دورية أكاديمية
Quality and Perceived Usefulness of Patient-Submitted Store-and-Forward Teledermatology Images.
| العنوان: | Quality and Perceived Usefulness of Patient-Submitted Store-and-Forward Teledermatology Images. |
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| المؤلفون: | Jiang SW; Department of Dermatology, Duke University School of Medicine, Durham, North Carolina., Flynn MS; Department of Dermatology, Duke University School of Medicine, Durham, North Carolina., Kwock JT; Department of Dermatology, Duke University School of Medicine, Durham, North Carolina., Liu B; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina., Quow K; Department of Dermatology, Duke University School of Medicine, Durham, North Carolina., Blanchard SK; Department of Dermatology, Duke University School of Medicine, Durham, North Carolina., Breglio KF; Department of Dermatology, Duke University School of Medicine, Durham, North Carolina., Fresco A; Department of Dermatology, Duke University School of Medicine, Durham, North Carolina., Jamison MO; Department of Dermatology, Duke University School of Medicine, Durham, North Carolina., Lesesky E; Department of Dermatology, Duke University School of Medicine, Durham, North Carolina., Bellet JS; Department of Dermatology, Duke University School of Medicine, Durham, North Carolina.; Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina., Green CL; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina., Shearer SM; Department of Dermatology, Duke University School of Medicine, Durham, North Carolina., Nicholas MW; Department of Dermatology, Duke University School of Medicine, Durham, North Carolina. |
| المصدر: | JAMA dermatology [JAMA Dermatol] 2022 Oct 01; Vol. 158 (10), pp. 1183-1186. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Medical Association Country of Publication: United States NLM ID: 101589530 Publication Model: Print Cited Medium: Internet ISSN: 2168-6084 (Electronic) Linking ISSN: 21686068 NLM ISO Abbreviation: JAMA Dermatol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Chicago, IL : American Medical Association, [2013]- |
| مواضيع طبية MeSH: | Dermatology*/methods , Skin Diseases*/diagnosis , Remote Consultation* , Telemedicine*/methods, Humans ; Health Personnel |
| مستخلص: | Importance: Patient-submitted images vary considerably in quality and usefulness. Studies that characterize patient-submitted images in a real-life setting are lacking. Objective: To evaluate the quality and perceived usefulness of patient-submitted images as determined by dermatologists and characterize agreement of their responses. Design, Setting, and Participants: This survey study included patient images submitted to the Department of Dermatology at Duke University (Durham, North Carolina) between August 1, 2018, and December 31, 2019. From a total pool of 1200 images, 10 dermatologists evaluated 200 or 400 images each, with every image being evaluated by 3 dermatologists. Data analysis occurred during the year leading up to the article being written. Main Outcomes and Measures: The primary outcomes were the responses to 2 questions and were analyzed using frequency counts and interrater agreement (Fleiss κ) to assess image quality and perceived usefulness. We performed a random-effects logistic regression model to investigate factors associated with evaluators' decision-making comfort. We hypothesized that most images would be of low quality and perceived usefulness, and that interrater agreement would be poor. Results: A total of 259 of 2915 patient-submitted images (8.9%) did not depict a skin condition at all. The final analysis comprised 3600 unique image evaluations. Dermatologist evaluators indicated that 1985 images (55.1%) were useful for medical decision-making and 2239 (62.2%) were of sufficient quality. Interrater agreement for a given image's diagnostic categorization was fair to substantial (κ range, 0.36-0.64), while agreement on image quality (κ range, 0.35-0.47) and perceived usefulness (κ range, 0.29-0.38) were fair to moderate. Senior faculty had higher odds of feeling comfortable with medical decision-making than junior faculty (odds ratio [OR], 3.68; 95% CI, 2.9-4.66; P < .001) and residents (OR, 5.55; 95% CI, 4.38-7.04; P < .001). Images depicting wounds (OR, 1.75; 95% CI, 1.18-2.58; P = .01) compared with inflammatory skin conditions and that were in focus (OR, 5.56; 95% CI, 4.63-6.67; P < .001) had higher odds of being considered useful for decision-making. Conclusions and Relevance: In this survey study including 10 dermatologists, a slight majority of patient-submitted images were judged to be of adequate quality and perceived usefulness. Fair agreement between dermatologists was found regarding image quality and perceived usefulness, suggesting that store-and-forward teledermatology initiatives should consider a physician's individual experiences and comfort level. The study results suggest that images are most likely to be useful when they are in focus and reviewed by experienced attending physicians for wound surveillance, but dermatologists may be burdened by irrelevant or unsuitable images. |
| تواريخ الأحداث: | Date Created: 20220727 Date Completed: 20221021 Latest Revision: 20230728 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC9330374 |
| DOI: | 10.1001/jamadermatol.2022.2815 |
| PMID: | 35895039 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2168-6084 |
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| DOI: | 10.1001/jamadermatol.2022.2815 |