Internet-based skin cancer screening using clinical images alone or in conjunction with dermoscopic images: A randomized teledermoscopy trial.
J Am Acad Dermatol
; 76(4): 676-682, 2017 Apr.
Article
em En
| MEDLINE
| ID: mdl-28089728
ABSTRACT
BACKGROUND:
Teledermoscopy involves the use of dermoscopic images for remote consultation and decision-making in skin cancer screening.OBJECTIVE:
We sought to analyze the potential benefits gained from the addition of dermoscopic images to an internet-based skin cancer screening system.METHODS:
A randomized clinical trial assessed the diagnostic performance and cost-effectiveness of clinical teleconsultations (CTC) and clinical with dermoscopic teleconsultations.RESULTS:
A total of 454 patients were enrolled in the trial (nCTC = 226, nclinical with dermoscopic teleconsultation = 228). Teledermoscopy improved sensitivity and specificity (92.86% and 96.24%, respectively) compared with CTC (86.57% and 72.33%, respectively). Correct decisions were made in 94.30% of patients through clinical with dermoscopic teleconsultations and in 79.20% in CTC (P < .001). The only variable associated with an increased likelihood of correct diagnosis was management using teledermoscopy (odds ratio 4.04; 95% confidence interval 2.02-8.09; P < .0001). The cost-effectiveness analysis showed teledermoscopy as the dominant strategy, with a lower cost-effectiveness ratio (65.13 vs 80.84).LIMITATIONS:
Potentially, a limitation is the establishment of an experienced dermatologist as the gold standard for the in-person evaluation.CONCLUSIONS:
The addition of dermoscopic images significantly improves the results of an internet-based skin cancer screening system, compared with screening systems based on clinical images alone.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Atenção Primária à Saúde
/
Neoplasias Cutâneas
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Programas de Rastreamento
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Telemedicina
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Internet
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Dermoscopia
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Dermatologia
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
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Prognostic_studies
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Screening_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article