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智能手机皮肤镜转诊:一种改善皮肤癌患者分诊的新流程。

Smartphone teledermoscopy referrals: a novel process for improved triage of skin cancer patients.

作者信息

Börve Alexander, Dahlén Gyllencreutz Johan, Terstappen Karin, Johansson Backman Eva, Aldenbratt Anette, Danielsson Markus, Gillstedt Martin, Sandberg Carin, Paoli John

出版信息

Acta Derm Venereol. 2015 Feb;95(2):186-90. doi: 10.2340/00015555-1906.

Abstract

In this open, controlled, multicentre and prospective observational study, smartphone teledermoscopy referrals were sent from 20 primary healthcare centres to 2 dermatology departments for triage of skin lesions of concern using a smartphone application and a compatible digital dermoscope. The outcome for 816 patients referred via smartphone teledermoscopy was compared with 746 patients referred via the traditional paper-based system. When surgical treatment was required, the waiting time was significantly shorter using teledermoscopy for patients with melanoma, melanoma in situ, squamous cell carcinoma, squamous cell carcinoma in situ and basal cell carcinoma. Triage decisions were also more reliable with teledermoscopy and over 40% of the teledermoscopy patients could potentially have avoided face-to-face visits. Only 4 teledermoscopy referrals (0.4%) had to be excluded due to poor image quality. Smartphone teledermoscopy referrals allow for faster and more efficient management of patients with skin cancer as compared to traditional paper referrals.

摘要

在这项开放、对照、多中心前瞻性观察性研究中,20个基层医疗中心通过一款智能手机应用程序和一台兼容的数字皮肤镜,将智能手机皮肤镜转诊病例发送至2个皮肤科进行可疑皮肤病变的分诊。将816例通过智能手机皮肤镜转诊的患者的结果与746例通过传统纸质系统转诊的患者进行比较。当需要手术治疗时,对于黑色素瘤、原位黑色素瘤、鳞状细胞癌、原位鳞状细胞癌和基底细胞癌患者,使用皮肤镜检查时的等待时间显著缩短。皮肤镜检查的分诊决策也更可靠,超过40%的皮肤镜检查患者可能避免了面对面就诊。由于图像质量差,只有4例皮肤镜转诊病例(0.4%)被排除。与传统纸质转诊相比,智能手机皮肤镜转诊能更快、更有效地管理皮肤癌患者。

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