70 CHAPTER 4 ABSTRACT Early recognition of skin cancer is vital to enhance patient outcomes. Teledermoscopy, a telemedicine service, supports general practitioners (GPs) in gaining fast access to dermatologists’ feedback to detect skin cancer. This study aimed to assess if GPs gain expertise in diagnosing skin disorders after continued use of teledermoscopy, based on diagnosis classification by the International Statistical Classification of Diseases and Related Health Problems (ICD-10). A retrospective study was conducted on teledermoscopy consultations sent by GPs to teledermatologists in the Netherlands (July 2015 – June 2018). GP sensitivity and confirmed cases in diagnosing skin disorders slightly increased over time. However, the total positive predictive value showed a decrease. In three years, 43 melanomas were diagnosed by the TD for which the GP did not provide a (correct) pre-diagnosis. Though GPs appear to improve their expertise in skin disorder detection after continued teledermoscopy use, teledermoscopy remains imperative to early melanoma detection.
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