Finnane 2017 — Teledermatology for the diagnosis and management of skin cancer: systematic review
Citation
Finnane A, Dallest K, Janda M, Soyer HP. Teledermatology for the Diagnosis and Management of Skin Cancer: A Systematic Review. JAMA Dermatol. 2017 Mar 1;153(3):319–327. DOI: 10.1001/jamadermatol.2016.4361. PMID 27926766.
Study design and population
PROSPERO-registered systematic review. 21 studies evaluating teledermatology accuracy, efficiency and clinical outcomes for skin cancer vs. face-to-face assessment. 6 databases searched to April 2016.
Reported metrics
- Face-to-face diagnostic concordance with histopathology: 67–85 % (Cohen κ ≈ 0.90)
- Teledermatology concordance with histopathology: 51–85 % (κ 0.41–0.63)
- Teledermoscopy consistently outperformed macroscopic teledermatology
- Consistent waiting-time reductions and shortened time-to-treatment across included studies (narrative synthesis; no pooled CI)
Surrogate-to-outcome linkage
Establishes diagnostic concordance of teledermatology with in-person reference standard as sufficient to support triage use; consistent reduction in time-to-assessment and time-to-treatment anchors the access-to-care surrogate to the downstream earlier-treatment outcome. Foundational SR for the EU HTA / NICE assessment literature on teledermatology pathway redesign.
CRIT1–7 appraisal
| Criterion | Score | Justification |
|---|---|---|
| CRIT1 Relevance | 3 | Direct — skin-cancer teledermatology systematic review. |
| CRIT2 Methodology | 3 | PROSPERO-registered; 6-database search; QUADAS-2 applied. |
| CRIT3 Reporting | 2 | Narrative synthesis (heterogeneity precluded pooling); no pooled CIs. |
| CRIT4 Applicability | 3 | International literature, directly applicable. |
| CRIT5 Evidence weight | 3 | Systematic review. |
| CRIT6 Risk of bias | 2 | Heterogeneous primary studies; many observational; QUADAS-2 concerns. |
| CRIT7 Contribution | 3 | Core evidence base for remote-assessment adequacy as a Pillar-1 surrogate. |
Aggregate: very strong.
Limitations and notes
Heterogeneity precluded meta-analytic pooling; pre-smartphone-era studies under-represent modern imaging workflows.
Strength as anchor
Very strong for the accepted-surrogate and directional claims in Domain 3. Cross-referenced in Domain 1 (diagnostic-accuracy teledermatology concordance). Pairs with Bourkas 2023 and Chuchu 2018 Cochrane to span the systematic-review evidence base.