74 CHAPTER 4 RESULTS In total 7,649 completed teledermoscopy consultation requests by 839 GPs were extracted from the Ksyos digital health record system (Figure 4.2). Overall, 314 GPs were active before January 2015 and for this reason the corresponding 4,216 consultations in the study period were excluded. In addition, 512 GPs did not perform five or more consultations for each study year respectively and were excluded. After exclusion, thirteen experienced GPs and 659 consultations were analyzed (minimum of 20, maximum of 157 consultations per GP). The total number of consultations performed by the included GPs for each year were 209, 228, 222 respectively and were assessed among 32 TDs. Figure 4.2: Number of consultations. Sensitivity and PPV of GP in teledermoscopy No diagnosis was provided by the TD in 26 (12.4%), 21 (9.2%) and 33 (14.9%) of the cases. These cases were excluded from the statistical analyses. As shown in Table 4.2, the percentage of confirmed GP diagnosed cases is increasing over years from 6.0 percent in year 1 to 13.2 percent in year 3. However, the GP’s PPV is slightly decreasing over time from 0.85 [95% CI 0.58-0.96] to 0.74 [95% CI 0.57-0.85]. As presented in Figure 4.3 the GP’s PPV though is increasing over time for diagnosis category L20-L30 Dermatitis and eczema. The number of incorrect pre-diagnosed cases by the GP is marginally increasing from 15.4 percent in the first year to 26.5 percent in the third year.
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