Pediatric dermatology: parent-submitted photos >80% accurate for diagnosis

  • JAMA Dermatol

  • Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • Diagnosis by parent-submitted smartphone photographs has high concordance with in-person diagnosis in patients with pediatric dermatology.

Why this matters

  • Teledermatology can improve access to care and reduce time to treatment in a cost-effective manner.

Key results

  • Overall concordance between photo-based and in-person diagnosis was 83% (95% CI, 71%-94%; Cohen κ=0.81).
  • Concordance was 89% (95% CI, 75%-97%; Cohen κ=0.88) in patients with photos considered high enough quality to make a diagnosis.
  • Concordance was 64% for alopecia, 67% for nodules and tumors, 92% for rash, 100% for birthmark, 100% for pigmented lesions, and 100% for morphea.
  • Image quality differed based on whether or not a diagnosis could be provided (mean photograph quality rating score with diagnosis rendered, 8.9; mean score with no diagnosis, 7.0; P=.001)
  • Parents who received instructions on how to take photographs had similar concordance rates as those who did not (85% vs 80%; P=.68).

Study design

  • 40 pediatric dermatology patients and their parents were analyzed for diagnostic concordance between submitted photographs and in-person diagnosis.
  • Funding: Office of Entrepreneurship and Innovation at Children’s Hospital of Philadelphia.

Limitations

  • Small sample size.