Ferrara 2004.

Study characteristics
Patient sampling	Study design: case control Data collection: retrospective image selection/prospective interpretation Period of data collection: NR Country: NR; likely Italy
Patient characteristics and setting	Inclusion criteria: pigmented melanocytic lesions with dermoscopic images (a single image per case) and accompanying histological material were retrieved; approach to lesion selection was not described. Setting: unspecified Prior testing: clinical or dermatoscopic (or both) suspicion Setting for prior testing: NR Exclusion criteria: none reported Sample size (participants): NR Sample size (lesions): number included: 12 Participant characteristics: 10 males and 2 females, aged 14–79 (median 41) years. Lesion characteristics: 7 lesions removed from the trunk, 4 from the limbs and 1 from the face. Lesions ranged in size from 4 mm to 14 mm in diameter (median 6 mm).
Index tests	TD Acquisition and transmission of images: dermoscopic images were either acquired on film (Dermaphot) and then digitised (8) or were acquired directly from a digital camera (4); (MoleMax or Videocap) photographic images were also available in 9/12 cases. Nature of images used: dermoscopic images Any additional participant information provided: clinical examination or case notes (or both) Observer qualifications (remote diagnosis): dermatologist Diagnosis based on: single observer Number of examiners: 3 Method of diagnosis: stored images were viewed on a standard‐resolution colour monitor by 3 remote consultants in a single session; the teledermoscopy diagnosis (melanoma or other lesion type) was recorded by a single consultant, followed by a teledermatopathology diagnosis (based on histological image). The original histological diagnosis from the consultation file was then presented (apparently along with the original clinical diagnosis). "Dermoscopic–pathological remarks" were made and finally a consensus diagnosis was reached by 2 consultants; the latter was taken as the 'gold standard' for the study.
Target condition and reference standard(s)	Reference standard: histological diagnosis alone Details: 12 cases with dermoscopic images (1 image per case) and accompanying histological material were retrieved from consultation files. The conventional histopathology diagnosis was regarded as the gold standard: a consensus diagnosis between 2 consultants was requested in order to minimise any influence of the previous dermatopathology diagnosis Target condition (final diagnoses) Melanoma (in situ and invasive, or NR): 7. Invasive melanoma: 4; MiS: 3 'Benign' diagnoses: 5. Junctional nevus: 1; Reed naevus: 1; blue naevus: 1; actinic lentigo: 1; SN: 1
Flow and timing	Excluded participants: NR Time interval to reference test: images taken at time of FTF consultation; interval to excision NR Time interval between index test(s): NR
Comparative
Notes	—
Methodological quality
Item	Authors' judgement	Risk of bias	Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled?	Unclear
Was a case‐control design avoided?	No
Did the study avoid inappropriate exclusions?	Unclear
Are the included patients and chosen study setting appropriate?	Unclear
Did the study avoid including participants with multiple lesions?	Unclear
		High	Unclear
DOMAIN 2: Index Test Teledermatology
Were the index test results interpreted without knowledge of the results of the reference standard?	Yes
If a threshold was used, was it pre‐specified?	Yes
Was the test applied and interpreted in a clinically applicable manner?	No
Were thresholds or criteria for diagnosis reported in sufficient detail to allow replication?	Unclear
Was the test interpretation carried out by an experienced examiner?	Yes
		Low	High
DOMAIN 3: Reference Standard
Is the reference standards likely to correctly classify the target condition?	Yes
Were the reference standard results interpreted without knowledge of the results of the index tests?	Unclear
For studies comparing TD/FTF clinical diagnosis to histology, was histology interpretation carried out by an experienced histopathologist or by a dermatopathologist?	Yes
For studies comparing TD to FTF diagnosis, was the clinical diagnosis carried out by an experienced observer?
		Low	Low
DOMAIN 4: Flow and Timing
Was there an appropriate interval between index test and reference standard?	Unclear
Did all patients receive the same reference standard?	Yes
Were all patients included in the analysis?	Yes
If the reference standard includes clinical FU of borderline/benign appearing lesions, was there a minimum FU following application of index test(s) of at least: 3 months for melanoma or cSCC or 6 months for BCC?
		Unclear