STUDY Comparison of Skin Biopsy Triage Decisions in 49 Patients With Pigmented Lesions and Skin Neoplasms Store-and-Forward Teledermatology vs Face-to-Face Dermatology Michael Shapiro, MD; William D. James, MD; Rex Kessler, MD; Francis C. Lazorik, MD†; Kenneth A. Katz, MD; John Tam, MD; David S. Nieves, MD; Jeffrey J. Miller, MD Objective: To determine the relative efficacy of store- face by a dermatologist. A biopsy was performed if either and-forward teledermatology vs face-to-face dermatol- dermatologist favored biopsy. ogy consultations in triage decisions about the need for a biopsy of neoplastic skin changes. Main Outcome Measures: Decisions to perform a bi- opsy. Agreement between the dermatologists was as- sessed. Design: Prospective study of consecutive patients judged by an internist to require dermatologic consultation for Results: Of the 49 patients with evaluable photographs, a skin growth. the face-to-face dermatologist and teledermatologist rec- ommended a biopsy for the same 26 patients, yielding a Setting: Private primary care and dermatology prac- sensitivity of the teledermatologist of 1.00 (95% confi- tices and an academic dermatology practice. dence interval [CI], 0.87-1.00) and a specificity of 1.00 (95% CI, 0.85-1.00). The agreement between the dermatolo- Patients: Patients requiring dermatology consultation gists () was 1.00 (95% CI, 0.72-1.00).
JAMA Dermatology – American Medical Association
Published: May 1, 2004