Preprints (earlier versions) of this paper are available at https://preprints.jmir.org/preprint/35401, first published .
A 9-Year Teledermoscopy Service: Retrospective Service Review

A 9-Year Teledermoscopy Service: Retrospective Service Review

A 9-Year Teledermoscopy Service: Retrospective Service Review

Authors of this article:

Novell Shu Chyng Teoh 1 Author Orcid Image ;   Amanda Oakley 1 Author Orcid Image

Abstract

Waikato District Health Board, Hamilton, New Zealand

Corresponding Author:

Novell Shu Chyng Teoh, MBChB

Waikato District Health Board

183 Pembroke Street

Hamilton, 3204

New Zealand

Phone: 64 7 839 8899

Email: novell.teoh@waikatodhb.health.nz


Background: A teledermoscopy service was established in January 2010, where patients attended nurse-led clinics for imaging of lesions of concern and remote diagnosis by a dermatologist.

Objective: The study aimed to review the number of visits, patient characteristics, the efficiency of the service, and the diagnoses made.

Methods: We evaluated the waiting time and diagnosis of skin lesions for all patient visits from January 1, 2010, to May 31, 2019. The relationships between patient characteristics and the diagnosis of melanoma were specifically analyzed.

Results: The teledermoscopy clinic was attended by 6479 patients for 11,005 skin lesions on 8805 occasions. Statistically significant risk factors for the diagnosis of melanoma/melanoma in situ were male sex, European ethnicity, and Fitzpatrick skin type 2. Attendance was maximal during 2015 and 2016. The seasonal variation in visits 2011-2018 revealed a consistent peak at the end of summer and a dip at the end of winter. In the year 2010, 306 patients attended; 76% (233/306) of these were discharged to primary care and 24% (73/306) were referred to hospital for specialist assessment. For patients diagnosed by the dermatologist with suspected melanoma from January 1, 2010, to May 31, 2019, the median waiting time for an imaging appointment was 44.5 days (average 57.9 days, range 8-218 days). The most common lesions diagnosed were benign naevus (2933/11,005, 27%), benign keratosis (2576/11,005, 23%), and keratinocytic cancer (1707/11,005, 15%); melanoma was suspected in 5% (507/11,005) of referred lesions (Multimedia Appendix 1). The positive predictive value of melanoma/melanoma in situ was 61.1% (320 true positives and 203 false positives). The number needed to treat (ie, the ratio of the total number of excisions to the number with a histological diagnosis of melanoma/melanoma in situ) was 2.02.

Conclusions: Diagnoses were comparable to the experience of other teledermoscopy services. Teledermoscopy using a nurse-led imaging clinic can provide efficient and convenient access to dermatology by streamlining referrals to secondary care and prioritizing patients with skin cancer for treatment.

Conflicts of Interest: None declared.

iproc 2021;7(1):e35401

doi:10.2196/35401

Keywords


Multimedia Appendix 1

Diagnosis in patients who attended the teledermoscopy clinic from January 2010-May 2019 (n=11,005).

PDF File (Adobe PDF File), 75 KB

Edited by T Derrick; This is a non–peer-reviewed article. submitted 02.12.21; accepted 03.12.21; published 17.12.21

Copyright

©Novell Shu Chyng Teoh, Amanda Oakley. Originally published in Iproceedings (https://www.iproc.org), 17.12.2021.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in Iproceedings, is properly cited. The complete bibliographic information, a link to the original publication on https://www.iproc.org/, as well as this copyright and license information must be included.