Incidence of melanoma and keratinocytic carcinomas in patients evaluated by store‐and‐forward teledermatology vs. dermatology clinic
Background It is unclear whether incidence of detected skin cancer in patients evaluated by store‐and‐forward teledermatology (SAF) vs. face‐to‐face consultation (F2F) significantly differs, and whether such differences are because of variations in patient demographics, diagnostic accuracy, or both....
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| Veröffentlicht in: | International journal of dermatology 2017-10, Vol.56 (10), p.1026-1031 |
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| creator | Creighton‐Smith, Malcolm Murgia, Robert D. Konnikov, Nellie Dornelles, Adriana Garber, Caren Nguyen, Bichchau T. |
| description | Background
It is unclear whether incidence of detected skin cancer in patients evaluated by store‐and‐forward teledermatology (SAF) vs. face‐to‐face consultation (F2F) significantly differs, and whether such differences are because of variations in patient demographics, diagnostic accuracy, or both.
Methods
This retrospective cohort study compares patient skin cancer risk profile, pre‐post biopsy diagnostic accuracy, and detection rates of any skin cancer, melanoma, and keratinocytic carcinoma between all SAF teledermatology patients and a subset of randomly selected F2F consultations at VA‐Boston Healthcare System in 2014.
Results
Patients in the teledermatology (n = 434) and F2F visit cohorts (n = 587) had similar baseline demographics except a higher proportion of F2F patients had prior history of skin cancer, 22% (131/587) vs. 10% (45/434), P < 0.001, and received biopsies, 27.2% (160/587) vs. 11.5% (50/434), P < 0.001. When adjusted for age, immunosuppression, and personal and family history of skin cancer, there were no significant differences between the two cohorts in detection rates for any skin cancer (9.5% vs. 5.8%, P = 0.3), melanoma (0.6% vs. 0%, P = N/A), or keratinocytic carcinoma (8.5% vs. 5.5%, P = 0.7). The two cohorts also had similar pre‐post biopsy perfect diagnostic concordance, time from initial consult request to biopsy (45.5 d vs. 47.3 d, P = 0.8), and time from biopsy to definitive treatment (67.5 d vs. 65.4 d, P = 0.8).
Conclusion
F2F patients were more likely to have prior history of skin cancer and receive biopsies. When adjusted for presence of skin cancer risk factors, incidence of detected melanoma, keratinocytic carcinoma, and any skin cancer was similar between SAF teledermatology and F2F patients. |
| doi_str_mv | 10.1111/ijd.13672 |
| format | Article |
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It is unclear whether incidence of detected skin cancer in patients evaluated by store‐and‐forward teledermatology (SAF) vs. face‐to‐face consultation (F2F) significantly differs, and whether such differences are because of variations in patient demographics, diagnostic accuracy, or both.
Methods
This retrospective cohort study compares patient skin cancer risk profile, pre‐post biopsy diagnostic accuracy, and detection rates of any skin cancer, melanoma, and keratinocytic carcinoma between all SAF teledermatology patients and a subset of randomly selected F2F consultations at VA‐Boston Healthcare System in 2014.
Results
Patients in the teledermatology (n = 434) and F2F visit cohorts (n = 587) had similar baseline demographics except a higher proportion of F2F patients had prior history of skin cancer, 22% (131/587) vs. 10% (45/434), P < 0.001, and received biopsies, 27.2% (160/587) vs. 11.5% (50/434), P < 0.001. When adjusted for age, immunosuppression, and personal and family history of skin cancer, there were no significant differences between the two cohorts in detection rates for any skin cancer (9.5% vs. 5.8%, P = 0.3), melanoma (0.6% vs. 0%, P = N/A), or keratinocytic carcinoma (8.5% vs. 5.5%, P = 0.7). The two cohorts also had similar pre‐post biopsy perfect diagnostic concordance, time from initial consult request to biopsy (45.5 d vs. 47.3 d, P = 0.8), and time from biopsy to definitive treatment (67.5 d vs. 65.4 d, P = 0.8).
Conclusion
F2F patients were more likely to have prior history of skin cancer and receive biopsies. When adjusted for presence of skin cancer risk factors, incidence of detected melanoma, keratinocytic carcinoma, and any skin cancer was similar between SAF teledermatology and F2F patients.</description><identifier>ISSN: 0011-9059</identifier><identifier>EISSN: 1365-4632</identifier><identifier>DOI: 10.1111/ijd.13672</identifier><identifier>PMID: 28631824</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Ambulatory Care - statistics & numerical data ; Biopsy ; Cancer ; Carcinoma ; Carcinoma - diagnosis ; Carcinoma - pathology ; Child ; Child, Preschool ; Consultation ; Demographics ; Demography ; Dermatology ; Diagnostic systems ; Female ; Genetics ; Health care ; Health risk assessment ; Health risks ; Humans ; Immunosuppression ; Incidence ; Infant ; Infant, Newborn ; Male ; Melanoma ; Melanoma - diagnosis ; Melanoma - pathology ; Middle Aged ; Patients ; Retrospective Studies ; Risk analysis ; Risk assessment ; Risk Factors ; Skin - pathology ; Skin cancer ; Skin Neoplasms - diagnosis ; Skin Neoplasms - pathology ; Telemedicine - methods ; Telemedicine - statistics & numerical data ; Time Factors ; Time-to-Treatment - statistics & numerical data ; Young Adult</subject><ispartof>International journal of dermatology, 2017-10, Vol.56 (10), p.1026-1031</ispartof><rights>2017</rights><rights>2017 The International Society of Dermatology.</rights><rights>International Journal of Dermatology © 2017 International Society of Dermatology</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3532-74fccff6fdf43273095b909e2891df6e364501cfd46094283cfbde500e9d38783</citedby><cites>FETCH-LOGICAL-c3532-74fccff6fdf43273095b909e2891df6e364501cfd46094283cfbde500e9d38783</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fijd.13672$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fijd.13672$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28631824$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Creighton‐Smith, Malcolm</creatorcontrib><creatorcontrib>Murgia, Robert D.</creatorcontrib><creatorcontrib>Konnikov, Nellie</creatorcontrib><creatorcontrib>Dornelles, Adriana</creatorcontrib><creatorcontrib>Garber, Caren</creatorcontrib><creatorcontrib>Nguyen, Bichchau T.</creatorcontrib><title>Incidence of melanoma and keratinocytic carcinomas in patients evaluated by store‐and‐forward teledermatology vs. dermatology clinic</title><title>International journal of dermatology</title><addtitle>Int J Dermatol</addtitle><description>Background
It is unclear whether incidence of detected skin cancer in patients evaluated by store‐and‐forward teledermatology (SAF) vs. face‐to‐face consultation (F2F) significantly differs, and whether such differences are because of variations in patient demographics, diagnostic accuracy, or both.
Methods
This retrospective cohort study compares patient skin cancer risk profile, pre‐post biopsy diagnostic accuracy, and detection rates of any skin cancer, melanoma, and keratinocytic carcinoma between all SAF teledermatology patients and a subset of randomly selected F2F consultations at VA‐Boston Healthcare System in 2014.
Results
Patients in the teledermatology (n = 434) and F2F visit cohorts (n = 587) had similar baseline demographics except a higher proportion of F2F patients had prior history of skin cancer, 22% (131/587) vs. 10% (45/434), P < 0.001, and received biopsies, 27.2% (160/587) vs. 11.5% (50/434), P < 0.001. When adjusted for age, immunosuppression, and personal and family history of skin cancer, there were no significant differences between the two cohorts in detection rates for any skin cancer (9.5% vs. 5.8%, P = 0.3), melanoma (0.6% vs. 0%, P = N/A), or keratinocytic carcinoma (8.5% vs. 5.5%, P = 0.7). The two cohorts also had similar pre‐post biopsy perfect diagnostic concordance, time from initial consult request to biopsy (45.5 d vs. 47.3 d, P = 0.8), and time from biopsy to definitive treatment (67.5 d vs. 65.4 d, P = 0.8).
Conclusion
F2F patients were more likely to have prior history of skin cancer and receive biopsies. When adjusted for presence of skin cancer risk factors, incidence of detected melanoma, keratinocytic carcinoma, and any skin cancer was similar between SAF teledermatology and F2F patients.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Ambulatory Care - statistics & numerical data</subject><subject>Biopsy</subject><subject>Cancer</subject><subject>Carcinoma</subject><subject>Carcinoma - diagnosis</subject><subject>Carcinoma - pathology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Consultation</subject><subject>Demographics</subject><subject>Demography</subject><subject>Dermatology</subject><subject>Diagnostic systems</subject><subject>Female</subject><subject>Genetics</subject><subject>Health care</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>Humans</subject><subject>Immunosuppression</subject><subject>Incidence</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Melanoma</subject><subject>Melanoma - diagnosis</subject><subject>Melanoma - pathology</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk assessment</subject><subject>Risk Factors</subject><subject>Skin - pathology</subject><subject>Skin cancer</subject><subject>Skin Neoplasms - diagnosis</subject><subject>Skin Neoplasms - pathology</subject><subject>Telemedicine - methods</subject><subject>Telemedicine - statistics & numerical data</subject><subject>Time Factors</subject><subject>Time-to-Treatment - statistics & numerical data</subject><subject>Young Adult</subject><issn>0011-9059</issn><issn>1365-4632</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kT1PHDEQhq0IBMdHwR-ILNFAsYe_9sNlBCEcQkoT6pXPHkc-du2LvXtou5Qp8xv5JZgcoChSppjRaJ55NaMXoRNK5jTHhVuZOeVVzT6gWa5lISrOdtCMEEoLSUq5jw5SWuWWMyr20D5rKk4bJmbo18JrZ8BrwMHiHjrlQ6-w8gY_QFSD80FPg9NYq6jdyyxh5_E6T8APCcNGdaMawODlhNMQIjz9_J23c7YhPqpo8AAdGIi9GkIXvk94k-b47153zjt9hHat6hIcv9ZDdH_9-dvlTXH39cvi8tNdoXnJWVELq7W1lTVWcFZzIsulJBJYI6mxFfBKlIRqa0RFpGAN13ZpoCQEpOFN3fBDdLbVXcfwY4Q0tL1LGrr8OIQxtVRSWlNWCpbR03_QVRijz9dlitdlVRNZZ-p8S-kYUopg23V0vYpTS0n7Yk-b7Wn_2JPZj6-K47IH806--ZGBiy3w6DqY_q_ULm6vtpLPwnSdSQ</recordid><startdate>201710</startdate><enddate>201710</enddate><creator>Creighton‐Smith, Malcolm</creator><creator>Murgia, Robert D.</creator><creator>Konnikov, Nellie</creator><creator>Dornelles, Adriana</creator><creator>Garber, Caren</creator><creator>Nguyen, Bichchau T.</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>201710</creationdate><title>Incidence of melanoma and keratinocytic carcinomas in patients evaluated by store‐and‐forward teledermatology vs. dermatology clinic</title><author>Creighton‐Smith, Malcolm ; Murgia, Robert D. ; Konnikov, Nellie ; Dornelles, Adriana ; Garber, Caren ; Nguyen, Bichchau T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3532-74fccff6fdf43273095b909e2891df6e364501cfd46094283cfbde500e9d38783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Ambulatory Care - statistics & numerical data</topic><topic>Biopsy</topic><topic>Cancer</topic><topic>Carcinoma</topic><topic>Carcinoma - diagnosis</topic><topic>Carcinoma - pathology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Consultation</topic><topic>Demographics</topic><topic>Demography</topic><topic>Dermatology</topic><topic>Diagnostic systems</topic><topic>Female</topic><topic>Genetics</topic><topic>Health care</topic><topic>Health risk assessment</topic><topic>Health risks</topic><topic>Humans</topic><topic>Immunosuppression</topic><topic>Incidence</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Melanoma</topic><topic>Melanoma - diagnosis</topic><topic>Melanoma - pathology</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Retrospective Studies</topic><topic>Risk analysis</topic><topic>Risk assessment</topic><topic>Risk Factors</topic><topic>Skin - pathology</topic><topic>Skin cancer</topic><topic>Skin Neoplasms - diagnosis</topic><topic>Skin Neoplasms - pathology</topic><topic>Telemedicine - methods</topic><topic>Telemedicine - statistics & numerical data</topic><topic>Time Factors</topic><topic>Time-to-Treatment - statistics & numerical data</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Creighton‐Smith, Malcolm</creatorcontrib><creatorcontrib>Murgia, Robert D.</creatorcontrib><creatorcontrib>Konnikov, Nellie</creatorcontrib><creatorcontrib>Dornelles, Adriana</creatorcontrib><creatorcontrib>Garber, Caren</creatorcontrib><creatorcontrib>Nguyen, Bichchau T.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of dermatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Creighton‐Smith, Malcolm</au><au>Murgia, Robert D.</au><au>Konnikov, Nellie</au><au>Dornelles, Adriana</au><au>Garber, Caren</au><au>Nguyen, Bichchau T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence of melanoma and keratinocytic carcinomas in patients evaluated by store‐and‐forward teledermatology vs. dermatology clinic</atitle><jtitle>International journal of dermatology</jtitle><addtitle>Int J Dermatol</addtitle><date>2017-10</date><risdate>2017</risdate><volume>56</volume><issue>10</issue><spage>1026</spage><epage>1031</epage><pages>1026-1031</pages><issn>0011-9059</issn><eissn>1365-4632</eissn><abstract>Background
It is unclear whether incidence of detected skin cancer in patients evaluated by store‐and‐forward teledermatology (SAF) vs. face‐to‐face consultation (F2F) significantly differs, and whether such differences are because of variations in patient demographics, diagnostic accuracy, or both.
Methods
This retrospective cohort study compares patient skin cancer risk profile, pre‐post biopsy diagnostic accuracy, and detection rates of any skin cancer, melanoma, and keratinocytic carcinoma between all SAF teledermatology patients and a subset of randomly selected F2F consultations at VA‐Boston Healthcare System in 2014.
Results
Patients in the teledermatology (n = 434) and F2F visit cohorts (n = 587) had similar baseline demographics except a higher proportion of F2F patients had prior history of skin cancer, 22% (131/587) vs. 10% (45/434), P < 0.001, and received biopsies, 27.2% (160/587) vs. 11.5% (50/434), P < 0.001. When adjusted for age, immunosuppression, and personal and family history of skin cancer, there were no significant differences between the two cohorts in detection rates for any skin cancer (9.5% vs. 5.8%, P = 0.3), melanoma (0.6% vs. 0%, P = N/A), or keratinocytic carcinoma (8.5% vs. 5.5%, P = 0.7). The two cohorts also had similar pre‐post biopsy perfect diagnostic concordance, time from initial consult request to biopsy (45.5 d vs. 47.3 d, P = 0.8), and time from biopsy to definitive treatment (67.5 d vs. 65.4 d, P = 0.8).
Conclusion
F2F patients were more likely to have prior history of skin cancer and receive biopsies. When adjusted for presence of skin cancer risk factors, incidence of detected melanoma, keratinocytic carcinoma, and any skin cancer was similar between SAF teledermatology and F2F patients.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>28631824</pmid><doi>10.1111/ijd.13672</doi><tpages>6</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Ambulatory Care - statistics & numerical data Biopsy Cancer Carcinoma Carcinoma - diagnosis Carcinoma - pathology Child Child, Preschool Consultation Demographics Demography Dermatology Diagnostic systems Female Genetics Health care Health risk assessment Health risks Humans Immunosuppression Incidence Infant Infant, Newborn Male Melanoma Melanoma - diagnosis Melanoma - pathology Middle Aged Patients Retrospective Studies Risk analysis Risk assessment Risk Factors Skin - pathology Skin cancer Skin Neoplasms - diagnosis Skin Neoplasms - pathology Telemedicine - methods Telemedicine - statistics & numerical data Time Factors Time-to-Treatment - statistics & numerical data Young Adult |
| title | Incidence of melanoma and keratinocytic carcinomas in patients evaluated by store‐and‐forward teledermatology vs. dermatology clinic |
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