scholarly journals Healing From a Distance: A Cross-sectional Study on the Diagnostic Reliability of Store-and-Forward Teledermatology

Iproceedings ◽  
10.2196/35386 ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. e35386
Author(s):  
Erika Kim R Chan ◽  
Jacqueline Michelle D Melendres
Keyword(s):  
Health Care Services ◽  
Conflicts Of Interest ◽  
Cross Sectional Study ◽  
Senior Resident ◽  
Complete Agreement ◽  
Sectional Study ◽  
Cross Sectional ◽  
Diagnostic Reliability ◽  
Face To Face ◽  
The Face

Background Telemedicine delivers health care services between two distant locations through the use of information and communication technology. Several medical specializations, such as dermatology, have incorporated telemedicine into their practice. Since dermatologists are trained to diagnose skin, hair, and nail conditions with a clinical eye, teledermatology may be an alternative when a traditional face-to-face clinic visit is not feasible. Objective The purpose of this study was to evaluate the diagnostic reliability of teledermatology. Methods A cross-sectional study was conducted among patients from 2 government hospitals. A total of 39 patients were seen in a face-to-face setting and diagnosed by a consultant dermatologist. A written history of their present illness and accompanying photographs were taken and were shown to 3 consultant teledermatologists, who then diagnosed their condition. Two senior dermatology residents then rated the face-to-face and teledermatology diagnoses as either complete agreement, partial agreement, or no agreement. Descriptive statistics was used to summarize the general and clinical characteristics of the participants. The Cohen kappa was used to assess agreement in the evaluations between the teledermatology and face-to-face diagnoses by senior resident raters #1 and #2. Results Over 70% of the diagnoses were deemed as either partial or in complete agreement with the face-to-face diagnosis for senior resident rater #1. Similarly, over 80% of the diagnoses were deemed as either partial or in complete agreement with the face-to-face diagnosis for senior resident rater #2. The agreement between the ratings of senior residents #1 and #2 ranged from fair to substantial. Conclusions The findings of the study showed that the diagnostic concordance of in-person clinicians and teledermatologists ranges from fair to substantial, with over 70% of the diagnoses in partial or complete agreement. Although face-to-face consultations remain the gold standard, teledermatology is an important alternative where dermatologic care is not accessible. Conflicts of Interest None declared.

scholarly journals Healing From a Distance: A Cross-sectional Study on the Diagnostic Reliability of Store-and-Forward Teledermatology (Preprint)

2021 ◽  
Author(s):  
Erika Kim R Chan ◽  
Jacqueline Michelle D Melendres
Keyword(s):  
Health Care Services ◽  
Cross Sectional Study ◽  
Clinic Visit ◽  
Senior Resident ◽  
Complete Agreement ◽  
Sectional Study ◽  
Cross Sectional ◽  
Diagnostic Reliability ◽  
Face To Face ◽  
The Face

BACKGROUND Telemedicine delivers health care services between two distant locations through the use of information and communication technology. Several medical specializations, such as dermatology, have incorporated telemedicine into their practice. Since dermatologists are trained to diagnose skin, hair, and nail conditions with a clinical eye, teledermatology may be an alternative when a traditional face-to-face clinic visit is not feasible. OBJECTIVE The purpose of this study was to evaluate the diagnostic reliability of teledermatology. METHODS A cross-sectional study was conducted among patients from 2 government hospitals. A total of 39 patients were seen in a face-to-face setting and diagnosed by a consultant dermatologist. A written history of their present illness and accompanying photographs were taken and were shown to 3 consultant teledermatologists, who then diagnosed their condition. Two senior dermatology residents then rated the face-to-face and teledermatology diagnoses as either complete agreement, partial agreement, or no agreement. Descriptive statistics was used to summarize the general and clinical characteristics of the participants. The Cohen kappa was used to assess agreement in the evaluations between the teledermatology and face-to-face diagnoses by senior resident raters #1 and #2. RESULTS Over 70% of the diagnoses were deemed as either partial or in complete agreement with the face-to-face diagnosis for senior resident rater #1. Similarly, over 80% of the diagnoses were deemed as either partial or in complete agreement with the face-to-face diagnosis for senior resident rater #2. The agreement between the ratings of senior residents #1 and #2 ranged from fair to substantial. CONCLUSIONS The findings of the study showed that the diagnostic concordance of in-person clinicians and teledermatologists ranges from fair to substantial, with over 70% of the diagnoses in partial or complete agreement. Although face-to-face consultations remain the gold standard, teledermatology is an important alternative where dermatologic care is not accessible.

Healing From a Distance: A Cross-sectional Study on the Diagnostic Reliability of Store-and-Forward Teledermatology (Preprint)

2021 ◽  
Author(s):  
Erika Kim Chan ◽  
Jacqueline Michelle Melendres
Keyword(s):  
Health Care Services ◽  
Cross Sectional Study ◽  
Clinic Visit ◽  
Senior Resident ◽  
Complete Agreement ◽  
Sectional Study ◽  
Cross Sectional ◽  
Diagnostic Reliability ◽  
Face To Face ◽  
The Face

UNSTRUCTURED Telemedicine delivers health care services between two distant locations through the use of information and communication technology. Several medical specializations, such as dermatology, have incorporated telemedicine into their practice. Since dermatologists are trained to diagnose skin, hair, and nail conditions with a clinical eye, teledermatology may be an alternative when a traditional face-to-face clinic visit is not feasible. The purpose of this study was to evaluate the diagnostic reliability of teledermatology. A cross-sectional study was conducted among patients from 2 government hospitals. A total of 39 patients were seen in a face-to-face setting and diagnosed by a consultant dermatologist. A written history of their present illness and accompanying photographs were taken and were shown to 3 consultant teledermatologists, who then diagnosed their condition. Two senior dermatology residents then rated the face-to-face and teledermatology diagnoses as either complete agreement, partial agreement, or no agreement. Descriptive statistics was used to summarize the general and clinical characteristics of the participants. The Cohen kappa was used to assess agreement in the evaluations between the teledermatology and face-to-face diagnoses by senior resident raters #1 and #2. Over 70% of the diagnoses were deemed as either partial or in complete agreement with the face-to-face diagnosis for senior resident rater #1. Similarly, over 80% of the diagnoses were deemed as either partial or in complete agreement with the face-to-face diagnosis for senior resident rater #2. The agreement between the ratings of senior residents #1 and #2 ranged from fair to substantial. The findings of the study showed that the diagnostic concordance of in-person clinicians and teledermatologists ranges from fair to substantial, with over 70% of the diagnoses in partial or complete agreement. Although face-to-face consultations remain the gold standard, teledermatology is an important alternative where dermatologic care is not accessible.

Healing from a distance: A cross-sectional study on the diagnostic reliability of store-and-forward Teledermatology (Preprint)

2021 ◽  
Author(s):  
Erika Kim Chan ◽  
Jacqueline Michelle Melendres
Keyword(s):  
Health Care Services ◽  
Medical Center ◽  
Cross Sectional Study ◽  
Senior Resident ◽  
Complete Agreement ◽  
Sectional Study ◽  
Cross Sectional ◽  
Diagnostic Reliability ◽  
Face To Face ◽  
The Face

BACKGROUND Telemedicine delivers health care services between two distant locations through the use of information and communication technology. Several medical specializations, such as dermatology, have incorporated telemedicine into their practice. Since dermatologists are trained to diagnose skin, hair and nail conditions with a clinical eye, teledermatology may be an alternative when a traditional face-to-face clinic visit is not feasible. OBJECTIVE The purpose of this study is to evaluate the diagnostic reliability of teledermatology. METHODS A cross-sectional study was conducted among patients from Culion Sanitarium and General Hospital and Rizal Medical Center. Thirty-nine patients were seen face-to-face and diagnosed by a consultant dermatologist. A written history of their present illness and accompanying photographs were taken, and were shown to three consultant teledermatologists who then diagnosed their condition. Two senior dermatology residents then rated the face-to-face and teledermatology diagnoses as either complete agreement, partial agreement, or no agreement. Descriptive statistics was used to summarize the general and clinical characteristics of the participants. Cohen’s Kappa was used to determine the agreement of the evaluations between the teledermatology and face to face diagnoses by senior residents 1 and 2. RESULTS Over 70% of the diagnoses were deemed as either partial or in complete agreement with the face-to-face diagnosis for senior resident rater 1. Similarly, over 80% of the diagnoses were deemed as either partial or in complete agreement with the face-to-face diagnosis for senior resident rater 2. The agreement between the agreement ratings of senior residents 1 and 2 were fair to substantial. CONCLUSIONS The findings of the study show that the diagnostic concordance of in-person clinicians and teledermatologists are fair to substantial, with over 70% of the diagnoses in partial or complete agreement. Though face-to-face consultations remain the gold standard, teledermatology is an important alternative where dermatologic care is not accessible.

scholarly journals Prevalence and Predictors of Exclusive Breastfeeding Practices In Seberang Ulu I, Palembang: A Cross-Sectional Study

2019 ◽  
Vol 10 (3) ◽  
pp. 163-171
Author(s):  
Indah Purnama Sari ◽  
Dewi Handayani ◽  
Fatmalina Febry
Keyword(s):  
Exclusive Breastfeeding ◽  
Health Workers ◽  
Multiple Logistic Regression Analysis ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Face To Face ◽  
Breastfeeding Practices ◽  
The Face

Exclusive breastfeeding is one of the successful indicators in improving the health of babies. From 2013 until 2014, the practice of exclusive breastfeeding has decreased in Indonesia and has not reached the national targets of around 80% of babies being exclusively breastfed. This study aimed to identify the prevalence and determinants of exclusive breastfeeding in Seberang Ulu I, Palembang. A community-based cross sectional study was executed from July 5, 2016 to August 5, 2016 among mothers who had infants aged less than six months. A purposive sampling technique was used to select a sample of 125 participants. Data were collected using a structured questionnaire by the face-to-face interview technique. Bivariate and multiple logistic regression analysis were used to determine factors associated with the practice of breastfeeding exclusively and to control confounding effects. The prevalence of exclusive breastfeeding was 26.4% (95% CI: 20.0%-35.1%). After adjusting for confounders (mothers’ attitudes and health workers’ support), mothers who had good knowledge were 11.66 times more likely to breastfeed exclusively than those who had poor knowledge (AOR: 11.66, 95% CI: 3.07-44.31). The prevalence of exclusive breastfeeding in Seberang Ulu I, Palembang, was still very low and has not reached the national target. The recommendation is to maximize the role of health workers in providing information about exclusive breastfeeding, so that they can continue providing motivation for mothers, husbands and families, so that the success and sustainability of exclusive breastfeeding practices could be achieved.   Keywords: Mother’s knowledge, mother’s attitude, health workers support, exclusive breastfeeding

Knowledge and Practices Regarding Early Colostrum Feeding Among Mothers in Erbil Governorate: a Comparative Study

2021 ◽  
Author(s):  
Madiha M Abas ◽  
Shukir Saleem Hasan
Keyword(s):  
Statistical Difference ◽  
Cross Sectional Study ◽  
Normal Vaginal Delivery ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Face To Face ◽  
Colostrum Feeding ◽  
Spss Software ◽  
Data Frequency

Abstract Background and objectives: Colostrum is the first breastfeed which is a product by the mother. it has containing high amounts and concentrations of nutrients and antibodies. Methods: A comparative, cross-sectional study was conducted in different areas in Erbil Governorate. During the period started on 2nd Jan. to the end of May. 2019. Non- probability of 400 mothers who delivered their baby by normal vaginal delivery in the hospitals were recruited. A special tool was constructed by researchers, a direct face-to-face interview was adapted. Data were collected and interpreted to the computer. A special SPSS software version 23 was used for analyzing the data, frequency, chi-square, and two tailed t-test statistical analysis was applied for the study.Results: Incorrect knowledge among Erbil city and Koy-Sanjaq city was observed, with better information among Shaqlawa mothers. Poor practices of colostrum feeding among all mothers, and found a statistically significant association between mother’s knowledge, and relay to an association between mothers’ practices. Statistically significant differences were found between Erbil city and Koy-Sanjaq city; between Shaqlawa city and Koy-Sanjaq city concerning mothers’ practices respectively, with non-statistically differences between Erbil and Shaqlawa mothers, also non-statistically significant differences between mothers’ practices in Erbil and Shaqlawa city. There are statistically differences between mothers in Erbil, Koy-Sanjaq, and between Erbil and Shaqlawa with no statistical difference between Koy-Sanjaq and Shaqlawa mothers regarding knowledge. Conclusions: The mothers in Shaqlawa city had better knowledge and all three districts were having poor practices regarding colostrum feeding.

Giving when it costs

2017 ◽  
Vol 35 (5) ◽  
pp. 722-742 ◽  
Author(s):  
Lisa C. Day ◽  
Emily A. Impett
Keyword(s):  
Romantic Relationships ◽  
Low Cost ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Daily Experience ◽  
Self Construal ◽  
Interdependent Self ◽  
The Face ◽  
Willingness To Sacrifice

Do some people exhibit a greater willingness to sacrifice in romantic relationships and derive more satisfaction from doing so, even in the face of high costs? In a cross-sectional study and a daily experience study, we show that people low in interdependent self-construal were less willing to sacrifice when the costs were relatively high, whereas people high in interdependent self-construal were equally willing to make high- and low-cost sacrifices. Further, when people low in interdependent self-construal chose to sacrifice, they felt less authentic when the costs were high, which in turn, detracted from their satisfaction with sacrifice. In contrast, people high in interdependent self-construal did not feel less authentic and were buffered against feeling less satisfied when making more costly sacrifices. The findings identify a set of individuals who are more willing to sacrifice, even in the face of high costs, and who feel more satisfied and authentic when doing so.

scholarly journals Associations between residual depressive symptoms, cognition, and functioning in patients with euthymic bipolar disorder: results from the FACE-BD cohort

2017 ◽  
Vol 211 (6) ◽  
pp. 381-387 ◽  
Author(s):  
Paul Roux ◽  
Aurélie Raust ◽  
Anne-Sophie Cannavo ◽  
Valérie Aubin ◽  
Bruno Aouizerate ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Depressive Symptoms ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Cognitive Component ◽  
Cognitive Components ◽  
The Face ◽  
Sources Of Variation ◽  
The Relationship

BackgroundThe relationship between residual depressive symptoms, cognition and functioning in patients with euthymic bipolar disorder is a subject of debate.AimsTo assess whether cognition mediates the association between residual depressive symptoms and functioning in patients with bipolar disorder who were euthymic.MethodWe included 241 adults with euthymic bipolar disorder in a multicentre cross-sectional study. We used a battery of tests to assess six cognition domains. A path analysis was then used to perform a mediation analysis of the relationship between residual depressive symptoms, cognitive components and functioning.ResultsOnly verbal and working memory were significantly associated with better functioning. Residual depressive symptoms were associated with poorer functioning. No significant relationship was found between residual depressive symptoms and any cognitive component.ConclusionsCognition and residual depressive symptoms appear to be two independent sources of variation in the functioning of people with euthymic bipolar disorder.

scholarly journals A cross-sectional study of all clinicians’ conflict of interest disclosures to NHS hospital employers in England 2015-2016

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e019952 ◽  
Author(s):  
Harriet Ruth Feldman ◽  
Nicholas J DeVito ◽  
Jonathan Mendel ◽  
David E Carroll ◽  
Ben Goldacre
Keyword(s):  
Conflict Of Interest ◽  
Conflicts Of Interest ◽  
Current System ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Freedom Of Information ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Gift ◽  
The Uk

ObjectiveWe set out to document how NHS trusts in the UK record and share disclosures of conflict of interest by their employees.DesignCross-sectional study of responses to a Freedom of Information Act request for Gifts and Hospitality Registers.SettingNHS Trusts (secondary/tertiary care organisations) in England.Participants236 Trusts were contacted, of which 217 responded.Main outcome measuresWe assessed all disclosures for completeness and openness, scoring them for achieving each of five measures of transparency.Results185 Trusts (78%) provided a register. 71 Trusts did not respond within the 28 day time limit required by the FoIA. Most COI registers were incomplete by design, and did not contain the information necessary to assess conflicts of interest. 126/185 (68%) did not record the names of recipients. 47/185 (25%) did not record the cash value of the gift or hospitality. Only 31/185 registers (16%) contained the names of recipients, the names of donors, and the cash amounts received. 18/185 (10%) contained none of: recipient name, donor name, and cash amount. Only 15 Trusts had their disclosure register publicly available online (6%). We generated a transparency index assessing whether each Trust met the following criteria: responded on time; provided a register; had a register with fields identifying donor, recipient, and cash amount; provided a register in a format that allowed further analysis; and had their register publicly available online. Mean attainment was 1.9/5; no NHS trust met all five criteria.ConclusionOverall, recording of employees’ conflicts of interest by NHS trusts is poor. None of the NHS Trusts in England met all transparency criteria. 19 did not respond to our FoIA requests, 51 did not provide a Gifts and Hospitality Register and only 31 of the registers provided contained enough information to assess employees’ conflicts of interest. Despite obligations on healthcare professionals to disclose conflicts of interest, and on organisations to record these, the current system for logging and tracking such disclosures is not functioning adequately. We propose a simple national template for reporting conflicts of interest, modelled on the US ‘Sunshine Act’.

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