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Half of diagnoses concordant between online, in-person dermatological consultations

Online consultations and physical consultations with a dermatologist produced concordant diagnoses in 52% of cases, according to recently published study results.

Researchers in Switzerland compared the adequacy of an online diagnosis with an in-person dermatological consultation after referral by performing a retrospective review of inquiries between June 2007 and September 2014. There were 102 submissions (32 with photographs) referred for in-person consultation, with 82 patients (median age, 38 years; 50% male) included in the study.

A diagnostic index developed by the German Dermatologic Society DDG was used to classify diagnoses. A matching of digits of the index code was used to define concordance in six groups.

“Diagnostic concordance was evenly distributed from low to high (χ² P = .16),” the researchers wrote. “A lack of differentials online (χ² P  = .001), as well as on physical consultation (χ² P  < .001) was associated with diagnostic concordance, but neither photograph submission, prediagnosed conditions or personal or family history information was significant (Kendall τ P = .80, P = .04, P = .30, P = .16, respectively).”

Diagnostic concordance was associated with the type of physician contact (χ² P = .02). A second diagnosis was made at physical consultation in 42% of cases, including one basal cell and one squamous epithelial carcinoma.

Diagnoses were concordant in 52% of online and physical consultations, and enlarged concordant in 66% of cases. Sixty percent of patients had already visited a physician for complex dermatological problems.

“Previous physician contact was not associated with diagnostic concordance except in cases in which more than one dermatologist or another specialist was visited,” the researchers wrote. “We noted absence of differential diagnosis as a factor in diagnostic confidence in both online (χ² P = .001) and physical consultation (P < .001).” – By Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.