How high-res video can improve remote dermatology consults

Telemedicine

New research finds significant differences between in-person and remote dermatology consultations, though it poses high-resolution uncompressed video as a more feasible technology than alternative remote methods.

The study, published online in Telemedicine and e-Health, compared in-person diagnoses with still photos, high-resolution uncompressed video and lower-resolution compressed video.

It also based the results on opinions of multiple clinicians, which sets the research apart from previous work, according to the authors, from the Medical University of South Carolina, the National Institutes of Health and the University of Alabama at Birmingham. The researchers examined primary and differential diagnoses, biopsy recommendations and confidence levels for diagnoses.

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Overall, 214 patients were evaluated three times in a single clinical session: in person, via store-and-forward methods (still photography) and by either high-definition uncompressed or compressed video. The videoconferencing system comprised pan, tilt, and zoom cameras that could be controlled outside the exam room.

The high levels of agreement on diagnosis, confidence and decisions contrasted significantly for in-person exams compared with remote methods, the authors reported. However, there was no significant difference in confidence between the still photos and uncompressed live video. Confidence in diagnosis, differential and biopsy recommendation was significantly lower for compressed video.

The still photos--a minimum of three 10 megapixel JPEG images--however, likely were of higher resolution than those normally taken in practice, the authors noted as a limitation of the study.

What's more, they said, uncompressed video requires network infrastructure and technical support that must be considered when comparing it to store-and-forward technology.

Researchers from the University of California, San Francisco and elsewhere earlier this year raised questions about the accuracy of dermatology consultations from direct-to-consumer telemedicine vendors.