A new “hub and spoke” teledermoscopy system involving general practitioners and dermatologists for the early detection of cutaneous melanoma: a pilot study

Gabriella Fabbrocini; Sara Cacciapuoti; Gaia De Fata Salvatores; Claudia Costa; Paolo Chiodini; Maria Antonietta Luciano; Serena Poggi; Silvestro Scotti; Luigi Sparano; Giuseppe Di Leo; Paolo Sommella; Matteo Ferro; Massimiliano Scalvenzi; Gabriella Fabbrocini; Sara Cacciapuoti; Gaia De Fata Salvatores; Claudia Costa; Paolo Chiodini; Maria Antonietta Luciano; Serena Poggi; Silvestro Scotti; Luigi Sparano; Giuseppe Di Leo; Paolo Sommella; Matteo Ferro; Massimiliano Scalvenzi

doi:10.3934/bioeng.2020025

AIMS Bioengineering

2020, Volume 7, Issue 4: 306-320. doi: 10.3934/bioeng.2020025

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Research article Special Issues

A new “hub and spoke” teledermoscopy system involving general practitioners and dermatologists for the early detection of cutaneous melanoma: a pilot study

1.
Section of Dermatology–Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
2.
Medical Statistics Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy
3.
FIMMG–Italian Federation General Pratictioners
4.
Department of Industrial Engineering–University of Salerno, Italy

Received: 18 May 2020 Accepted: 24 July 2020 Published: 16 October 2020

The incidence of cutaneous melanoma has been increasing over the past few decades. The introduction of dermoscopy has enriched the diagnostic armamentarium of dermatologists improving diagnostic accuracy. The involvement of General Practitioners (GPs) and the use of telemedicine systems could constitute a new resource to make available early diagnosis to a larger population and to rationalize health resources in favor of patients at high risk of developing skin tumors.
Aims Primary aim of this study is to assess the feasibility of a “hub and spoke” model for the cooperation between high-specialty hospital units and GPs, using a new online teledermatology platform (I3DermoscopyApp®), that recently has been proved as a valid semiautomatic diagnostic image-based measurement system. Secondary aim is to evaluate the reliability of this semiautomatic diagnostic system in a clinical model of real life.
Methods An observational cross-sectional study using a “hub and spoke” model, was conducted at Dermatology Unit of Department of Clinical Medicine and Surgery of University Federico II of Naples. GPs and dermatologists were involved in this study after a demormoscopy traninig.
Results The system proved to be reliable in the triage phase and useful in the rationalization of highly specialized medical resources. Comparing patients diagnosed with malignant skin tumors through teledermoscopy system with patients with the same skin lesions of our department not participating to the study, we noticed that latency time between diagnosis and surgical excision were significantly decreased demonstrating the reliability of this semiautomatic diagnostic system in a clinical model of real life.
Discussion This study demonstrating the feasibility of a hub and spoke system based on a teledermatology cooperation between GPs and dermoscopy trained dermatologists. The use of teledermoscopy improves the ability of GPs selecting lesions suggestive of skin cancer without increasing the number of unnecessary expert consultations.
- teledermoscopy,
- melanoma,
- General Practitioners,
- early detection
Citation: Gabriella Fabbrocini, Sara Cacciapuoti, Gaia De Fata Salvatores, Claudia Costa, Paolo Chiodini, Maria Antonietta Luciano, Serena Poggi, Silvestro Scotti, Luigi Sparano, Giuseppe Di Leo, Paolo Sommella, Matteo Ferro, Massimiliano Scalvenzi. A new “hub and spoke” teledermoscopy system involving general practitioners and dermatologists for the early detection of cutaneous melanoma: a pilot study[J]. AIMS Bioengineering, 2020, 7(4): 306-320. doi: 10.3934/bioeng.2020025

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Abstract

The incidence of cutaneous melanoma has been increasing over the past few decades. The introduction of dermoscopy has enriched the diagnostic armamentarium of dermatologists improving diagnostic accuracy. The involvement of General Practitioners (GPs) and the use of telemedicine systems could constitute a new resource to make available early diagnosis to a larger population and to rationalize health resources in favor of patients at high risk of developing skin tumors.

Aims Primary aim of this study is to assess the feasibility of a “hub and spoke” model for the cooperation between high-specialty hospital units and GPs, using a new online teledermatology platform (I3DermoscopyApp®), that recently has been proved as a valid semiautomatic diagnostic image-based measurement system. Secondary aim is to evaluate the reliability of this semiautomatic diagnostic system in a clinical model of real life.

Methods An observational cross-sectional study using a “hub and spoke” model, was conducted at Dermatology Unit of Department of Clinical Medicine and Surgery of University Federico II of Naples. GPs and dermatologists were involved in this study after a demormoscopy traninig.

Results The system proved to be reliable in the triage phase and useful in the rationalization of highly specialized medical resources. Comparing patients diagnosed with malignant skin tumors through teledermoscopy system with patients with the same skin lesions of our department not participating to the study, we noticed that latency time between diagnosis and surgical excision were significantly decreased demonstrating the reliability of this semiautomatic diagnostic system in a clinical model of real life.

Discussion This study demonstrating the feasibility of a hub and spoke system based on a teledermatology cooperation between GPs and dermoscopy trained dermatologists. The use of teledermoscopy improves the ability of GPs selecting lesions suggestive of skin cancer without increasing the number of unnecessary expert consultations.

Statement of ethics

A written informed consent was obtained from the patients for the publication of this study and accompanying images. The authors have no ethical conflicts to disclose.

Disclosure statement

The authors have no conflicts of interest to declare.

Funding sources

The authors declare they had no funding sources supporting this work.

Author contributions

Gabriella Fabbrocini conceived the work.
Massimiliano Scalvenzi approved the version to be published.
Paolo Chiodini, Matteo Ferro, Giuseppe Di Leo, Paolo Sommella wrote the manuscript and analysed data.
Sara Cacciapuoti wrote the manuscript and revised it critically.
Claudia Costa, Mariantonietta Luciano, Serena Poggi and wrote the manuscript and acquired data.
Silvestro Scotti and Luigi Sparano acquired data.
Gaia De Fata Salvatores drafted the work and ensured the accuracy of any part of it.

Conflict of interest

The authors declare no conflict of interest.

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