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Use of teledermatology by dermatology hospitalists is effective in the diagnosis and management of inpatient disease.

BACKGROUND: Patient outcomes are improved when dermatologists provide inpatient consults. Inpatient access to dermatologists is limited, illustrating an opportunity to utilize teledermatology. Little is known about the ability of dermatologists to accurately diagnose and manage inpatients using tele...

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Autores principales: Gabel, Colleen K., Nguyen, Emily, Karmouta, Ryan, Liu, Kristina Jing, Zhou, Guohai, Alloo, Allireza, Arakaki, Ryan, Balagula, Yevgeniy, Bridges, Alina G., Cowen, Edward W., Davis, Mark Denis P., Femia, Alisa, Harp, Joanna, Kaffenberger, Benjamin, Keller, Jesse J., Kwong, Bernice Y., Markova, Alina, Mauskar, Melissa, Micheletti, Robert, Mostaghimi, Arash, Pierson, Joseph, Rosenbach, Misha, Schwager, Zachary, Seminario-Vidal, Lucia, Sharon, Victoria R., Song, Philip I., Strowd, Lindsay C., Walls, Andrew C., Wanat, Karolyn A., Wetter, David A., Worswick, Scott, Ziemer, Carolyn, Kvedar, Joseph, Mikailov, Anar, Kroshinsky, Daniela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Published by Elsevier on behalf of the American Academy of Dermatology, Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204758/
https://www.ncbi.nlm.nih.gov/pubmed/32389716
http://dx.doi.org/10.1016/j.jaad.2020.04.171
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author Gabel, Colleen K.
Nguyen, Emily
Karmouta, Ryan
Liu, Kristina Jing
Zhou, Guohai
Alloo, Allireza
Arakaki, Ryan
Balagula, Yevgeniy
Bridges, Alina G.
Cowen, Edward W.
Davis, Mark Denis P.
Femia, Alisa
Harp, Joanna
Kaffenberger, Benjamin
Keller, Jesse J.
Kwong, Bernice Y.
Markova, Alina
Mauskar, Melissa
Micheletti, Robert
Mostaghimi, Arash
Pierson, Joseph
Rosenbach, Misha
Schwager, Zachary
Seminario-Vidal, Lucia
Sharon, Victoria R.
Song, Philip I.
Strowd, Lindsay C.
Walls, Andrew C.
Wanat, Karolyn A.
Wetter, David A.
Worswick, Scott
Ziemer, Carolyn
Kvedar, Joseph
Mikailov, Anar
Kroshinsky, Daniela
author_facet Gabel, Colleen K.
Nguyen, Emily
Karmouta, Ryan
Liu, Kristina Jing
Zhou, Guohai
Alloo, Allireza
Arakaki, Ryan
Balagula, Yevgeniy
Bridges, Alina G.
Cowen, Edward W.
Davis, Mark Denis P.
Femia, Alisa
Harp, Joanna
Kaffenberger, Benjamin
Keller, Jesse J.
Kwong, Bernice Y.
Markova, Alina
Mauskar, Melissa
Micheletti, Robert
Mostaghimi, Arash
Pierson, Joseph
Rosenbach, Misha
Schwager, Zachary
Seminario-Vidal, Lucia
Sharon, Victoria R.
Song, Philip I.
Strowd, Lindsay C.
Walls, Andrew C.
Wanat, Karolyn A.
Wetter, David A.
Worswick, Scott
Ziemer, Carolyn
Kvedar, Joseph
Mikailov, Anar
Kroshinsky, Daniela
author_sort Gabel, Colleen K.
collection PubMed
description BACKGROUND: Patient outcomes are improved when dermatologists provide inpatient consults. Inpatient access to dermatologists is limited, illustrating an opportunity to utilize teledermatology. Little is known about the ability of dermatologists to accurately diagnose and manage inpatients using teledermatology, particularly utilizing non-dermatologist generated clinical data. METHODS: This prospective study assessed the ability of teledermatology to diagnose and manage 41 dermatology consults from a large urban tertiary care center utilizing internal medicine referral documentation and photos. Twenty-seven dermatology hospitalists were surveyed. Interrater agreement was assessed by the kappa statistic. RESULTS: There was substantial agreement between in-person and teledermatology assessment of the diagnosis with differential diagnosis (median kappa = 0.83), substantial agreement in laboratory work-up decisions (median kappa = 0.67), almost perfect agreement in imaging decisions (median kappa = 1.0), and moderate agreement in biopsy decisions (median kappa = 0.43). There was almost perfect agreement in treatment (median kappa = 1.0), but no agreement in follow-up planning (median kappa = 0.0). There was no association between raw photo quality and the primary plus differential diagnosis or primary diagnosis alone. LIMITATIONS: Selection bias and single-center nature. CONCLUSIONS: Teledermatology may be effective in the inpatient setting, with concordant diagnosis, evaluation, and management decisions.
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spelling pubmed-72047582020-05-07 Use of teledermatology by dermatology hospitalists is effective in the diagnosis and management of inpatient disease. Gabel, Colleen K. Nguyen, Emily Karmouta, Ryan Liu, Kristina Jing Zhou, Guohai Alloo, Allireza Arakaki, Ryan Balagula, Yevgeniy Bridges, Alina G. Cowen, Edward W. Davis, Mark Denis P. Femia, Alisa Harp, Joanna Kaffenberger, Benjamin Keller, Jesse J. Kwong, Bernice Y. Markova, Alina Mauskar, Melissa Micheletti, Robert Mostaghimi, Arash Pierson, Joseph Rosenbach, Misha Schwager, Zachary Seminario-Vidal, Lucia Sharon, Victoria R. Song, Philip I. Strowd, Lindsay C. Walls, Andrew C. Wanat, Karolyn A. Wetter, David A. Worswick, Scott Ziemer, Carolyn Kvedar, Joseph Mikailov, Anar Kroshinsky, Daniela J Am Acad Dermatol Article BACKGROUND: Patient outcomes are improved when dermatologists provide inpatient consults. Inpatient access to dermatologists is limited, illustrating an opportunity to utilize teledermatology. Little is known about the ability of dermatologists to accurately diagnose and manage inpatients using teledermatology, particularly utilizing non-dermatologist generated clinical data. METHODS: This prospective study assessed the ability of teledermatology to diagnose and manage 41 dermatology consults from a large urban tertiary care center utilizing internal medicine referral documentation and photos. Twenty-seven dermatology hospitalists were surveyed. Interrater agreement was assessed by the kappa statistic. RESULTS: There was substantial agreement between in-person and teledermatology assessment of the diagnosis with differential diagnosis (median kappa = 0.83), substantial agreement in laboratory work-up decisions (median kappa = 0.67), almost perfect agreement in imaging decisions (median kappa = 1.0), and moderate agreement in biopsy decisions (median kappa = 0.43). There was almost perfect agreement in treatment (median kappa = 1.0), but no agreement in follow-up planning (median kappa = 0.0). There was no association between raw photo quality and the primary plus differential diagnosis or primary diagnosis alone. LIMITATIONS: Selection bias and single-center nature. CONCLUSIONS: Teledermatology may be effective in the inpatient setting, with concordant diagnosis, evaluation, and management decisions. Published by Elsevier on behalf of the American Academy of Dermatology, Inc. 2020-05-07 /pmc/articles/PMC7204758/ /pubmed/32389716 http://dx.doi.org/10.1016/j.jaad.2020.04.171 Text en © 2020 Published by Elsevier on behalf of the American Academy of Dermatology, Inc. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Gabel, Colleen K.
Nguyen, Emily
Karmouta, Ryan
Liu, Kristina Jing
Zhou, Guohai
Alloo, Allireza
Arakaki, Ryan
Balagula, Yevgeniy
Bridges, Alina G.
Cowen, Edward W.
Davis, Mark Denis P.
Femia, Alisa
Harp, Joanna
Kaffenberger, Benjamin
Keller, Jesse J.
Kwong, Bernice Y.
Markova, Alina
Mauskar, Melissa
Micheletti, Robert
Mostaghimi, Arash
Pierson, Joseph
Rosenbach, Misha
Schwager, Zachary
Seminario-Vidal, Lucia
Sharon, Victoria R.
Song, Philip I.
Strowd, Lindsay C.
Walls, Andrew C.
Wanat, Karolyn A.
Wetter, David A.
Worswick, Scott
Ziemer, Carolyn
Kvedar, Joseph
Mikailov, Anar
Kroshinsky, Daniela
Use of teledermatology by dermatology hospitalists is effective in the diagnosis and management of inpatient disease.
title Use of teledermatology by dermatology hospitalists is effective in the diagnosis and management of inpatient disease.
title_full Use of teledermatology by dermatology hospitalists is effective in the diagnosis and management of inpatient disease.
title_fullStr Use of teledermatology by dermatology hospitalists is effective in the diagnosis and management of inpatient disease.
title_full_unstemmed Use of teledermatology by dermatology hospitalists is effective in the diagnosis and management of inpatient disease.
title_short Use of teledermatology by dermatology hospitalists is effective in the diagnosis and management of inpatient disease.
title_sort use of teledermatology by dermatology hospitalists is effective in the diagnosis and management of inpatient disease.
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204758/
https://www.ncbi.nlm.nih.gov/pubmed/32389716
http://dx.doi.org/10.1016/j.jaad.2020.04.171
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