Department of Dermatology, Division of General Dermatology, Medical University of Vienna, Austria.
J Telemed Telecare. 2013 Jun;19(4):213-8. doi: 10.1177/1357633x13490890. Epub 2013 Jun 14.
We evaluated the accuracy of diagnoses made from pictures taken with the built-in cameras of mobile phones in a 'real-life' clinical setting. A total of 263 patients took part, who photographed their own lesions where possible, and provided clinical information via a questionnaire. After the teledermatology procedure, each patient was examined face-to-face and a gold standard diagnosis was made. The telemedicine data and pictures were diagnosed by 15 dermatologists. The 299 cases contained 1-22 clinical images each (median 3). Nine dermatologists finished all the cases and the remaining six completed some of them, thus providing 2893 decisions. Overall, 61% of all cases were rated as possible to diagnose and of those, 80% were correct in comparison with the face-to-face diagnosis. Image quality was evaluated and the median was 5 on a 10-point scale. There was a significant correlation between the correct diagnosis and the quality of the photographs taken (P < 0.001). In nearly two-thirds of all cases, a teledermatology diagnosis was possible; however, there was insufficient information to make a telemedicine diagnosis in about one-third of the cases. If applied carefully, mobile phones could be a powerful tool for people to optimize their health care status.
我们评估了在“真实生活”临床环境中使用手机内置摄像头拍摄的照片进行诊断的准确性。共有 263 名患者参与,他们尽可能地拍摄自己的病变部位,并通过问卷提供临床信息。远程皮肤病学程序完成后,对每位患者进行面对面检查,并做出金标准诊断。15 名皮肤科医生对远程医疗数据和图片进行诊断。299 例包含 1-22 张临床图像(中位数为 3 张)。9 名皮肤科医生完成了所有病例,其余 6 名完成了部分病例,因此提供了 2893 个决策。总体而言,61%的病例被认为可以诊断,其中 80%的病例与面对面诊断相比是正确的。对图像质量进行了评估,中位数为 10 分制的 5 分。正确诊断与拍摄照片的质量之间存在显著相关性(P < 0.001)。在近三分之二的病例中,可以进行远程皮肤病学诊断;然而,大约三分之一的病例中,信息不足无法进行远程医疗诊断。如果谨慎应用,手机可以成为人们优化医疗保健状况的有力工具。