Ebner Christoph, Wurm Elisabeth Mt, Binder Barbara, Kittler Harald, Lozzi Gian Piero, Massone Cesare, Gabler Gerald, Hofmann-Wellenhof Rainer, Soyer H Peter
Department of Dermatology, Medical University of Graz, Graz, Austria.
J Telemed Telecare. 2008;14(1):2-7. doi: 10.1258/jtt.2007.070302.
We investigated the diagnostic agreement between teledermatology based on images from a mobile phone camera and face-to-face (FTF) dermatology. Diagnostic agreement was assessed for two teledermatologists (TD) in comparison with FTF consultations in 58 subjects. In almost three-quarters of the cases (TD1: 71%; TD2: 76%), the telediagnosis was fully concordant with the FTF diagnosis. Furthermore, the diagnosed diseases were almost all in the same diagnostic category (TD1: 97%; TD2: 90%). If mobile teledermatology had been used for remote triage, TD1 could have treated 53% subjects remotely and 47% subjects would have had to consult a dermatologist FTF. TD2 could have treated 59% subjects remotely, whereas 41% subjects would have had to consult a dermatologist FTF. Forty-eight subjects responded to a questionnaire, of whom only 10 had any concerns regarding teledermatology. Thirty-one subjects stated that they would be willing to pay to use a similar service in future and suggested an amount ranging from euro5 to euro50 per consultation (mean euro22) (euro = pound0.7, US $1.4). These results are encouraging as patient acceptance and reimbursement represent potential obstacles to the implementation of telemedicine services.
我们研究了基于手机摄像头图像的远程皮肤病学与面对面皮肤病学之间的诊断一致性。将两名远程皮肤科医生(TD)的诊断一致性与58名受试者的面对面会诊进行了比较。在近四分之三的病例中(TD1:71%;TD2:76%),远程诊断与面对面诊断完全一致。此外,诊断出的疾病几乎都属于同一诊断类别(TD1:97%;TD2:90%)。如果使用移动远程皮肤病学进行远程分诊,TD1可以远程治疗53%的受试者,47%的受试者将不得不去看皮肤科医生进行面对面会诊。TD2可以远程治疗59%的受试者,而41%的受试者将不得不去看皮肤科医生进行面对面会诊。48名受试者回答了一份问卷,其中只有10人对远程皮肤病学有任何担忧。31名受试者表示他们愿意在未来付费使用类似服务,并建议每次会诊的费用在5欧元至50欧元之间(平均22欧元)(1欧元 = 0.7英镑,1.4美元)。这些结果令人鼓舞,因为患者接受度和报销是远程医疗服务实施的潜在障碍。