Tuknayat Ankita, Bhalla Mala, Dogar Kanika, Thami Gurvinder Pal, Sandhu Jasleen Kaur
All authors are with the Department of Dermatology at the Government Medical College and Hospital in Chandigar, India.
J Clin Aesthet Dermatol. 2023 Apr;16(4):21-25.
The COVID-19 pandemic has shifted healthcare from physical in-person patient visits to teleconsultations in order to curtail the spread of this virus. Dermatology, being a visual science, lends itself amenably to teleconsultation.
This study was performed to assess the basic dermatological diseases which are more easily diagnosable and managed through teleconsultation, distinguishing them from diseases for which a face-to-face consultation may be a better option and to delineate the factors affecting the image quality which is the cornerstone of a teledermatology consultation.
A retrospective observational study was conducted over a three-month period during the pandemic. Store and forward, video conferencing, and hybrid consultations were included. Two dermatologists of different clinical experience independently assessed the clinical photographs of the patients and gave each photograph an objective score (Physician Quality Rating Scale) and a diagnosis. The diagnostic concordance between the two dermatologists as well as the correlation of this score with the certainty of diagnosis was calculated.
A total of 651 patients completed the study. Mean PQRS score of Dermatologist 1 was 6.22 while the mean score of Dermatologist 2 was 6.24. Patients in whom both the dermatologists were absolutely certain about their diagnosis had a higher PQRS score and interestingly had a higher education level than the rest. There was 97.7 percent diagnostic concordance between the two dermatologists. Infections, acne, follicular disorders, pigmentary disorders, tumors, and STDs had the largest proportion of cases wherein both the dermatologists were in total agreement with each other.
Teledermatology might be best for the care of patients with characteristic clinical presentation or for follow-up of already diagnosed patients. It can be used in the post-COVID era to triage patients requiring emergency care and reduce patient wait times.
为遏制新冠病毒传播，新冠疫情已促使医疗保健从面对面的患者就诊转向远程会诊。皮肤科作为一门视觉科学，很适合进行远程会诊。
本研究旨在评估通过远程会诊更易于诊断和管理的基本皮肤科疾病，将它们与更适合面对面会诊的疾病区分开来，并确定影响图像质量的因素，而图像质量是远程皮肤病会诊的基石。
在疫情期间进行了为期三个月的回顾性观察研究。包括存储转发、视频会议和混合会诊。两位临床经验不同的皮肤科医生独立评估患者的临床照片，并给每张照片一个客观评分（医生质量评定量表）和诊断结果。计算两位皮肤科医生之间的诊断一致性以及该评分与诊断确定性的相关性。
共有651名患者完成了研究。皮肤科医生1的平均PQRS评分为6.22，而皮肤科医生2的平均评分为6.24。两位皮肤科医生对诊断都绝对确定的患者PQRS评分更高，有趣的是，他们的教育水平也高于其他患者。两位皮肤科医生之间的诊断一致性为97.7%。感染、痤疮、毛囊疾病、色素沉着疾病、肿瘤和性传播疾病中，两位皮肤科医生完全一致的病例比例最高。
远程皮肤病学可能最适合护理具有典型临床表现的患者或对已确诊患者进行随访。它可用于新冠疫情后的时代，对需要紧急护理的患者进行分诊，并减少患者等待时间。
