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[Preprint]. 2023 Apr 5:rs.3.rs-2754683.
doi: 10.21203/rs.3.rs-2754683/v1.

Inter-observer agreement among specialists in the diagnosis of Oral Potentially Malignant Disorders and Oral Cancer using Store-and-Forward technology

Keerthi Gurushanth  1 , Nirza Mukhia  1 , Sumsum P Sunny  2 , Bofan Song  3 , Shubhasini A Raghavan  1 , Shubha Gurudath  1 , Pramila Mendonca  2 , Shaobai Li  3 , Sanjana Patrick  4 , Tsusennaro Imchen  5 , Shirley T Leivon  5 , Tulika Shruti  6 , Trupti Kolur  2 , Vivek Shetty  2 , Vidya Bhushan R  2 , Rohan Michael Ramesh  5 , Vijay Pillai  2 , Kathryn O S  7 , Petra Wilder Smith  7 , Amritha Suresh  2 , Rongguang Liang  3 , Praveen Birur N  1 , Moni A Kuriakose  8
Affiliations

Inter-observer agreement among specialists in the diagnosis of Oral Potentially Malignant Disorders and Oral Cancer using Store-and-Forward technology

Keerthi Gurushanth et al. Res Sq. .

Update in

Abstract

Oral Cancer is one of the most common causes of morbidity and mortality. Screening and mobile Health (mHealth) based approach facilitates remote early detection of Oral cancer in a resource-constrained settings. The emerging eHealth technology has aided specialist reach to rural areas enabling remote monitoring and triaging to downstage Oral cancer. Though the diagnostic accuracy of the remote specialist has been evaluated, there are no studies evaluating the consistency among the remote specialists, to the best of our knowledge. The purpose of the study was to evaluate the interobserver agreement between the specialists through telemedicine systems in real-world settings using store and forward technology. Two remote specialists independently diagnosed the clinical images from image repositories, and the diagnostic accuracy was compared with onsite specialist and histopathological diagnosis when available. Moderate agreement (k = 0.682) between two remote specialists and (k = 0.629) between the onsite specialist and two remote specialists in diagnosing oral lesions. The sensitivity and specificity of remote specialist 1 were 92.7% and 83.3%, whereas remote specialist 2 was 95.8% and 60%, respectively, compared to histopathology. The store and forward technology and telecare can be effective tools in triaging and surveillance of patients.

Keywords: Agreement; Oral cancer; Specialist; Telemedicine; diagnosis; potentially malignant.

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Conflict of interest statement

Declarations Authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Photograph of normal buccal mucosa
Figure 2
Figure 2
Photograph of benign exophytic growth on left buccal mucosa
Figure 3
Figure 3
Photograph of Speckled leukoplakia (mixed red and white lesion) on right buccal mucosa
Figure 4
Figure 4
Photograph of malignant proliferative growth on left buccal mucosa
See this image and copyright information in PMC

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