Stromatology Department and Post-Graduate Program in Dentistry, Federal University of Paraná, Curitiba, Paraná, Brazil.
Telemed J E Health. 2013 Feb;19(2):117-21. doi: 10.1089/tmj.2012.0087. Epub 2013 Jan 28.
The purpose of this study was to evaluate the applicability of telediagnosis in oral medicine, through the transmission of clinical digital images by e-mail.
The sample included 60 consecutive patients who sought oral medicine services at the Federal University of Paraná, in the state of Paraná, located in southern Brazil. The clinical history and oral lesion images were recorded using clinical electronic charts and a digital camera, respectively, and sent by e-mail to two oral medicine consultants. The consultants provided a maximum of two clinical hypotheses for each case, which were compared with biopsy results that served as the gold standard.
In 31 of the 60 cases (51.7%), both consultants made the correct diagnosis; in 17 cases (28.3%), only one consultant made the correct diagnosis; and in 12 cases (20%), neither consultant made the correct diagnosis. Therefore, in 80% of cases, at least one consultant provided the correct diagnosis. The agreement between the first consultant and the gold standard was substantial (κ=0.669), and the agreement between the second consultant and the gold standard was fair (κ=0.574).
The use of information technology can increase the accuracy of consultations in oral medicine. As expected, the participation of two remote experts increased the possibility of correct diagnosis.
本研究旨在通过电子邮件传输临床数字图像来评估远程诊断在口腔医学中的适用性。
本研究纳入了 60 名连续就诊于巴西南部巴拉那州联邦大学口腔医学科的患者。使用临床电子病历记录临床病史，使用数码相机拍摄口腔病变图像，并通过电子邮件发送给两位口腔医学顾问。每位顾问最多为每个病例提供两个临床假设，并将其与作为金标准的活检结果进行比较。
在 60 例病例中，有 31 例（51.7%）两位顾问均做出了正确诊断；17 例（28.3%）仅一位顾问做出了正确诊断；12 例（20%）两位顾问均未做出正确诊断。因此，在 80%的病例中，至少有一位顾问做出了正确诊断。第一位顾问与金标准的一致性为中等（κ=0.669），第二位顾问与金标准的一致性为适度（κ=0.574）。
信息技术的使用可以提高口腔医学咨询的准确性。不出所料，两位远程专家的参与增加了正确诊断的可能性。
