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社交媒体上的远程医疗与远程皮肤病学中心的诊断一致性。

Diagnostic Agreement Between Telemedicine on Social Networks and Teledermatology Centers.

机构信息

Department of General Medicine, University of Paris, Paris, France.

Department of General Medicine, University of Paris, Paris, France

出版信息

Ann Fam Med. 2021 Jan-Feb;19(1):24-29. doi: 10.1370/afm.2608.

Abstract

PURPOSE

With increasing delays in obtaining a dermatological consultation, general practitioners (GPs) are using social networks for telemedicine to obtain advice on dermatological images. The objective was to analyze diagnostic agreement between telemedicine on social networks (Twitter and MedPics) and standard teledermatology services (TDS).

METHODS

This retrospective observational study included images published on Twitter and MedPics by GPs in 2016. The contextualized images were evaluated by 2 teledermatology services in Paris, France and an expert committee. Diagnoses obtained from telemedicine on social networks, TDS, and the expert committee were collected for each image. The agreement between the diagnoses made on social networks and by TDS was measured using Cohen statistic. The number of correct diagnoses obtained using social networks and TDS as determined by agreement with the expert's diagnoses were compared with tests.

RESULTS

Two hundred and seventy health professionals responded to the 60 selected images from social networks. The main diagnoses, according to the experts were: purpura (8.3%), eczema (6.7%), mycosis (6.7%), and viral infections (6.7%). Diagnostic agreement between telemedicine on social networks and TDS was moderate over the entire set of images ( = 0.55; 95% CI, 0.42-0.68) and good for images containing dermatologist's answers ( = 0.63; 95% CI, 0.45-0.85). The number of correct diagnoses was not statistically different between telemedicine on social networks and TDS on all images (60% vs 55%; = .28) but was higher on social networks when a dermatologist answered (65% vs 55%; <.01).

CONCLUSIONS

Diagnostic agreement using social network images showed that use of this telemedicine tool could be a reliable means to alleviate the difficulties of accessing dermatology consultations although data safety probably needs to be improved.

摘要

目的

随着皮肤科咨询的延误越来越多,全科医生(GP)正在使用社交网络进行远程医疗,以获取皮肤科图像的建议。目的是分析社交网络(Twitter 和 MedPics)上的远程医疗与标准远程皮肤病学服务(TDS)之间的诊断一致性。

方法

本回顾性观察研究包括 2016 年全科医生在 Twitter 和 MedPics 上发布的图像。由法国巴黎的 2 个远程皮肤病学服务和一个专家委员会对上下文图像进行评估。为每张图像收集了从社交网络、TDS 和专家委员会获得的诊断。使用 Cohen 统计量测量从社交网络和 TDS 获得的诊断之间的一致性。使用 检验比较通过与专家诊断的一致性获得的使用社交网络和 TDS 的正确诊断数量。

结果

270 名卫生专业人员对来自社交网络的 60 张精选图像做出了回应。根据专家的说法,主要诊断是:紫癜(8.3%)、湿疹(6.7%)、真菌感染(6.7%)和病毒感染(6.7%)。整个图像集的社交网络远程医疗和 TDS 之间的诊断一致性为中度( = 0.55;95%CI,0.42-0.68),对于包含皮肤科医生答案的图像则为良好( = 0.63;95%CI,0.45-0.85)。在所有图像上,社交网络远程医疗的正确诊断数量与 TDS 没有统计学差异(60%与 55%; =.28),但当皮肤科医生回答时,社交网络上的诊断数量更高(65%与 55%;<.01)。

结论

使用社交网络图像的诊断一致性表明,尽管数据安全性可能需要提高,但使用这种远程医疗工具可以成为缓解皮肤科咨询困难的可靠手段。

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本文引用的文献

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[Medicine on Twitter: A question of confraternity or a danger?].[推特上的医学:是兄弟情谊的问题还是一种危险?]
Ann Dermatol Venereol. 2020 Sep;147(8-9):491-493. doi: 10.1016/j.annder.2020.04.001. Epub 2020 May 12.
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Application of mobile teledermatology for skin cancer screening.移动远程皮肤病学在皮肤癌筛查中的应用。
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