Table 2. Diagnostic and Management Concordance Between PCPs, Teledermatologists, and In-Clinic Dermatologists.
| Concordance Comparison (Total No. of Cases Compared) | Discordant, No. (%) of Cases | Partially Concordant Level 1, No. (%) of Casesa,b |
Partially Concordant Level 2, No. (%) of Casesa,b |
Completely Concordant, No. (%) of Cases | Observed Concordance (Partial 1 and 2 and Completely), No. (%) of Cases | Expected Concordance (Partial 1 and 2 and Completely), %c | 1-Sided P Value Using Yates Correction (95% CI)d |
|---|---|---|---|---|---|---|---|
| PCP vs tele 1 diagnosis (79) | 49 (62) | 9 (11) | 10 (13) | 11 (14) | 30 (38) | 68 | >.99 (27-49) |
| Tele 1 vs tele 2 diagnosis (79) | 0 | 10 (13) | 44 (56) | 25 (32) | 79 (100) | 88 | .001 |
| Tele 1 vs derm clinic diagnosis (29) | 3 (10) | 5 (17) | 10 (35) | 11 (38) | 26 (90) | 67 | .008 (79-100) |
| PCP vs tele 1 management (79) | 44 (56) | 8 (10) | 23 (29) | 4 (5) | 35 (44) | 61 | .99 (33-55) |
| Tele 1 vs tele 2 management (79) | 12 (15) | 4 (5) | 33 (42) | 30 (38) | 67 (85) | 75 | .03 (77-93) |
Abbreviations: Derm, in-person dermatologist; PCP, primary care physician; tele, teledermatologist.
Diagnostic concordance: Discordant, no agreement or differential diagnosis not provided. Partially concordant level 1, agreement between at least 1 but not all diagnoses. Partially concordant level 2, agreement between diagnostic categories only (from Table 1). Concordant, full agreement.
Management concordance: Discordant, no agreement or management plan not provided. Partially concordant level 1, partial agreement with 1 category of change only. Partially concordant level 2, partial agreement with more than 1 category of change. Concordant, full agreement.
Expected concordance percentage was assigned based on previously published studies.
One-sample proportions tests using a Yates correction were performed to compare observed vs expected concordances between the physicians’ diagnoses and management recommendations. Probability that event was larger than expected [null hypothesis]. A 1-sided P value <.05 was considered significant. Bold font indicates statistical significance.