Interobserver variability of teledermoscopy: An international study Journal Article

Authors: Tan, E.; Oakley, A.; Soyer, H. P.; Haskett, M.; Marghoob, A.; Jameson, M.; Rademaker, M.
Article Title: Interobserver variability of teledermoscopy: An international study
Abstract: Summary Background Teledermoscopy is a rapidly developing field of dermatology with studies demonstrating excellent agreement with face-to-face diagnosis. However, we are unaware of studies evaluating interobserver variability in diagnosis between dermatologists from different continents. This evaluation is important to determine the robustness of teledermoscopy and allow comparisons to be made between different studies. Objectives To assess the interobserver diagnostic variability between five independent experienced dermatologists (A-E) in New Zealand, Australia and the U.S.A. Methods Images from 979 lesions from 206 patients were distributed to five dermatologists. The lesions were viewed and diagnoses recorded using MoleMap Diagnose® (MoleMap, Auckland, New Zealand) software. The diagnoses were analysed for interobserver variability. Results There was excellent agreement between four of five dermatologists (A-D) for lesions that were agreed upon as melanoma (κ = 0·81-0·97) and benign naevus (κ = 0·77-0·82). The fifth dermatologist (E) made a more frequent diagnosis of atypical naevus and melanoma than the others. For nonmelanocytic lesions, there was moderate to very good agreement for seborrhoeic keratosis (κ = 0·64- 0·80) and basal cell carcinoma (κ = 0·55-0·67), but poor agreement for invasive squamous cell carcinoma (SCC) (κ = 0·05-0·15). Agreement for actinic keratosis (κ = 0·32-0·67) and SCC in situ (κ = 0·15-0·32) was only moderate. When atypical and benign naevi were grouped together and actinic keratosis and SCC in situ grouped together, there was better agreement among all dermatologists. There was good ability to distinguish malignant from benign lesions (κ = 0·57-0·93). Conclusions There was good agreement among dermatologists A-D but dermatologist E varied from the group with more frequent diagnosis of melanoma and atypical naevus. This difference could be due to different definition of terms with lack of consensus guidelines in definition of atypical naevus, lack of familiarity with the specific patient population and/or diagnostic drift. © 2010 British Association of Dermatologists.
Keywords: major clinical study; squamous cell carcinoma; united states; melanoma; dermoscopy; actinic keratosis; basal cell carcinoma; image analysis; skin defect; nevus; diagnostic value; seborrheic keratosis; medical specialist; malignant neoplastic disease; australia; dysplastic nevus; dermatofibroma; computer program; hemangioma; new zealand; teledermoscopy; keratoacanthoma; variability; interobserver; agreement; telemedicine
Journal Title: British Journal of Dermatology
Volume: 163
Issue: 6
ISSN: 0007-0963
Publisher: Blackwell Publishing  
Date Published: 2010-12-01
Start Page: 1276
End Page: 1281
Language: English
DOI: 10.1111/j.1365-2133.2010.10010.x
PROVIDER: scopus
PUBMED: 20795998
Notes: --- - "Export Date: 20 April 2011" - "CODEN: BJDEA" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Ashfaq A Marghoob
    507 Marghoob