Heffner Viday A, Lyon Valerie B, Brousseau David C, Holland Kristin E, Yen Kenneth
Department of Pediatrics, Section of Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
J Am Acad Dermatol. 2009 Jun;60(6):956-61. doi: 10.1016/j.jaad.2008.11.026. Epub 2009 Apr 11.
The role of teledermatology in the diagnosis of pediatric skin conditions has not been studied exclusively.
To determine the ability of a pediatric dermatologist to correctly diagnose rashes by history and digital images.
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.
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.
The study was performed at a single site, theoretically limiting generalizability.
Teledermatology appears to have a useful role in the care of children with rashes.
远程皮肤病学在儿科皮肤病诊断中的作用尚未得到专门研究。
确定儿科皮肤科医生通过病史和数字图像正确诊断皮疹的能力。
连续纳入转诊至儿科皮肤科门诊的新发皮疹患儿进行研究。收集每位患者的病史、人口统计学数据和数字照片。由儿科皮肤科医生对数据进行审查并做出初步诊断。然后对患儿进行面诊并做出最终诊断。计算一致性和kappa值。分析诊断不一致的病例对治疗的影响。
共纳入135例患者。诊断一致性为82%（95%置信区间[CI]，73%-88%），kappa值为0.80。12%的病例出现临床相关的诊断不一致。
该研究在单一地点进行，理论上限制了可推广性。
远程皮肤病学在皮疹患儿的护理中似乎具有有用的作用。
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