Teledentistry: Distant Diagnosis of Oral Disease Using E-Mails

TLDR

Information technology can improve the accuracy of oral medicine consultations, as shown by substantial agreement between remote experts and biopsy results. The study evaluated the feasibility of telediagnosis in oral medicine by transmitting clinical digital images via e‑mail to remote consultants. Clinical histories and lesion images were recorded electronically and photographed, then emailed to two oral medicine consultants who each provided up to two diagnostic hypotheses compared against biopsy gold standards. In 80 % of cases at least one consultant correctly diagnosed the lesion; both consultants were correct in 51.7 %, one correct in 28.3 %, and neither correct in 20 %, demonstrating that dual remote expert participation improves diagnostic accuracy.

Abstract

The purpose of this study was to evaluate the applicability of telediagnosis in oral medicine, through the transmission of clinical digital images by e-mail.The sample included 60 consecutive patients who sought oral medicine services at the Federal University of Paraná, in the state of Paraná, located in southern Brazil. The clinical history and oral lesion images were recorded using clinical electronic charts and a digital camera, respectively, and sent by e-mail to two oral medicine consultants. The consultants provided a maximum of two clinical hypotheses for each case, which were compared with biopsy results that served as the gold standard.In 31 of the 60 cases (51.7%), both consultants made the correct diagnosis; in 17 cases (28.3%), only one consultant made the correct diagnosis; and in 12 cases (20%), neither consultant made the correct diagnosis. Therefore, in 80% of cases, at least one consultant provided the correct diagnosis. The agreement between the first consultant and the gold standard was substantial (κ=0.669), and the agreement between the second consultant and the gold standard was fair (κ=0.574).The use of information technology can increase the accuracy of consultations in oral medicine. As expected, the participation of two remote experts increased the possibility of correct diagnosis.