International inter‐rater agreement in scoring acne severity utilizing cloud‐based image sharing of mobile phone photographs

• DOI: 10.1111/ijd.13621
• Publication Date: 2017-04-24T10:09:53Z
• Authors: Negar Foolad; Jennifer N. Ornelas; Ashley K. Clark; Ifrah Ali; Victoria R. Sharon; Luluah Al Mubarak; Andrés Lopez; Ali Alikhan; Bishr Al Dabagh; Alireza Firooz; Smita Awasthi; Yu Liu; Chin‐Shang Li; Raja K. Sivamani
• Keywords: Adult; Male; Observer Variation; Internet; Internationality; Adolescent; Administration, Cutaneous; Severity of Illness Index; Telemedicine; Anti-Bacterial Agents; Retinoids; 03 medical and health sciences; 0302 clinical medicine; Acne Vulgaris; Photography; Humans; Female; Dermatologic Agents; Prospective Studies; Smartphone; Isotretinoin; Facial Dermatoses

AbstractBackgroundCloud‐based image sharing technology allows facilitated sharing of images. Cloud‐based image sharing technology has not been well‐studied for acne assessments or treatment preferences, among international evaluators. We evaluated inter‐rater variability of acne grading and treatment recommendations among an international group of dermatologists that assessed photographs.MethodsThis is a prospective, single visit photographic study to assess inter‐rater agreement of acne photographs shared through an integrated mobile device, cloud‐based, and HIPAA‐compliant platform. Inter‐rater agreements for global acne assessment and acne lesion counts were evaluated by the Kendall's coefficient of concordance while correlations between treatment recommendations and acne severity were calculated by Spearman's rank correlation coefficient.ResultsThere was good agreement for the evaluation of inflammatory lesions (KCC = 0.62, P < 0.0001), noninflammatory lesions (KCC = 0.62, P < 0.0001), and the global acne grading system score (KCC = 0.69, P < 0.0001). Topical retinoid, oral antibiotic, and isotretinoin treatment preferences correlated with photographic based acne severity.ConclusionsOur study supports the use of mobile phone based photography and cloud‐based image sharing for acne assessment. Cloud‐based sharing may facilitate acne care and research among international collaborators.