关键词: 远程医学, 皮肤疾病, 诊断, 一致率, 可穿戴设备

Abstract: 【Abstract】 Objective To preliminarily verify the feasibility of applying a wearable teleconsultation device in the diagnosis of common skin diseases. Methods Totally, 600 outpatients with skin diseases were prospectively enrolled from the Department of Dermatology from November 1 to December 31 2023, and both on-site and remote diagnoses were performed. In the face-to-face clinic, there was one resident physician A and one chief physician B, while there was one resident physician C and one chief physician D in the remote consultation clinic. Using the diagnostic results of physician B in the face-to-face clinic as a reference, diagnostic agreement rates of physicians A, C, and D were calculated separately. Additionally, diagnostic results were compared between physician A and physician C, as well as between physician A and physician D. Statistical analysis was carried out using McNemar's test and Kappa consistency analysis. Results Among the 600 patients with skin diseases, there were 285 males （47.50%） and 315 females （52.50%）, and their age was 38.75 ± 21.12 years. The most common skin diseases were dermatitis and eczema （138 cases, 23.00%）, followed by viral skin diseases （79 cases, 13.17%）, urticaria （53 cases, 8.83%）, hair diseases （53 cases, 8.83%）, skin tumors （46 cases, 7.67%）, fungal skin diseases （38 cases, 6.33%）, etc. Compared with the physician B, the physician A made consistent diagnoses in 477 cases （79.5%） and inconsistent diagnoses in 123 cases （20.5%）, the physician C made consistent diagnoses in 465 cases （77.5%） and inconsistent diagnoses in 135 cases （22.5%）, and the physician D made consistent diagnoses in 568 cases （94.6%） and inconsistent diagnoses in 32 cases （5.33%）. There was no significant difference in the diagnostic accuracy between the physician A and physician C （P = 0.430）, with a Kappa value of 0.852, indicating very strong consistency. The diagnostic accuracy of the physician D was significantly higher than that of the physician A （P = 0.001）, with a Kappa value of 0.274, indicating weak consistency. Conclusion Chief dermatologists can provide medical guidance to resident physicians through a wearable teleconsultation system.

Key words: Telemedicine, Skin diseases, Diagnosis, Consistency rate, Wearable equipment