التفاصيل البيبلوغرافية
| العنوان: |
Comparative effectiveness study of face-to-face and teledermatology workflows for diagnosing skin cancer. |
| المؤلفون: |
Marwaha, S, Fevrier, H B, Alexeeff, S E, Crowley, E, Haiman, M, Pham, N, Tuerk, M J, Wukda, D, Hartmann, M, Herrinton, L J, Marwaha, Sangeeta S, Fevrier, Helene, Alexeeff, Stacey, Crowley, Eileen, Haiman, Michael, Pham, Ngoc, Tuerk, Melanie J, Wukda, Danny, Hartmann, Michael, Herrinton, Lisa J |
| المصدر: |
Journal of the American Academy of Dermatology; Feb2019, Vol. 80 Issue 2, pN.PAG-N.PAG, 1p |
| مستخلص: |
Background: The effectiveness and value of teledermatology and face-to-face workflows for diagnosing lesions are not adequately understood.Objective: We compared the risks of biopsy and cancer diagnosis among 2 face-to-face workflows (direct referral and roving dermatologist) and 4 teledermatology workflows.Methods: Retrospective study of 59,279 primary care patients presenting with a lesion from January through June 2017.Results: One teledermatology workflow achieved high-resolution images with use of a dermatoscope-fitted digital camera, a picture archiving and communication system, and image retrieval to a large computer monitor (in contrast to a smartphone screen). Compared with direct referral, this workflow was associated with a 9% greater probability of cancer detection (95% confidence interval [CI], 2%-16%), a 4% lower probability of biopsy (relative risk, 0.96; 95% CI, 0.93-0.99), and 39% fewer face-to-face visits (relative risk, 0.61; 95% CI, 0.57-0.65). Other workflows were less effective.Limitations: Differing proficiencies across teledermatology workflows and selection of patients for direct referral could have caused bias.Conclusion: Implementation is critical to the effectiveness of teledermatology. [ABSTRACT FROM AUTHOR] |
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