RELIABILITY OF TELEMEDICINE IN EVALUATING SKIN TUMORS

Objectives: To determine the reliability of videoconferencing technolo gy in evaluating skin tumors, the impact of the technology on the clin icians' degree of suspicion that a skin tumor is malignant, and the re commendation to do a biopsy. Materials and Methods: Four skin cancer s creenings were conducted at rural health care facilities in eastern No rth Carolina that were connected to East Carolina University School of Medicine. A dermatologist saw the patients in person at the local fac ility, and the same patient was seen by a dermatologist via a T-l conn ection to Greenville, North Carolina. Results: The two physicians were in absolute agreement on 59% of the 107 skin tumors evaluated. There were five lesions identified by the on-site dermatologist as a probabl e or definite malignancy. The degree of concern about a lesion being m alignant and the decision whether to do a biopsy were not significantl y different, as shown by kappa analysis. Conclusion: The concern about the malignancy of a particular skin lesion and the recommendation whe ther to do a biopsy were not significantly affected by telemedicine te chnology.