Accuracy and reliability of teledermatoscopy with images taken by general practitioners during everyday practice

J Telemed Telecare. 2013 Sep;19(6):320-5. doi: 10.1177/1357633X13503437. Epub 2013 Sep 9.


We assessed the accuracy and reliability of teledermatoscopy with images taken by a general practitioner (GP) compared to face-to-face dermatological examination. GPs selected patients for teledermatoscopy and took both macro and dermatoscopic photographs. Patients were then referred to the local dermatologist for face-to-face examination. Accuracy and inter-observer reliability were calculated for the diagnosis and management plan. Image quality was rated by two observers on a three-point scale. A total of 108 teledermatoscopy consultations sent by 13 GPs were assessed by four dermatologists. Agreement was 0.61 (kappa) on diagnostic group and 0.23 on management plan. The inter-observer reliability was 0.65 on diagnostic group and 0.36 on management plan. The image quality was reported as bad in 36% of cases, reasonable in 28% and good in 36%. Agreement for cases with good quality images was 0.66 on diagnostic group and 0.42 on management plan. Teledermatoscopy in general practice had overall a lower accuracy and reliability than face-to-face consultation. In cases where a good quality image was reported, the accuracy increased, which emphasises that teledermatoscopy is highly dependent on a good quality images.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Dermoscopy / education*
  • Dermoscopy / instrumentation
  • Dermoscopy / standards*
  • Family Practice
  • Female
  • General Practitioners / education
  • Humans
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Referral and Consultation
  • Remote Consultation / methods
  • Remote Consultation / standards
  • Reproducibility of Results
  • Skin Neoplasms / diagnosis*
  • Telemedicine / methods*
  • Telemedicine / standards
  • Time Factors
  • Young Adult