Smartphone diagnosis of pediatric rash in the ED is pretty accurate

  • Devrim İ & al.
  • BMC Pediatr
  • 31 Jan 2019

  • curated by Jenny Blair, MD
  • Clinical Essentials
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Takeaway

  • For pediatric patients with rash in the emergency department (ED), remote diagnosis based on phone consultation and smartphone photos was nearly always confirmed upon next-day in-person evaluation.

Why this matters

  • The practice could improve diagnostic, treatment, and disposition decisions for an often-confusing clinical presentation in the ED.

Key results

  • Most frequent diagnoses: chickenpox, skin infections, shingles, insect bite, herpes simplex.
  • Initial diagnosis agreed with final diagnosis 96.3% of the time.

Study design

  • For 194 children presenting to a high-volume Turkish pediatric ED during the night shift with rash, researchers sent smartphone images of the lesions via instant messaging to the chief consultant in pediatric infectious disease.
  • Consultant’s diagnosis based on images and phone consultation was compared with final diagnosis made by another clinician in person the next day.
  • Outcome: performance of remote diagnosis based on smartphone images.
  • Funding: None.

Limitations

  • Up to 12 hours passed between first and second clinical evaluations; lesions could have evolved.