Display options
Cite
Patro BK, Tripathy JP, De D, et al. Diagnostic agreement between a primary care physician and a teledermatologist for common dermatological conditions in North India. Indian Dermatol Online J. 2015;6(1):21-6doi: 10.4103/2229-5178.148927.
Patro, B. K., Tripathy, J. P., De, D., Sinha, S., Singh, A., & Kanwar, A. J. (2015). Diagnostic agreement between a primary care physician and a teledermatologist for common dermatological conditions in North India. Indian dermatology online journal, 6(1), 21-6. https://doi.org/10.4103/2229-5178.148927
Patro, Binod Kumar, et al. "Diagnostic agreement between a primary care physician and a teledermatologist for common dermatological conditions in North India." Indian dermatology online journal vol. 6,1 (2015): 21-6. doi: https://doi.org/10.4103/2229-5178.148927
Patro BK, Tripathy JP, De D, Sinha S, Singh A, Kanwar AJ. Diagnostic agreement between a primary care physician and a teledermatologist for common dermatological conditions in North India. Indian Dermatol Online J. 2015 Jan-Feb;6(1):21-6. doi: 10.4103/2229-5178.148927. PMID: 25657912; PMCID: PMC4314882.
Copy Download .nbib Format: NLM
Share it on

Indian Dermatol Online J. 2015 Jan-Feb;6(1):21-6. doi: 10.4103/2229-5178.148927.

Diagnostic agreement between a primary care physician and a teledermatologist for common dermatological conditions in North India.

Indian dermatology online journal

Binod Kumar Patro, Jaya Prasad Tripathy, Dipankar De, Smita Sinha, Amarjeet Singh, Amrinder Jit Kanwar

Affiliations

  1. Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
  2. Department of Community Medicine, School of Public Health, PGIMER, Chandigarh, India.
  3. Department of Dermatology, Venereology and Leprology, PGIMER, Chandigarh, India.

PMID: 25657912 PMCID: PMC4314882 DOI: 10.4103/2229-5178.148927

Abstract

BACKGROUND: Primary care physicians (PCPs) encounter a large number of patients with dermatological diseases. However, delivering appropriate management is a challenge considering the inadequate dermatology training offered during the undergraduate medical curriculum. Teledermatology is the clinical evaluation of skin lesions by dermatologists and allows patients to be diagnosed and treated from a distant site. It is seen as a potential solution to the shortage of specialists and providing equitable service in remote areas.

AIM: The study was aimed at estimating the diagnostic agreement of common dermatological conditions between a PCP and a teledermatologist.

MATERIALS AND METHODS: Consecutive patients with dermatological ailments who attended a primary health care clinic were recruited into the study, examined by the PCP and offered a diagnosis. The clinical images and patients' history were collected and transferred to a dermatologist at a tertiary center who also made a diagnosis. Agreement between diagnosis made by the PCPs and the teledermatologist was measured using kappa (κ) statistics.

RESULTS: Overall agreement between the diagnoses made by a PCP and the dermatologist was found to be 56%. Poor κ agreement (<0.4) was seen in the diagnosis of psoriasis and eczema.

CONCLUSION: Teledermatology can supplement specialist dermatology service in remote areas. There was poor agreement in the diagnosis of psoriasis, classifying various types of eczematous conditions and fungal infections. Scarce manpower in dermatology at the primary health care level compounded by the burden of skin ailments necessitates training of PCPs in common dermatological conditions.

Keywords: Dermatologist; diagnostic agreement; primary care physician

References

  1. J Postgrad Med. 2002 Apr-Jun;48(2):160-5 - PubMed
  2. Indian J Med Sci. 2003 Mar;57(3):108-10 - PubMed
  3. Br J Dermatol. 2004 Feb;150(2):312-6 - PubMed
  4. Australas J Dermatol. 2005 Aug;46(3):144-9 - PubMed
  5. Actas Dermosifiliogr. 2007 Apr;98(3):171-7 - PubMed
  6. Indian J Dermatol Venereol Leprol. 2003 Jan-Feb;69(1):16-8 - PubMed
  7. Actas Dermosifiliogr. 2008 Apr;99(3):207-12 - PubMed
  8. Telemed J E Health. 2008 Apr;14(3):289-302 - PubMed
  9. Arch Dermatol. 2010 Jun;146(6):676-7 - PubMed
  10. Indian J Dermatol Venereol Leprol. 2000 Sep-Oct;66(5):247-8 - PubMed
  11. Indian J Dermatol Venereol Leprol. 1999 Nov-Dec;65(6):261-3 - PubMed
  12. Actas Dermosifiliogr. 2011 May;102(4):277-83 - PubMed
  13. Clin Exp Dermatol. 2011 Jul;36(5):489-94 - PubMed
  14. Indian J Dermatol Venereol Leprol. 2013 Sep-Oct;79(5):668-78 - PubMed
  15. Indian J Dermatol Venereol Leprol. 1977 Sep-Oct;43(5):258-261 - PubMed
  16. Indian J Dermatol Venereol Leprol. 1976 Mar-Apr;42(2):49-51 - PubMed
  17. J Am Acad Dermatol. 1987 Aug;17(2 Pt 1):239-45 - PubMed
  18. Arch Dermatol. 1985 Dec;121(12):1529-30 - PubMed
  19. J Am Acad Dermatol. 1995 Sep;33(3):535-7 - PubMed
  20. J Am Acad Dermatol. 1995 May;32(5 Pt 1):726-9 - PubMed
  21. J Am Acad Dermatol. 1993 Nov;29(5 Pt 1):773-7 - PubMed
  22. J Invest Dermatol. 1994 Jan;102(1):93-7 - PubMed
  23. J Am Acad Dermatol. 1996 Apr;34(4):601-7 - PubMed
  24. Arch Dermatol. 1996 Sep;132(9):1030-8 - PubMed
  25. J Am Acad Dermatol. 1996 Dec;35(6):1005-8 - PubMed

Publication Types