A teledermatologia como ferramenta de apoio ao diagnóstico do câncer de pele

• Autor(a) principal: Oliveira, Keilla Taciane Martins de Melo
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/5923
• topic: Telemedicine; Dermatology; Computer diagnostics; Reliability of data; Primary Health Care; Telemedicina; Dermatologia; Diagnóstico por computador; Confiabilidade dos dados; Atenção Primária a Saúde; Pele - Câncer - Imagem; Neoplasias cutâneas; Teledermatologia; Diagnóstico por computador; CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::DERMATOLOGIA

Teledermatology uses the use of Information and Communication Technologies (ICT) for dermatological practice without the need for face-to-face intervention of the specialized doctor, since it has an important visual component, which favors the development of iconographic representation techniques for use in telemedicine. Its practice aggregates the documentation of clinical information and images of dermatological lesions for the purpose of care support, offering additional benefits to the traditional methods of dermatological evaluation by allowing the health professional to provide diagnostic assistance, evaluation of the progress of chronic conditions and therapeutic responses, disease tracking, patient monitoring, and health promotion. This project aims to evaluate the reproducibility and diagnostic sensitivity of teledermatology using teledermatoscopy as a tool to support the diagnosis of skin cancer; for that, a specific environment of teledermatology was developed and implemented in the TeleNET HealthNET Platform - a telehealth platform developed by the Telessaúde Nucleus of the Federal University of Pernambuco - and a photo documentation protocol was developed for teledermatology in basic care, in order to standardize this practice at this level of health care. This protocol was evaluated by physicians specializing in dermatology and family and community medicine in terms of objectives, content, language, relevance, functionality and usability. The protocol was considered validated in appearance and content according to the Content Validit Index (CVI), reaching an index of 0.94 for all aspects evaluated. This work is under development with prospects for the evaluation of the concordance and diagnostic validity of teledermatoscopy through teledermatology environment implanted Telehealth Platform HN, through the application of the photo documentation protocol elaborated. Regarding the evaluation of the reproducibility of teledermatology through the environment implanted in the Platform of Telehealth HealthNET, it was obtained for the evaluation of agreement, observing the main diagnostic hypothesis attributed by the online and virtual evaluators the variation of the kappa of 0.57 to 0.70 , considered as a good level of agreement among the evaluators. When, however, the level of agreement was evaluated between the presencial and virtual evaluators with regard to the main and secondary diagnostic hypotheses, a kappa equivalent to 1.0 corresponding to the excellent concordance index was obtained, the reliability of the study