Remote Skin Cancer Diagnosis: Adding Images to Electronic Referrals Is More Efficient Than Wait-Listing for a Nurse-Led Imaging Clinic

We undertook a retrospective comparison of two teledermatology pathways that provide diagnostic and management advice for suspected skin cancers, to evaluate the time from referral to diagnosis and its concordance with histology. Primary Care doctors could refer patients to either the Virtual Lesion...

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Autores principales:	Leah Jones, Michael Jameson, Amanda Oakley
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	teledermatology teledermoscopy skin cancer squamous cell carcinoma basal cell carcinoma melanoma Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/76c87b5118c240cb83b4972d6b5db074
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id	oai:doaj.org-article:76c87b5118c240cb83b4972d6b5db074
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spelling	oai:doaj.org-article:76c87b5118c240cb83b4972d6b5db0742021-11-25T17:04:29ZRemote Skin Cancer Diagnosis: Adding Images to Electronic Referrals Is More Efficient Than Wait-Listing for a Nurse-Led Imaging Clinic10.3390/cancers132258282072-6694https://doaj.org/article/76c87b5118c240cb83b4972d6b5db0742021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/22/5828https://doaj.org/toc/2072-6694We undertook a retrospective comparison of two teledermatology pathways that provide diagnostic and management advice for suspected skin cancers, to evaluate the time from referral to diagnosis and its concordance with histology. Primary Care doctors could refer patients to either the Virtual Lesion Clinic (VLC), a nurse-led community teledermoscopy clinic or, more recently, to the Suspected Skin Cancer (SSC) pathway, which requires them to attach regional, close-up, and dermoscopic images. The primary objective of this study was to determine the comparative time course between the SSC pathway and VLC. Secondary objectives included comparative diagnostic concordance, skin lesion classification, and evaluation of missed skin lesions during subsequent follow-up. VLC referrals from July to December 2016 and 2020 were compared to SSC referrals from July to December 2020. 408 patients with 682 lesions in the VLC cohort were compared with 480 patients with 548 lesions from the 2020 SSC cohort, matched for age, sex, and ethnicity, including histology where available. Median time (SD) from referral to receipt of teledermatology advice was four (2.8) days and 50 (43.0) days for the SSC and VLC cohorts, respectively (<i>p</i> < 0.001). Diagnostic concordance between teledermatologist and histopathologist for benign versus malignant lesions was 70% for 114 lesions in the SSC cohort, comparable to the VLC cohort (71% of 122 lesions). Referrals from primary care, where skin lesions were imaged with variable devices and quality resulted in faster specialist advice with similar diagnostic performance compared to high-quality imaging at nurse-led specialist dermoscopy clinics.Leah JonesMichael JamesonAmanda OakleyMDPI AGarticleteledermatologyteledermoscopyskin cancersquamous cell carcinomabasal cell carcinomamelanomaNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5828, p 5828 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	teledermatology teledermoscopy skin cancer squamous cell carcinoma basal cell carcinoma melanoma Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	teledermatology teledermoscopy skin cancer squamous cell carcinoma basal cell carcinoma melanoma Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Leah Jones Michael Jameson Amanda Oakley Remote Skin Cancer Diagnosis: Adding Images to Electronic Referrals Is More Efficient Than Wait-Listing for a Nurse-Led Imaging Clinic
description	We undertook a retrospective comparison of two teledermatology pathways that provide diagnostic and management advice for suspected skin cancers, to evaluate the time from referral to diagnosis and its concordance with histology. Primary Care doctors could refer patients to either the Virtual Lesion Clinic (VLC), a nurse-led community teledermoscopy clinic or, more recently, to the Suspected Skin Cancer (SSC) pathway, which requires them to attach regional, close-up, and dermoscopic images. The primary objective of this study was to determine the comparative time course between the SSC pathway and VLC. Secondary objectives included comparative diagnostic concordance, skin lesion classification, and evaluation of missed skin lesions during subsequent follow-up. VLC referrals from July to December 2016 and 2020 were compared to SSC referrals from July to December 2020. 408 patients with 682 lesions in the VLC cohort were compared with 480 patients with 548 lesions from the 2020 SSC cohort, matched for age, sex, and ethnicity, including histology where available. Median time (SD) from referral to receipt of teledermatology advice was four (2.8) days and 50 (43.0) days for the SSC and VLC cohorts, respectively (<i>p</i> < 0.001). Diagnostic concordance between teledermatologist and histopathologist for benign versus malignant lesions was 70% for 114 lesions in the SSC cohort, comparable to the VLC cohort (71% of 122 lesions). Referrals from primary care, where skin lesions were imaged with variable devices and quality resulted in faster specialist advice with similar diagnostic performance compared to high-quality imaging at nurse-led specialist dermoscopy clinics.
format	article
author	Leah Jones Michael Jameson Amanda Oakley
author_facet	Leah Jones Michael Jameson Amanda Oakley
author_sort	Leah Jones
title	Remote Skin Cancer Diagnosis: Adding Images to Electronic Referrals Is More Efficient Than Wait-Listing for a Nurse-Led Imaging Clinic
title_short	Remote Skin Cancer Diagnosis: Adding Images to Electronic Referrals Is More Efficient Than Wait-Listing for a Nurse-Led Imaging Clinic
title_full	Remote Skin Cancer Diagnosis: Adding Images to Electronic Referrals Is More Efficient Than Wait-Listing for a Nurse-Led Imaging Clinic
title_fullStr	Remote Skin Cancer Diagnosis: Adding Images to Electronic Referrals Is More Efficient Than Wait-Listing for a Nurse-Led Imaging Clinic
title_full_unstemmed	Remote Skin Cancer Diagnosis: Adding Images to Electronic Referrals Is More Efficient Than Wait-Listing for a Nurse-Led Imaging Clinic
title_sort	remote skin cancer diagnosis: adding images to electronic referrals is more efficient than wait-listing for a nurse-led imaging clinic
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/76c87b5118c240cb83b4972d6b5db074
work_keys_str_mv	AT leahjones remoteskincancerdiagnosisaddingimagestoelectronicreferralsismoreefficientthanwaitlistingforanurseledimagingclinic AT michaeljameson remoteskincancerdiagnosisaddingimagestoelectronicreferralsismoreefficientthanwaitlistingforanurseledimagingclinic AT amandaoakley remoteskincancerdiagnosisaddingimagestoelectronicreferralsismoreefficientthanwaitlistingforanurseledimagingclinic
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Remote Skin Cancer Diagnosis: Adding Images to Electronic Referrals Is More Efficient Than Wait-Listing for a Nurse-Led Imaging Clinic

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