Critical appraisal:Oztas MO, Calikoglu E, Baz K, Birol A, Onder M, Calikoglu T, et al 2004

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Critical Appraisal

Article being appraised

Oztas MO, Calikoglu E, Baz K, Birol A, Onder M, Calikoglu T, et al. Reliability of Web-based teledermatology consultations. J Telemed Telecare 2004;10(1):25-8 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/15006212.


Applicable clinical question

Key Facts

Study Design

case series

Study aims:

To determine if a store and forward tele dermatology approach is as good as the histopathological diagnosis. Additionally to determine if clinical information adds to the diagnostic accuracy compared to using images alone.

Number of Patients:

125

Patient were randomised but no specifics about the randomisation process was explained. No control arm. Only 12 of the 125 cases under study were skin tumours.
Reported outcome(s):

Diagnostic accuracy of the 3 teledermatologists. Agreement rate between the 3 teledermatologists

Results of outcome(s):

Number of correct diagnoses increased from 68 to 76% when clinical information was added to the images. The agreement rate between the teledermatologists ranged from 0.46 to 0.70. Inter observer agreement rates were within the literature boundaries of 54% to 96%. Without clinical information the accuracy of tele dermatology was 55 to 61% and this increased to 62-80% with additional clinical information.

Comments on results:

The tele dermatologists only had 3 or more years of experience so in all likelihood were junior.

Includes an economic evaluation

no

Evidence ratings

Level of evidence

IV

Risk of bias
High risk of bias Comments: Single institution but patients were randomly sleeted from the outpatient department. Not explicitly stated that the diagnoses were blinded. Minimal number of tumour cases included in the 125 patients.

Risk of bias assessment: case series

Subject selection:
Highly selected or not described (e.g. single-institution study)
Were the outcome measures blind to pre/post-intervention?
Yes
Follow-up complete and all patients included in the analysis?
Yes (follow-up >95%)
Size of effect
5 Reason for decision: No statistical analysis performed of the results so no conclusions on the effect size possible.
Relevance of evidence
4 Additional comments: Case series. Minimal skin tumour cases included. Technology used in 2004 is outdated in 2015.
Result of appraisal

Jutta's tick icon.png Included




Completed by

Dr Rob Zielinski


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Article
Oztas MO, Calikoglu E, Baz K, Birol A, Onder M, Calikoglu T, et al. Reliability of Web-based teledermatology consultations. J Telemed Telecare 2004;10(1):25-8 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/15006212.
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