DIAGNOSTIC-ACCURACY AND CLINICAL MANAGEMENT BY REALTIME TELEDERMATOLOGY - RESULTS FROM THE NORTHERN-IRELAND ARMS OF THE UK MULTICENTER TELEDERMATOLOGY TRIAL

Diagnostic accuracy and management recommendations of realtime teleder matology consultations using low-cost telemedicine equipment were eval uated. Patients were seen by a dermatologist over a video-link and a d iagnosis and treatment plan were recorded. This was followed by a face -to-face consultation on the same day to confirm the earlier diagnosis and management plan. A total of 351 patients with 427 diagnoses parti cipated. Sixty-seven per cent of the diagnoses made over the video-lin k agreed with the face-to-face diagnosis. Clinical management plans we re recorded for 214 patients with 252 diagnoses. For this cohort, 44% of the patients were seen by the same dermatologist at both consultati ons, while 56% were seen by a different dermatologist. In 64% of cases the same management plan was recommended at both consultations; a sub -optimum treatment plan was recommended in 8% of cases; and in 9% of c ases the video-link management plans were judged to be inappropriate. In 20% of cases the dermatologist was unable to recommend a suitable m anagement plan by video-link. There were significant differences in th e ability to recommend an optimum management plan by video-link when a different dermatologist made the reference management plan. The resul ts indicate that a high proportion of dermatological conditions can be successfully managed by realtime teledermatology.