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远程医疗在特应性皮炎中的准确性和效率。

Accuracy and efficiency of telemedicine in atopic dermatitis.

作者信息

Giavina-Bianchi Mara, Giavina-Bianchi Pedro, Santos Andre Pires, Rizzo Luiz Vicente, Cordioli Eduardo

机构信息

Department of Telemedicine, Hospital Israelita Albert Einstein, São Paulo, Brazil.

Clinical Immunology and Allergy Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

出版信息

JAAD Int. 2020 Oct 1;1(2):175-181. doi: 10.1016/j.jdin.2020.08.002. eCollection 2020 Dec.

Abstract

BACKGROUND

Telemedicine provides accurate diagnoses for skin disorders and has gained emphasis. It may be used for the triage and management of common skin diseases in primary care, improving patients' access and reducing time to treatment.

OBJECTIVE

To evaluate the proportion of atopic dermatitis patients who could be managed with the support of telemedicine and its accuracy. Second, we aimed to assess the frequency of atopic dermatitis, demographics, clinical features, and therapies dispensed in relation to the disease.

METHODS

Retrospective study in a population of 30,976 individuals, assisted by telemedicine. We assessed patients with the diagnosis of atopic dermatitis and evaluated the proportion of cases referred to biopsy, in-person dermatologists, or to be managed by primary care; the treatments suggested; and telemedicine accuracy to diagnose atopic dermatitis.

RESULTS

Atopic dermatitis was diagnosed in 1648 patients (5.3%), the sixth most common dermatosis, with 2058 lesions (3.7%) analyzed. Primary care physicians were able to manage 72% of the atopic dermatitis patients, whereas 28% of them were referred to in-person dermatologists. Accuracy for atopic dermatitis diagnosis was 84.4%.

CONCLUSION

Telemedicine was an accurate method and helped primary care physicians to treat 72% of the atopic dermatitis lesions, thereby optimizing the availability of in-person appointments with dermatologists for more severe cases.

摘要

背景

远程医疗可为皮肤疾病提供准确诊断,已受到重视。它可用于基层医疗中常见皮肤病的分诊和管理,改善患者就医途径并缩短治疗时间。

目的

评估在远程医疗支持下可得到管理的特应性皮炎患者比例及其准确性。其次,我们旨在评估特应性皮炎的发病率、人口统计学特征、临床特征以及与该疾病相关的治疗方法。

方法

在30976人的人群中进行回顾性研究,借助远程医疗。我们评估了诊断为特应性皮炎的患者,评估了转诊进行活检、面诊皮肤科医生或由基层医疗管理的病例比例;建议的治疗方法;以及远程医疗诊断特应性皮炎的准确性。

结果

1648例患者(5.3%)被诊断为特应性皮炎,是第六大常见皮肤病,共分析了2058处皮损(3.7%)。基层医疗医生能够管理72%的特应性皮炎患者,而其中28%的患者被转诊至面诊皮肤科医生处。特应性皮炎诊断的准确率为84.4%。

结论

远程医疗是一种准确的方法,帮助基层医疗医生治疗了72%的特应性皮炎皮损,从而优化了为更严重病例安排的面诊皮肤科医生的就诊机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f05/8361877/45f8318f7dd8/gr1.jpg

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