02012nas a2200325   4500000000100000008004100001260000900042653001100051653001100062653001200073653002700085653003000112653003200142653003000174653001700204100002800221700001100249700001200260700001500272700001500287700002100302700001400323245005600337856005800393300001100451490000700462050001900469520118400488022001401672       2008                            d  c200810aBrazil10aHumans10aleprosy10aQuality of Health Care10aReferral and Consultation10aSensitivity and Specificity10aSkin Diseases, Infectious10aTelemedicine1 aBianconcini Trindade MA1 aWen CL1 aNeto CF1 aEscuder MM1 aAndrade VL1 aYamashitafuji TM1 aManso VLS00aAccuracy of store-and-forward diagnosis in leprosy.  uhttp://jtt.sagepub.com/content/14/4/208.full.pdf+html  a208-100 v14  aTRINIDADE 20083 a<p>Telemedicine might increase the speed of diagnosis for leprosy and reduce the development of disabilities. We compared the accuracy of diagnosis made by telemedicine with that made by in-person examination. The cases were patients with suspected leprosy at eight public health clinics in outlying areas of the city of São Paulo. The case history and clinical examination data, and at least two clinical images for each patient, were stored in a web-based system developed for teledermatology. After the examination in the public clinic, patients then attended a teaching hospital for an in-person examination. The benchmark was the clinical examination of two dermatologists at the university hospital. From August 2005 to April 2006, 142 suspected cases of leprosy were forwarded to the website by the doctors at the clinics. Of these, 36 cases were excluded. There was overall agreement in the diagnosis of leprosy in 74% of the 106 remaining cases. The sensitivity was 78% and the specificity was 31%. Although the specificity was low, the study suggests that telemedicine may be a useful low-cost method for obtaining second opinions in programmes to control leprosy.</p>  a1357-633X