Assessing the usability and reliability of a web-based teledentistry tool for remote diagnosis of oral lesions: a cross-sectional study.
Oral lesion
Reliability
Remote diagnosis
Teleconsultation
Teledentistry
Usability
Journal
BMC oral health
ISSN: 1472-6831
Titre abrégé: BMC Oral Health
Pays: England
ID NLM: 101088684
Informations de publication
Date de publication:
16 Sep 2024
16 Sep 2024
Historique:
received:
11
01
2024
accepted:
01
08
2024
medline:
17
9
2024
pubmed:
17
9
2024
entrez:
16
9
2024
Statut:
epublish
Résumé
Oral mucosa lesions are the third most prevalent oral pathology, following caries and periodontal diseases. Teledentistry offers an effective way to manage patients with these lesions. The accuracy of remote diagnoses and consultations relies heavily on the quality of the information and photos sent to remote specialists. This study aims to evaluate the usability and reliability of a teledentistry tool for the remote diagnosis of oral lesions. The cross-sectional study included both usability evaluation and reliability assessment. The teledentistry platform, "OralMedTeledent", facilitated synchronous and asynchronous interactions, allowing for patient consultations, remote follow-ups, and doctor-to-doctor consultations. Usability was evaluated by 5 experts using the Nielsen heuristic checklist. Reliability was assessed from August 2022 to September 2023 with 109 patients, using Cohen's kappa coefficient to measure agreement between examiners and the gold standard in diagnosing oral lesions. The findings revealed 66 usability issues, most of which were related to helping users recognize, diagnose, and recover from errors, as well as issues with help and documentation. Among these, 11 issues were of minor severity. The reliability test, conducted with 109 participants (57.8% female, 42.2% male) showed that the web-based teleconsultation system performed significantly well. The system demonstrated significant substantial performance (0.81 ≤ κ < 1; P > 0.05). Overall, the web-based teleconsultation system has proven to be reliable for the remote diagnosis of oral lesions, making it a valuable alternative during emergencies such as the COVID-19 pandemic. However, several usability issues have been identified and need to be addressed.
Sections du résumé
BACKGROUND
BACKGROUND
Oral mucosa lesions are the third most prevalent oral pathology, following caries and periodontal diseases. Teledentistry offers an effective way to manage patients with these lesions. The accuracy of remote diagnoses and consultations relies heavily on the quality of the information and photos sent to remote specialists. This study aims to evaluate the usability and reliability of a teledentistry tool for the remote diagnosis of oral lesions.
METHODS
METHODS
The cross-sectional study included both usability evaluation and reliability assessment. The teledentistry platform, "OralMedTeledent", facilitated synchronous and asynchronous interactions, allowing for patient consultations, remote follow-ups, and doctor-to-doctor consultations. Usability was evaluated by 5 experts using the Nielsen heuristic checklist. Reliability was assessed from August 2022 to September 2023 with 109 patients, using Cohen's kappa coefficient to measure agreement between examiners and the gold standard in diagnosing oral lesions.
RESULTS
RESULTS
The findings revealed 66 usability issues, most of which were related to helping users recognize, diagnose, and recover from errors, as well as issues with help and documentation. Among these, 11 issues were of minor severity. The reliability test, conducted with 109 participants (57.8% female, 42.2% male) showed that the web-based teleconsultation system performed significantly well. The system demonstrated significant substantial performance (0.81 ≤ κ < 1; P > 0.05).
CONCLUSION
CONCLUSIONS
Overall, the web-based teleconsultation system has proven to be reliable for the remote diagnosis of oral lesions, making it a valuable alternative during emergencies such as the COVID-19 pandemic. However, several usability issues have been identified and need to be addressed.
Identifiants
pubmed: 39285380
doi: 10.1186/s12903-024-04696-7
pii: 10.1186/s12903-024-04696-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1094Informations de copyright
© 2024. The Author(s).
Références
Radwan-Oczko M, Sokół I, Babuśka K, Owczarek-Drabińska JE. Prevalence and characteristic of oral mucosa lesions. Symmetry. 2022;14(2):307.
doi: 10.3390/sym14020307
Ge S, Liu L, Zhou Q, Lou B, Zhou Z, Lou J, et al. Prevalence of and related risk factors in oral mucosa diseases among residents in the Baoshan District of Shanghai. China PeerJ. 2020;8:e8644.
doi: 10.7717/peerj.8644
pubmed: 32140308
Beaty CS, Short AG, Mewar P. Oral Mucosal Lesions, Immunologic Diseases. 2023 Nov 14. In: StatPearls [Internet]. Treasure Island: StatPearls Publishing; 2024.
Chiang CP, Chang JYF, Wang YP, Wu YH, Lu SY, Sun A. Oral lichen planus–differential diagnoses, serum autoantibodies, hematinic deficiencies, and management. J Formos Med Assoc. 2018;117(9):756–65.
doi: 10.1016/j.jfma.2018.01.021
pubmed: 29472048
Glick M, Greenberg MS, Lockhart PB, Challacombe SJ. Introduction to oral medicine and oral diagnosis: patient evaluation. Burket's Oral Medicine. 13th ed. Wiley-Blackwell; 2021. p. 1–18.
Zahid E, Bhatti O, Zahid MA, Stubbs M. Overview of common oral lesions. Malays Fam Physician. 2022;17(3):9.
doi: 10.51866/rv.37
pubmed: 36606178
pmcid: 9809440
Flores APdC, Lazaro SA, Molina-Bastos CG, Guattini VLdO, Umpierre RN, Gonçalves MR, et al. Teledentistry in the diagnosis of oral lesions: A systematic review of the literature. J Am Med Inform Assoc. 2020;27(7):1166–72.
doi: 10.1093/jamia/ocaa069
pubmed: 32568392
pmcid: 7647318
Torres-Pereira CC, Morosini IdAC, Possebon RS, Giovanini AF, Bortoluzzi MC, Leao JC, et al. Teledentistry: distant diagnosis of oral disease using e-mails. Telemed Health. 2013;19(2):117–21.
doi: 10.1089/tmj.2012.0087
Niknam F, Sharifian R, Bashiri A, Mardani M, Akbari R, Tuffaha H, et al. Tele-dentistry, its trends, scope, and future framework in oral medicine; a scoping review during January 1999 to December 2021. Arch Pub Health. 2023;81(1):1–14.
Pérez González A, Gallas Torreira M, Chamorro Petronacci CM, Pérez Sayáns M. Teledentistry: a new approach in dental medicine. In Enhanced Telemedicine and e-Health: Advanced IoT Enabled Soft Computing Framework. Cham: Springer International Publishing; 2021. p. 41–64.
Tesfalul M, Littman-Quinn R, Antwi C, Ndlovu S, Motsepe D, Phuthego M, et al. Evaluating the potential impact of a mobile telemedicine system on coordination of specialty care for patients with complicated oral lesions in Botswana. J Am Med Inform Assoc. 2016;23(e1):e142–5.
doi: 10.1093/jamia/ocv140
pubmed: 26510877
Goffin G, Carter N, Sari Widyarman A, Erri Astoeti T, Kabir Bulbul H, Puplampu P, et al. Role of teledentistry in enabling improved oral care outcomes. Br Dent J. 2024;236(3):162–8.
doi: 10.1038/s41415-024-7055-y
pubmed: 38332075
Di Fede O, Panzarella V, Buttacavoli F, La Mantia G, Campisi G. Doctoral: A smartphone-based decision support tool for the early detection of oral potentially malignant disorders. Digital Health. 2023;9:20552076231177140.
pubmed: 37256016
pmcid: 10226164
Birur NP, Gurushanth K, Patrick S, Sunny SP, Raghavan SA, Gurudath S, et al. Role of community health worker in a mobile health program for early detection of oral cancer. Indian J Cancer. 2019;56(2):107–13.
doi: 10.4103/ijc.IJC_232_18
pubmed: 31062727
Kengne Talla P, Allison P, Bussières A, Giraudeau N, Komarova S, Basiren Q, et al. Teledentistry for improving access to, and quality of oral health care: A protocol for an overview of systematic reviews and meta-analyses. PLoS ONE. 2024;19(1):e0288677.
doi: 10.1371/journal.pone.0288677
pubmed: 38165889
pmcid: 10760664
Alves FA, Saunders D, Sandhu S, Xu Y, de Mendonça NF, Treister NS. Implication of COVID-19 in oral oncology practices in Brazil, Canada, and the United States. Oral Dis. 2021;27(Suppl 3):793.
doi: 10.1111/odi.13493
pubmed: 32557965
Bastani P, Niknam F, Rezazadeh M, Rossi-Fedele G, Edirippulige S, Samadbeik M. Dentistry website analysis: An overview of the content of formulated questions and answers. Heliyon. 2022;8:e10250.
doi: 10.1016/j.heliyon.2022.e10250
pubmed: 36042730
pmcid: 9420359
Blomstrand L, Sand LP, Gullbrandsson L, Eklund B, Kildal M, Hirsch J-M. Telemedicine—A complement to traditional referrals in oral medicine. Telemedicine and e-Health. 2012;18(7):549–53.
doi: 10.1089/tmj.2011.0207
pubmed: 22823077
Macken J, Fortune F, Buchanan J. Remote telephone clinics in oral medicine: reflections on the place of virtual clinics in a specialty that relies so heavily on visual assessment. A note of caution. Br J Oral and Maxillofac Surg. 2021;59(5):605–8.
doi: 10.1016/j.bjoms.2020.11.010
Fricton J, Chen H. Using teledentistry to improve access to dental care for the underserved. Dental Clinics. 2009;53(3):537–48.
pubmed: 19482128
Haron N, Zain RB, Nabillah WM, Saleh A, Kallarakkal TG, Ramanathan A, et al. Mobile phone imaging in low resource settings for early detection of oral cancer and concordance with clinical oral examination. Telemedicine and e-Health. 2017;23(3):192–9.
doi: 10.1089/tmj.2016.0128
pubmed: 27541205
Maret D, Warnakulasuriya S, Herbault-Barres B, Savall F, Vigarios E. Telemedicine contributing to an incidental finding of a premalignant lesion. Oral Oncol. 2021;118:105331.
doi: 10.1016/j.oraloncology.2021.105331
pubmed: 34024725
pmcid: 9760787
Perdoncini NN, Schussel JL, Amenábar JM, Torres-Pereira CC. Use of smartphone video calls in the diagnosis of oral lesions: Teleconsultations between a specialist and patients assisted by a general dentist. J Am Dent Assoc. 2021;152(2):127–35.
doi: 10.1016/j.adaj.2020.10.013
pubmed: 33494867
Deshpande S, Patil D, Dhokar A, Bhanushali P, Katge F. Teledentistry: A boon amidst COVID-19 lockdown—a narrative review. Int J Telemed Appl. 2021;2021:1–6.
Maret D, Peters OA, Auria JP, Savall F, Vigarios E. Smartphone oral self-photography in teledentistry: recommendations for the patient. J Telemed Telecare. 2021;30:186–93.
doi: 10.1177/1357633X211028513
pubmed: 34160332
Di Fede O, La Mantia G, Cimino MG, Campisi G. Protection of patient data in digital Oral and general health care: A scoping review with respect to the current regulations. Oral. 2023;3(2):155–65.
doi: 10.3390/oral3020014
Zhou MX, Johnson EF, Arce K, Gruwell SF. Teledentistry in the management of a non-Hodgkin’s lymphoma manifesting as a gingival swelling: A case report. Spec Care Dentist. 2022;42(1):86–90.
doi: 10.1111/scd.12638
pubmed: 34329504
Lv N, Sun M, Polonowita A, Mei L, Guan G. Management of oral medicine emergencies during COVID-19: A study to develop practise guidelines. Journal of dental sciences. 2021;16(1):493–500.
doi: 10.1016/j.jds.2020.07.016
pubmed: 32837687
Fonseca BB, Perdoncini NN, da Silva VC, Gueiros LAM, Carrard VC, Lemos CA Jr, et al. Telediagnosis of oral lesions using smartphone photography. Oral Dis. 2022;28(6):1573–9.
doi: 10.1111/odi.13972
pubmed: 34289201
Gambino O, Lima F, Pirrone R, Ardizzone E, Campisi G, di Fede O. Second opinion system for intraoral lesions. In 2014 IEEE 27th International Symposium on Computer-Based Medical Systems. IEEE; 2014. p. 495–6.
Vinayagamoorthy K, Acharya S, Kumar M, Pentapati KC, Acharya S. Efficacy of a remote screening model for oral potentially malignant disorders using a free messaging application: a diagnostic test for accuracy study. Aust J Rural Health. 2019;27(2):170–6.
doi: 10.1111/ajr.12496
pubmed: 30942518
Valizadeh-Haghi H, Valizadeh-Haghi S, Naslseraji N, Zandian H. Smartphone Photography as a Teledentistry Method to Evaluate Anterior Composite Restorations. Int J Dent. 2023;2023(1):3171140.
Jeong J-S, Pang N-S, Choi Y, Park K-M, Kim T, Xu X, et al. Importance of photography education to improve image quality for accurate remote diagnoses in dental trauma patients: observational study. JMIR Mhealth Uhealth. 2020;8(3):e15152.
doi: 10.2196/15152
pubmed: 32213475
pmcid: 7146236
Estai M, Kanagasingam Y, Huang B, Shiikha J, Kruger E, Bunt S, et al. Comparison of a smartphone-based photographic method with face-to-face caries assessment: a mobile teledentistry model. Telemed e-Health. 2017;23(5):435–40.
doi: 10.1089/tmj.2016.0122
AlShaya MS, Assery MK, Pani SC. Reliability of mobile phone teledentistry in dental diagnosis and treatment planning in mixed dentition. J Telemed Telecare. 2020;26(1–2):45–52.
doi: 10.1177/1357633X18793767
pubmed: 30134778
Jeddi FR, Nabovati E, Bigham R, Farrahi R. Usability evaluation of a comprehensive national health information system: A heuristic evaluation. Informatics in Medicine Unlocked. 2020;19:100332.
doi: 10.1016/j.imu.2020.100332
Martins, AI, Queirós A, Silva AG, Rocha NP. Usability Evaluation Methods: A Systematic Review. Human-Computer Interaction: Concepts, Methodologies, Tools, and Applications. 2016. p. 613–36.
Koohjani Z, Aslani A, Abasi S, Kyiani S. A comprehensive tool for usability evaluation of telehealth. In pHealth 2019. IOS Press; 2019. p. 168–73.
Kasim HF, Salih AI, Attash FM. Usability of telehealth among healthcare providers during COVID-19 pandemic in Nineveh Governorate, Iraq. Public Health Pract. 2023;5:100368.
Jaspers MW. A comparison of usability methods for testing interactive health technologies: methodological aspects and empirical evidence. Int J Med Informatics. 2009;78(5):340–53.
doi: 10.1016/j.ijmedinf.2008.10.002
Donner A, Eliasziw M. A goodness-of-fit approach to inference procedures for the kappa statistic: confidence and sample size estimation interval construction, significance-testing. Stat Med. 1992;11(11):1511–9.
doi: 10.1002/sim.4780111109
pubmed: 1410963
Shoukri MM, Asyali M, Donner A. Sample size requirements for the design of reliability study: review and new results. Stat Methods Med Res. 2004;13(4):251–71.
doi: 10.1191/0962280204sm365ra
Nielsen J. Enhancing the explanatory power of usability heuristics. In Proceedings of the SIGCHI conference on Human Factors in Computing Systems. New York: Association for Computing Machinery; 1994. p. 152–158.
Stein CD, Xiao X, Levine S, Schleyer TK, Hochheiser H, Thyvalikakath TP. A prototype mobile application for triaging dental emergencies. J Am Dent Assoc. 2016;147(10):782–91. e1.
doi: 10.1016/j.adaj.2016.03.021
pubmed: 27206728
pmcid: 5045825
Lilholt PH, Jensen MH, Hejlesen OK. Heuristic evaluation of a telehealth system from the Danish TeleCare North Trial. Int J Med Informatics. 2015;84(5):319–26.
doi: 10.1016/j.ijmedinf.2015.01.012
Khashe Y, Tabibzadeh M, Zhou D. Improving Quality of Care in Virtual Visits: Heuristic Evaluations of the User Interface in Telehealth. In Proceedings of the Human Factors and Ergonomics Society Annual Meeting, vol. 65. Los Angeles: SAGE Publications; 2021. p. 1347–51.
Carrard V, Roxo Gonçalves M, Rodriguez Strey J, Pilz C, Martins M, Martins M, et al. Telediagnosis of oral lesions in primary care: The EstomatoNet Program. Oral Dis. 2018;24(6):1012–9.
doi: 10.1111/odi.12851
pubmed: 29505701