Table 83: Characteristics of the included SAF studies Author, year, Study design, Intervention Technology Who Population Outcomes reported Accuracy Safety Results Conclusion as country objective made the based on outcomes (management) reported in the paper (camera, IT (skin standard images system, quality conditions) (safety, outcomes of pictures, repeated pixels) requests (%), refusals, Store-and-Forward teledermatology with diagnosis accuracy based on histological analysis as an outcome Barnard, A study designed SAF TD (the In Results N/R 8 cancer Concordance was For the 25 Not a part of Not a part of The results show 2000 same images person of cases The determined by the study the study that this application to assess the cases Evaluation of assessed by 5 FTF biopsy, noncancer comparing primary ability of digital camera (including allows levels of an TDs) culture, and differential dermatologists to with a 105-mm cases include the 8 skin accuracy and or wet diagnoses made by lens. A a variety of cancers) concordance evaluate digital (by mount the teleconsultants contained viral, fungal confirmed by images of skin equivalent to those one of on all 50 cases with results or either biopsy cancers as well all 50 clinical obtained with live system for three those made by the (20), culture cases. Each bacterial skin as other skin interactive diagnosis of dermatologists who (1), or wet case was infections, diseases using a teleconsultation skin cancer originally examined mount presented inflammatory store-and-forward systems and other the patients in dermatoses, (4), the through a application. skin person. person reactive diseases. the For eight skin accuracy software dermatoses, Telemed J E case) cancers, the was 84% application. It benign Health diagnostic accuracy compared to tumors, contained a for the in-person 73% (range, number of systemic dermatologist was 65–88%) for digital diseases with USA 88% versus 90% the skin images along (range, 75–100%) with relevant for the vascular text; the teleconsultants. recipient reactions, The concordance opened and one between the disorder of and viewed the person and keratinization application on teleconsultant their personal diagnoses were in desktop agreement 77% computers of the time (90% if (Pentium differential 133MHz or diagnoses were
Table 83: Characteristics of the included SAF studies Author, year, country Study design, objective Intervention standard Technology (camera, IT system, quality of pictures, pixels) Who made the images Population (skin conditions) Outcomes reported Accuracy based on outcomes Safety outcomes (safety, repeated requests (%), refusals, Results (management) Conclusion as reported in the paper Store-and-Forward teledermatology with diagnosis accuracy based on histological analysis as an outcome Barnard, 2000 Evaluation of an system for diagnosis of skin cancer and other skin diseases. Telemed J E Health USA A study designed to assess the ability of dermatologists to evaluate digital images of skin cancers as well as other skin diseases using a store-and-forward application. SAF TD (the same images assessed by 5 TDs) In person FTF (by one of three the case) Results of biopsy, culture, or wet mount results digital camera with a 105-mm lens. A contained all 50 clinical cases. Each case was presented through a software application. It contained a number of digital images along with relevant text; the recipient opened and viewed the application on their personal desktop computers (Pentium 133MHz or N/R 8 cancer cases The noncancer cases include a variety of viral, fungal or bacterial skin infections, inflammatory dermatoses, reactive dermatoses, benign tumors, systemic diseases with skin vascular reactions, and one disorder of keratinization Concordance was determined by comparing primary and differential diagnoses made by the teleconsultants on all 50 cases with those made by the dermatologists who originally examined the patients in person. For eight skin cancers, the diagnostic accuracy for the in-person dermatologist was 88% versus 90% (range, 75–100%) for the teleconsultants. The concordance between the and teleconsultant diagnoses were in agreement 77% of the time (90% if differential diagnoses were For the 25 cases (including the 8 skin cancers) confirmed by either biopsy (20), culture (1), or wet mount (4), the accuracy was 84% compared to 73% (range, 65–88%) for the Not a part of the study Not a part of the study The results show that this application allows levels of accuracy and concordance equivalent to those obtained with live interactive teleconsultation systems person person
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