Histopathological accuracy of virtual clinic diagnosis from patient self-generated photographs
Author: Gabriella Guevara
Base Hospital / Institution: Moorfields Eye Hospital
ePoster presentation
Abstract ID: 24-494
Purpose
To analyse the diagnostic accuracy of assessment patient self-generated photographs in a benign lid lesion virtual clinic and correlation with final histopathological diagnosis at a tertiary referral centre in London, UK.
Methods
300 patients (57% female; median age 40 (16-90)) submitted 895 photographs. A provisional diagnosis was made in the virtual clinic. Accuracy of virtual clinic diagnosis was determined by comparison to diagnosis from histopathology or in-person review. All histopathology was reported by a consultant histopathologist on the EyePath database, from the University College London Institute of Ophthalmology.
Results
232 (98.3%) lesions were benign , 2 (0.8%) were pre-malignant (bowen’s disease and actinic keratosis), and 2 (0.8%) were malignant (basal cell carcinoma and ocular lymphoma). There was correct virtual clinic identification of lesions as benign in 230 (99.1%) cases and as suspicious of malignancy in 3 (75.0%) cases. An actinic keratosis was labelled a ‘benign lesion’ in the virtual clinic.
Of the 236 confirmed diagnoses, exact diagnosis was made in 190 (80.5%) patients. There was no statistical difference (Chi-square test p-value=0.61) between the quality of images in those with an exact versus incorrect diagnosis.
Conclusion
Virtual clinics are an effective way to assess eyelid pathology in oculoplastic services but video resolution can make assessment challenging. Self-captured photographs enable high levels of diagnostic accuracy of benign lesions. We recommend implementation of patient self-captured photographs to supplement teleconsultation and reduce need for in-person assessment. In-person review is still recommended where suspicious features are present or where photo quality is suboptimal.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Mumta | Kanda | Moorfields Eye Hospital |
| Hardeep | Kandola | Moorfields Eye Hospital |
| Swan | Kang | Moorfields Eye Hospital |
