Department of Stomatology, School of Dentistry, Federal University of Paraná, Curitiba, Paraná, Brazil.
Department of Clinic and Preventive Dentistry, School of Dentistry, Federal University of Pernambuco, Recife, Pernambuco, Brazil.
Oral Dis. 2022 Sep;28(6):1573-1579. doi: 10.1111/odi.13972. Epub 2021 Aug 6.
The objective of this observational study was to evaluate telediagnosis of oral lesions using smartphone photography.
Individuals with visible oral lesions composed a convenience sample. The lesions were photographed using a smartphone camera and emailed along with clinical information to three evaluators, who formulated up to two diagnostic hypotheses for each case. A total of 235 photographs from 113 clinical cases were obtained. The evaluators answered questions regarding referral decisions, requests for additional tests, diagnostic difficulties, and image quality. The diagnostic hypotheses were compared to the gold standard by means of percent agreement and kappa coefficient. Consensual face-to-face diagnoses of three specialists-when only a clinical diagnosis was necessary-or histopathological results-when a biopsy was necessary-were considered the gold standard.
The telediagnosis was similar to the gold standard in 76% of the cases, and kappa coefficients showed almost perfect agreement (k = 0.817-0.903). The evaluators considered that referrals could have been avoided on an average of 35,4% of the cases.
Diagnosis of oral lesions using images taken with a smartphone showed almost perfect agreement and diagnostic accuracy comparable to face-to-face diagnosis.
本观察性研究的目的是评估使用智能手机摄影进行口腔病变的远程诊断。
有可见口腔病变的个体组成了便利样本。使用智能手机摄像头拍摄病变，并将临床信息连同照片一起通过电子邮件发送给三位评估者，每位评估者为每个病例制定最多两个诊断假设。共获得了 113 例临床病例的 235 张照片。评估者回答了关于转诊决策、额外检查请求、诊断困难和图像质量的问题。通过百分比一致性和 Kappa 系数将诊断假设与金标准进行比较。当仅需要临床诊断时，三位专家进行共识性面对面诊断，或者当需要活检时，则以组织病理学结果作为金标准。
远程诊断与金标准在 76%的病例中相似，Kappa 系数显示出几乎完美的一致性（k=0.817-0.903）。评估者认为，平均有 35.4%的病例可以避免转诊。
使用智能手机拍摄的图像进行口腔病变诊断具有几乎完美的一致性和与面对面诊断相当的诊断准确性。
