Advances in smart phone-based photography (both quality and image transmission) offer the potential to greatly improve access to pediatric dermatologists. However, the accuracy of diagnoses reliant on parent-provided photographs has been neither measured nor compared to diagnoses based on in-person examinations. Therefore, the primary objective of this study was to assess the concordance between diagnoses based on photographs taken by parents (or legal guardians) and those based on in-person examinations. A secondary aim was to assess the effect of photography instructions on improving this concordance.
Each patient/parent dyad will be randomized into one of two approximately equally sized groups; half of the subjects will be provided with an instruction sheet on how best to take photographs of skin conditions with their mobile devices (study group) and half will not be provided this instruction sheet (control group). Photographs will be evaluated for image quality and to provide a diagnosis (See attached forms including Photograph Quality Rating Scale).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
DOUBLE
Enrollment
40
Parent-patient dyads were provided with written 3-step instructions on how best to take a photograph of skin conditions using a smart phone
The Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
The effect of photography instructions on average image quality, as evaluated using a photograph quality rating scale (PQRS)
The PQRS quantifies photograph quality based on five criteria: clarity, perspective, darkness, brightness, and color. Each criterion is rated on an integer scale from 0 to 2, yielding a total score ranging from 0 (lowest quality) to 10 (highest quality).
Time frame: 1 hour
Concordance between photograph-based versus in-person-based diagnosis, as quantified using Cohen's kappa.
Cohen's kappa is a measure of inter-rater agreement that takes into account the possibility of agreement occurring by chance.
Time frame: 1 hour
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