Evaluation and implementation of teledermoscopy in General Practice
In this study general practitioners (GPs), who suspect skin cancer in a patient, can send specialized photographs for evaluation by a skin cancer specialist. The patient is also referred for a face-to-face evaluation, and the diagnostic agreement between the to consultation methods will be assessed.
The incidence of malignant melanoma and other skin cancers (e.g. squamous cell carcinoma and basal cell carcinoma, hereafter non-melanoma skin cancer) is steadily increasing in Denmark. It is crucial that melanoma is diagnosed as early as possible, since the early stages of the disease can be cured by surgery. In regards to non-melanoma skin cancer, an early diagnosis can facilitate the use of smaller surgical procedures or even non-invasive treatments. In the clinical evaluation of both suspected malignant melanoma and non-melanoma skin cancer, the use of dermoscopy is essential. The accuracy of a clinical diagnosis of melanoma based on visual inspection by general practitioners is just over 50%. In the experienced hands of a dermatologist, the use of dermoscopy increases the sensitivity up to 90%.Previous studies have found an excellent correlation above 90% between the use of teledermoscopy and a traditional clinical examination using dermoscopy.
This study has the following aims:
- To assess the safety of teledermoscopic evaluation of patients with suspicious skin lesions referred from general practice.
- To assess whether incidental lesions are missed by teledermoscopy.
- To evaluate patients', GPs' and dermatologists' satisfaction with teledermoscopy.
- To calculate the change in average cost per patient by implementing teledermoscopy.
Description of the cohort
In this prospective study, general practitioners from 50 medical practices in the Region of Southern Denmark, are invited to participate. Consecutive patients over the age of 18 years, who consult their GP with a suspicious skin lesion or where the GP finds an incidental suspicious skin lesion, which the GP wishes to refer to a dermatologist for skin evaluation, can be included in the study.
Data and biological material
Standard photographs and dermoscopic images are obtained for each suspicious skin lesion. Questionnaires on patients', GPs' and dermatologists' experiences and satisfaction with teledermoscopy will be collected.
Collaborating researchers and departments
Department of Dermatology, Odense University Hospital
- Professor Anette Bygum, dr. med.
Research Unit of General Practice, Department of Public Health, University of Southern Denmark
- General practitioner Merethe Kirstine Andersen, PhD
Center for Innovative Medical Technology, Odense University Hospital
Publications associated with the project
Vestergaard T, Prasad SC, Schuster A, Laurinaviciene R, Andersen MK, Bygum A. Diagnostic accuracy and interobserver concordance: teledermoscopy of 600 suspicious skin lesions in Southern Denmark. J Eur Acad Dermatol Venereol. 2020 Jul;34(7):1601-1608. doi: 10.1111/jdv.16275. Epub 2020 Mar 27. PMID: 32031277.
Vestergaard T, Prasad SC, Schuster A, Laurinaviciene R, Bygum A, Munck A, Andersen MK. Introducing teledermoscopy of possible skin cancers in general practice in Southern Denmark. Fam Pract. 2020 Sep 5;37(4):513-518. doi: 10.1093/fampra/cmaa041. PMID: 32347299.
Vestergaard T, Andersen MK, Bygum A. Acceptance of Teledermoscopy by General Practitioners and Dermatologists in Denmark. Dermatol Pract Concept. 2021 Apr 12;11(2):e2021033. doi: 10.5826/dpc.1102a33. PMID: 33954016; PMCID: PMC8060020.
Gilling S, Mortz CG, Vestergaard T. Patient Satisfaction and Expectations Regarding Mobile Teledermoscopy in General Practice for Diagnosis of Non-melanoma Skin Cancer and Malignant Melanoma. Acta Derm Venereol. 2020 Apr 21;100(8):adv00117. doi: 10.2340/00015555-3459. PMID: 32179927.