J Am Acad and traditional port interface with TD1 vs CD 70% evaluation. FTF final diagnoses Dermatol face-to-face (FTF) and created (69/99) was in excess of only 3 2000;42: office visits. accompanying 81% for each of the all patients TD2 vs CD 64% Criteria for software. The 3 776-83. images. classified as (49/77) comparison teledermatologists. Sony DSC-F1 type V or VI. USA TD3 vs CD 77% included overall camera The study (76/99) accuracy displayed 640 × population of diagnosis, as 480 pixel contained a well as accuracy resolution with wide variety based on 24-bit colour. a of diagnostic PC with a Sony dermatologic Trinitron confidence, image conditions. Multiscan-15sf quality, and the Most colour monitor type of skin lesion frequent involved set to display 24-bit colour at 864 × 480 Nevus, pixels keratosis Kvedar et al. To investigate the SAF diagnosis FTF FTF a digital camera Two Malignant or 2 TDs aggregated Not a part of 27% of the Not a part of Still digital images The diagnostic provided by 2 (Kodak DCS premalignant diagnoses : the study images taken the study can substitute for substitution of accuracy of dermatologists 420) equipped design by this design the dermatologic 70% digital images clinicians independently; by one with a macro method had physical 67% for of 13 lens (Nikkor 50 a Q-index examination in up to viewing a patient's Patient record Primary diagnoses: dermatologic mm). The rating of less 83% of cases. This history and static 61% digital images than 4, study provides physical digital image set Pigmented 64% were stored on indicating a validation of the examination. compared with lesions optical disks as significant store-and-forward Arch clinicians who PICT files and number of concept of Dermatol conducted office viewed using a unacceptable telemedicine as based physical software images applied to examinations of program interspersed dermatology. the same patients. disorders USA (Adobe with the Systems Inc, images. San Jose, Calif) on a Macintosh computer (Apple Macintosh PowerMac
J Am Acad Dermatol 2000;42: 776-83. USA and traditional face-to-face (FTF) office visits. Criteria for comparison included overall accuracy of diagnosis, as well as accuracy based on diagnostic confidence, image quality, and the type of skin lesion involved port interface and accompanying software. The Sony DSC-F1 camera displayed 640 × 480 pixel resolution with 24-bit colour. a PC with a Sony Trinitron Multiscan-15sf colour monitor set to display 24-bit colour at 864 × 480 pixels created all images. with only 3 patients classified as type V or VI. The study population contained a wide variety of dermatologic conditions. Most frequent Nevus, keratosis TD1 vs CD 70% (69/99) TD2 vs CD 64% (49/77) TD3 vs CD 77% (76/99) evaluation. FTF final diagnoses was in excess of 81% for each of the 3 teledermatologists. Kvedar et al. The substitution of digital images for dermatologic physical examination. Arch Dermatol USA To investigate the diagnostic accuracy of clinicians viewing a patient's history and static digital image set compared with clinicians who conducted office based physical examinations of the same patients. SAF diagnosis provided by 2 dermatologists independently; Patient record FTF by one of 13 FTF a digital camera (Kodak DCS 420) equipped with a macro lens (Nikkor 50 mm). The digital images were stored on optical disks as PICT files and viewed using a software program (Adobe Systems Inc, San Jose, Calif) on a Macintosh computer (Apple Macintosh PowerMac Two Malignant or premalignant Pigmented lesions disorders 2 TDs aggregated diagnoses : 70% 67% Primary diagnoses: 61% 64% Not a part of the study design 27% of the images taken by this method had a Q-index rating of less than 4, indicating a significant number of unacceptable images interspersed with the images. Not a part of the study design Still digital images can substitute for the dermatologic physical examination in up to 83% of cases. This study provides validation of the store-and-forward concept of telemedicine as applied to dermatology.
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