Du Moulin M F M T, Bullens-Goessens Y I J M, Henquet C J M, Brunenberg D E M, de Bruyn-Geraerds D P, Winkens R A G, Dirksen C D, Vierhout W P M, Neumann H A M
Transmural Care Unit (Bze VII), University Hospital Maastricht, The Netherlands.
J Telemed Telecare. 2003;9(5):249-52. doi: 10.1258/135763303769211247.
We compared diagnoses made by a teledermatologist from digital photographs and patient histories sent from general practitioners using a store-and-forward technique and those made by another dermatologist in a face-to-face consultation with the same patients. A total of 117 patients (mean age 47 years) were referred by 18 general practitioners for diagnosis of a skin condition. Between one and seven digital images were transmitted per case. In 31% of the cases, three images were transmitted. There was full concordance between store-and-forward and face-to-face diagnoses in 57 of 106 cases (54%); in 10 cases (9%) there was overlap between the differential diagnoses provided by the teledermatologist and the face-to-face consultant. Diagnostic categories with relatively high concordances were eczema and follicular eruptions. General practitioners need to be trained in the making of digital images and in giving a good patient history.
我们比较了远程皮肤科医生根据全科医生采用存储转发技术发送的数码照片和患者病史做出的诊断，以及另一位皮肤科医生与相同患者进行面对面会诊后做出的诊断。共有117名患者（平均年龄47岁）由18名全科医生转诊来诊断皮肤疾病。每个病例传输了1至7张数码图像。在31%的病例中，传输了3张图像。106例中有57例（54%）存储转发诊断与面对面诊断完全一致；10例（9%）中，远程皮肤科医生和面对面会诊医生提供的鉴别诊断存在重叠。一致性相对较高的诊断类别是湿疹和毛囊疹。全科医生需要接受制作数码图像和提供详细患者病史方面的培训。
