema
Female
Humans
Infant
Male
Observer Variation
Telemedicine
