According to the study authors, the findings strengthen evidence that such technology could help reliably address diagnostic and treatment disparities for low-income populations with limited access to dermatologists. It could also help dermatologists quickly detect cases of melanoma, a serious form of skin cancer that kills more than 8,000 Americans a year.

Their new system, which researchers call SpotCheck, allows skin cancer specialists to remotely examine skin lesions using an established technique called dermoscopy, in which experts use a camera connected to a specialized magnifying glass. to peer beneath the surface of the skin.

While previous research has explored telemedicine options to speed up melanoma diagnoses and compared in-person and remote evaluation of dermoscopy images, the authors say their work is among the first to target skin growths first identified by the patients concerned rather than by primary care physicians. This is important, according to the research team, because most cases of melanoma are initially detected by patients or their friends and family.

Led by a team from NYU Langone Health and its Perlmutter Cancer Center, the new analysis used SpotCheck to evaluate dermoscopic images of 375 skin lesions from volunteers concerned that their skin blemishes were cancerous. According to the results, published online on November 9 in the Journal of the American Academy of Dermatologydermoscopy experts who remotely examined all samples were 91% accurate in their diagnoses, based on subsequent biopsies. Dermatologists who instead evaluated all volunteers in a doctor’s office achieved 93% accuracy.

“Our results suggest that this teledermoscopy method could not only help healthcare providers detect potentially dangerous skin cancers early, but also reduce costly and anxiety-inducing referrals to specialists for benign lesions,” said l The study’s lead author, David Polsky, MD, PhD.

According to the U.S. Centers for Disease Control and Prevention, melanoma is the most common form of cancer in the country and is notoriously difficult to treat after tumors have spread throughout the body. Previous studies have shown that the disease often goes unnoticed among people from disadvantaged neighborhoods, who may have difficulty finding dermatologists in their area or taking time off work to attend appointments.

For the research, the team administered questionnaires to 147 men and women who had responded to newspaper advertisements after identifying suspicious lesions on their skin. The surveys assessed personal and family history of skin cancer, risk factors for melanoma, and the history of each concerning skin spot, among other factors. Next, a general dermatologist performed a physical examination using the visual appearance of the blemishes and a dermatoscope to make a diagnosis and, if necessary, performed a biopsy.

Next, the study coordinator captured clinical and dermoscopic images, which were sent to a central server for remote review by a separate team of skin cancer specialists with expertise in dermoscopy. They examined the questionnaires and images to make their own diagnoses. This group of dermatologists was not informed of the results of the in-person evaluation. Researchers also conducted a telephone survey a week after patients’ appointments to assess patient satisfaction.

Among the results, the study showed that overall, 97% of lesions evaluated were subsequently determined by biopsy to be benign. Notably, dermatologists who examined participants in person and those who relied solely on clinical photos and dermoscopy detected 11 of the 13 cases of skin cancer, including two melanomas.

The results further revealed that almost 90% of patients were satisfied with the telemedicine experience, with a fifth saying they preferred this method of examination over an in-person appointment with a specialist.

“A key advantage of teledermoscopy platforms is that community health workers can be trained to collect images and send them for review by experts,” said Polsky, Alfred W. Kopf, MD, professor of dermatologic oncology. at NYU Grossman School of Medicine. “As a result, this technology could be used in the future to offer virtual triage services in walk-in clinics, pharmacies and community centers.”

Polsky, also a professor in the Department of Pathology at NYU Grossman School of Medicine, adds that the research team next plans to identify neighborhoods with higher rates of late-stage melanoma for possible SpotCheck deployment.

He cautions that the tool is intended to assess specific skin concerns and is not a substitute for a full body exam in a doctor’s office. Study participants were asked to limit their lesions of concern to three.

Funding for the study was provided by the Melanoma Research Alliance, the Sergei S. Zlinkoff Fund for Medical Research and Education, and the Orbuch Brand Pilot Program for Skin Diseases.

Besides Polsky, other NYU Langone investigators involved in the study are Shirin Bajaj, MD; Avani Kolla, MD; Vivienne Li, BA; Payal Shah, MD; Nicolas Gulati, MD, PhD; Maressa Criscito, MD; Yiping Xing, MD; Adriana Lopez, MD; Duy Tran, MD; Vignesh Ramachandran, MD; Efe Kakpovbia, MD; Shane Meehan, MD; Yongzhao Shao, PhD; Kristen Lo Sicco, MD; Emily Milam, MD; Amy Bieber, MD; Amanda Levine, MD; Tracey Liebman, MD; and Jennifer Stein, MD, PhD. The study’s lead author, Jenne Ingrassia, BA, is now a resident physician at New York Medical College in Valhalla.