Teledermatology for diagnosis and management of skin conditions: A systematic review - 10/08/11
, Yonatan J. Hillman, BA a, Nancy L. Greer, PhD a, Emily M. Hagel, MS a, Roderick MacDonald, MS a, Indulis R. Rutks, BS a, Timothy J. Wilt, MD, MPH a, c
Correspondence to: Erin M. Warshaw, MD, MS, Dept 111 K, Veterans Affairs Medical Center, 1 Veterans Dr, Minneapolis, MN 55417.Abstract |
Objective |
We performed a systematic review of the literature addressing teledermatology: (1) diagnostic accuracy/concordance; (2) management accuracy/concordance; (3) clinical outcomes; and (4) costs.
Methods |
Peer-reviewed controlled trials published in English between 1990 and 2009 were identified through MEDLINE and PubMed searches.
Results |
Of 78 included studies, approximately two-thirds comparing teledermatology and clinic dermatology found better diagnostic accuracy with clinic dermatology. Diagnostic concordance of store and forward with clinic dermatology was good; concordance rates for live interactive and clinic dermatology were higher, but based on fewer patients. Overall rates of management accuracy were equivalent, but teledermatology and teledermatoscopy were inferior to clinic dermatology for malignant lesions. Management concordance was fair to excellent. There was insufficient evidence to evaluate clinical course outcomes. Patient satisfaction and preferences were comparable. Teledermatology reduced time to treatment and clinic visits and was cost-effective if certain assumptions were met.
Limitations |
Heterogeneity in studies (design, skin conditions, outcomes) limited the ability to pool data.
Conclusion |
The benefits of teledermatology need to be evaluated in the context of potential limitations.
Le texte complet de cet article est disponible en PDF.Key words : clinical outcomes, diagnostic accuracy, diagnostic concordance, live interactive, management accuracy, management concordance, store and forward, teledermatology
Abbreviations used : LI, SAF, TEP, VA
Plan
| This material is based on work supported, in part, by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Evidence Synthesis Program, Project #09-009. The full report is available at: esp/. |
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| Conflicts of interest: None declared. |
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| The views expressed in this article are those of the authors and do not necessarily represent the position or policy of the Department of Veterans Affairs or the US government. |
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| Reprints not available from the authors. |
Vol 64 - N° 4
P. 759 - avril 2011 Retour au numéro
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