Diagnostic Accuracy of Pediatric Teledermatology Using Parent-Submitted Photographs

作者：Daniel O’Connor, Olivia S. Jew, Marissa J. Perman, Leslie Castelo‐Soccio, Flaura K. Winston, Patrick J. McMahon · 发表于：JAMA Dermatology · 年份：2017 · DOI：10.1001/jamadermatol.2017.4280 · 被引用次数：91 · 研究领域：Digital Imaging in Medicine、Pediatric Pain Management Techniques、Telemedicine and Telehealth Implementation

Importance: Advances in smartphone photography (both quality and image transmission) may improve access to care via direct parent-to-clinician telemedicine. However, the accuracy of diagnoses that are reliant on parent-provided photographs has not been formally compared with diagnoses made in person. Objective: To assess whether smartphone photographs of pediatric skin conditions taken by parents are of sufficient quality to permit accurate diagnosis. Design, Setting, and Participants: A prospective study was conducted among 40 patient-parent dyads at a pediatric dermatology clinic at the Children's Hospital of Philadelphia from March 1 to September 30, 2016, to assess concordance between diagnoses made by an independent pediatric dermatologist based on in-person examination and those based on parental photographs. Half of the patient-parent dyads were randomized for a secondary analysis to receive instructions on how best to take photographs with smartphones. Clinicians were blinded to whether parents had received photography instructions. Exposures: Half of the patient-parent dyads received a simple, 3-step instruction sheet on how best to take photographs using a smartphone (intervention group); the other half did not (control group). Main Outcomes and Measures: Concordance between photograph-based vs in-person diagnosis in the intervention vs control groups, as quantified using Cohen κ, a measure of interrater agreement that takes into account the possibility of agreement...