Sensitivity and Specificity of the Remote Evaluation of Therapeutic Response in Cutaneous Leishmaniasis Using Photographs from a Mobile Application

• DOI: 10.4269/ajtmh.22-0164
• Publication Date: 2022-07-25T12:38:00Z
• Authors: Alejandra Maria D...; Maria del Mar Castro; Alexandra Cossio; Jonny Alejandro G...; Domiciano Rincón; Ruth Mabel Castillo; Miguel Darío Prieto; David Esteban Reb...; Andrés Navarro; Neal Alexander
• Keywords: mHealth; Inter-Rater Reliability; Gold standard (test); Kappa; Positive predicative value

Cutaneous leishmaniasis (CL) primarily affects people in remote settings with limited access to health services. mHealth tools offer an opportunity overcome knowledge gaps about clinical response treatment. We evaluated the validity of Guaral+ST mobile application for assessment therapeutic patients CL, through photographs lesions captured app by community volunteers. Patients confirmed CL were followed at weeks 13 and 26 after completion treatment assess two southwest Colombia. Direct evaluation performed experienced physician was considered reference standard. Photographs taken CHV or nurse assistants app, independently three physicians define response. A summary measure outcome defined index test. Sensitivity, specificity, positive negative predictive values estimated. Interrater reliability (kappa) calculated. Among 53 participants who had least one follow-up visit, sensitivity compared direct expert physician, high 100% (95% confidence interval: 80.5-100%) specificity 97.2% 85.5-99.9%). The chance-adjusted agreement (κ) > 0.8, which is conventionally characterized as almost perfect. accuracy supports use improving CL.