Parent-operated smartphone photography could be another tool for diagnosing pediatric dermatology patients, according to findings in a recent study published by JAMA.
The study found that the overall concordance between photograph-based vs in-person diagnosis was 83 percent.
“Our study shows that, in most cases, parents can take photographs of sufficient quality to allow for accurate teledermatology diagnoses of pediatric skin conditions,” the study said. “Our results are consistent with previous literature studying teledermatology in adults showing concordance between primary care teledermatology consultations and in-person dermatologist diagnoses.”
Forty patient-parent dyads participated in the study at a pediatric dermatology clinic at the Children’s Hospital of Philadelphia. The mean patient age was 6.96-years old. The goal was to assess the concordance between diagnoses made by independent pediatric dermatologist based on in person exams and those based on parent’s photos.
Parents used their personal smartphone and uploaded to Epic's MyChart app, which is available on both Apple and Android products. Images were uploaded into the patient’s EHR securely using the MyChart app. Parents also completed a one page survey about their child’s medical history and demographics.
Half of the patient-parent dyads got instructions on how to take the best photographs using a smartphone and the other half didn’t.
But the study found no statistically significant effect of the photography training on the quality of the photos taken for this purpose.
The study noted the shortage of pediatric dermatologists in the United States. Currently there are only 300 board-certified physicians serving 75 million children in the United States. However, many sub-specialists do treat patients for dermatology related conditions.
“Despite this interest, the accuracy of teledermatology has not been evaluated specifically for the pediatric population using photographs taken by parents, to our knowledge,” the study said. “Thus, our study’s objective was to evaluate the quality of parent photography and the concordance between diagnoses made from in-person and photograph-based examinations. Furthermore, we explored whether a simple instruction sheet provided to parents would improve image quality and diagnostic accuracy.”
The term teledermatology has been around for more than two decades but more recently mobile has emerged as a tool for the practice. While this study discusses the lack of pediatric evaluations, teledermatology has also been evaluated in the adult population.
In 2013, a small validation study in Sweden, found that using a dedicated app connected to a dermascope could be roughly as effective as face-to-face dermatology appointments. While the teledermatology was comparable to in-person it was not as comprehensive, as it was not as accurate as in person visits.
A follow-up study concluded that teledermatology referrals using a smartphone with an attached dermascope allowed dermatologists to manage their patients faster and more efficiently than with traditional paper referrals.
But not all teledermatology studies have been so positive. Another study published in JAMA found direct-to-consumer dermatology telemedicine services lacking in a number of areas including transparency, diagnostics, and therapeutic quality.
Still, big names are jumping into the game. Walgreen’s website and mobile app now features a skin care service. In 2016, the pharmacy giant partnered with teledermatology provider lagnosis on an app called DermatologistOnCall, which lets users book and schedule online consultations with dermatologists and get information about common skin conditions.
