%0杂志文章%@ 2562-0959 %I JMIR出版物%V 5% 卡塔尔世界杯8强波胆分析N 3% P e40888 %T在远距皮肤镜中参考或不参考:回顾性研究%A Tensen,Esmée %A van Sinderen,Femke %A Bekkenk,Marcel W %A Jaspers,Monique W %A Peute,Linda W %+阿姆斯特丹联合医疗中心阿姆斯特丹大学医学信息系，Meibergdreef 9，阿姆斯特丹，1105 AZ，荷兰，31 20 5666204，e.tensen@amsterdamumc.nl %K远程皮肤镜%K皮肤镜%K远程医疗%K远程健康%K分诊%K全科医生%K全科医生%K家庭医生%K不必要的转诊%K转诊%K皮肤%K病变%K专家%K医生沟通%K诊断%K跨专业%K诊断%K皮肤科%K皮肤科%D 2022 %7 23.9.2022 %9原始论文%J JMIR皮肤%G英语%X背景:全科医生(gp)在诊断(前)恶性和良性皮肤病变方面仍然面临挑战。远程皮肤镜(TDsc)支持全科医生在远程皮肤科医生(TDs)诊断和建议的指导下诊断这些皮肤病变，并防止不必要的转诊到皮肤科护理。然而，TDsc的可用性对全科医生在TDsc会诊前后自我报告转介皮肤科护理决定的影响尚不清楚。目的:本研究的目的是评估和比较全科医生在TDsc前自我报告的转诊决定与TD诊断为(前)恶性或良性皮肤病变的TDsc后最终自我报告的转诊决定。方法:从荷兰全国远程医疗数据库中提取2015年7月至2020年6月期间全科医生在日常实践中要求的TDsc咨询，并进行TD评估和诊断。基于全科医生自己提出的问题，全科医生在TDsc会诊前的转诊决定和在TDsc会诊后的最终转诊决定被评估为(前)恶性和良性TD诊断。结果:6364例TDsc咨询评估了GP自我管理问题和TD诊断(9.3%为恶性，8.8%为癌前病变，81.9%为良性皮肤病变)。 In half of the TDsc consultations, GPs adjusted their initial referral decision after TD advice and TD diagnosis. Initially, GPs did not have the intention to refer 67 (56.8%) of 118 patients with a malignant TD diagnosis and 26 (16.0%) of 162 patients with a premalignant TD diagnosis but then decided to refer these patients after the TDsc consultation. Furthermore, GPs adjusted their decision from referral to nonreferral for 2534 (74.9%) benign skin lesions (including 676 seborrheic keratosis and 131 vascular lesions). Conclusions: GPs adjusted their referral decision in 52% (n=3306) of the TDsc consultations after the TD assessment. The availability of TDsc is thus of added value and assists GPs in their (non)referral for patients with skin lesions to dermatology care. TDsc resulted in referrals of patients with (pre)malignant skin lesions that GPs would not have referred directly to the dermatologist. TDsc also led to a reduction of unnecessary referrals of patients with low complex benign skin lesions (eg, seborrheic keratosis and vascular lesions). %R 10.2196/40888 %U https://derma.www.mybigtv.com/2022/3/e40888 %U https://doi.org/10.2196/40888