Pak Hon S, Harden David, Cruess David, Welch Mark L, Poropatich Ronald
Department of Dermatology, Brooke Army Medical Center, 3851 Roger Brooke Dr, Bldg 3600, San Antonio, TX 78258, USA.
Cutis. 2003 Jun;71(6):476-80.
This is part II of an intraobserver diagnostic correlation study comparing teledermatology with traditional face-to-face evaluation. Part I discussed the methodology and diagnostic correlation results between teledermatology and in-person consultation (Cutis. 2003;71:399-403). This second part reports the diagnostic certainty level between the 2 groups, which are shown to be significantly different (teledermatology, 7/10; in-person, 9/10). This difference held true in every category of skin condition evaluated (P < or = .0065). Unlike other studies, we found that teledermatologists recommended biopsies 10% more frequently than clinic-based evaluators. We discuss the reasons for the lower diagnostic certainty level of teledermatologists, as well as the limitations of this study. Despite the limitations, we conclude that teledermatology appears to be an effective method of delivering dermatologic care in the appropriate setting.
这是一项观察者内部诊断相关性研究的第二部分,该研究比较了远程皮肤病学与传统面对面评估。第一部分讨论了远程皮肤病学与面对面咨询之间的方法和诊断相关性结果(《皮肤学》,2003年;71:399 - 403)。第二部分报告了两组之间的诊断确定性水平,结果显示存在显著差异(远程皮肤病学组为7/10;面对面组为9/10)。在评估的每一类皮肤疾病中,这种差异均成立(P≤0.0065)。与其他研究不同的是,我们发现远程皮肤病学专家推荐活检的频率比基于诊所的评估者高10%。我们讨论了远程皮肤病学专家诊断确定性水平较低的原因以及本研究的局限性。尽管存在局限性,但我们得出结论,在适当的环境中,远程皮肤病学似乎是提供皮肤病护理的一种有效方法。