TY - JOUR KW - Brazil KW - Humans KW - leprosy KW - Quality of Health Care KW - Referral and Consultation KW - Sensitivity and Specificity KW - Skin Diseases, Infectious KW - Telemedicine AU - Bianconcini Trindade MA AU - Wen CL AU - Neto CF AU - Escuder MM AU - Andrade VL AU - Yamashitafuji TM AU - Manso VLS AB -

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.

BT - Journal of telemedicine and telecare C1 - http://www.ncbi.nlm.nih.gov/pubmed/18534956?dopt=Abstract CN - TRINIDADE 2008 DA - 2008 DO - 10.1258/jtt.2008.071203 IS - 4 J2 - J Telemed Telecare LA - eng N2 -

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.

PY - 2008 SP - 208 EP - 10 T2 - Journal of telemedicine and telecare TI - Accuracy of store-and-forward diagnosis in leprosy. UR - http://jtt.sagepub.com/content/14/4/208.full.pdf+html VL - 14 SN - 1357-633X ER -