Novel Approach to Improving Specialist Access in Underserved Populations with Suspicious Oral Lesions
Late detection and specialist referral result in poor oral cancer outcomes globally. High-risk LRMU populations usually do not have access to oral medicine specialists, a specialty of dentistry, whose expertise includes the identification, treatment, and management of oral cancers. To overcome this...
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| Vydané v: | Current oncology (Toronto) Ročník 30; číslo 1; s. 1046 - 1053 |
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| Hlavní autori: | , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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Switzerland
MDPI
11.01.2023
MDPI AG |
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| ISSN: | 1718-7729, 1198-0052, 1718-7729 |
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| Abstract | Late detection and specialist referral result in poor oral cancer outcomes globally. High-risk LRMU populations usually do not have access to oral medicine specialists, a specialty of dentistry, whose expertise includes the identification, treatment, and management of oral cancers. To overcome this access barrier, there is an urgent need for novel, low-cost tele-health approaches to expand specialist access to low-resource, remote and underserved individuals. The goal of this study was to compare the diagnostic accuracy of remote versus in-person specialist visits using a novel, low-cost telehealth platform consisting of a smartphone-based, remote intraoral camera and custom software application. A total of 189 subjects with suspicious oral lesions requiring biopsy (per the standard of care) were recruited and consented. Each subject was examined, and risk factors were recorded twice: once by an on-site specialist, and again by an offsite specialist. A novel, low-cost, smartphone-based intraoral camera paired with a custom software application were utilized to perform synchronous remote video/still imaging and risk factor assessment by the off-site specialist. Biopsies were performed at a later date following specialist recommendations. The study’s results indicated that on-site specialist diagnosis showed high sensitivity (94%) and moderate specificity (72%) when compared to histological diagnosis, which did not significantly differ from the accuracy of remote specialist telediagnosis (sensitivity: 95%; specificity: 84%). These preliminary findings suggest that remote specialist visits utilizing a novel, low-cost, smartphone-based telehealth tool may improve specialist access for low-resource, remote and underserved individuals with suspicious oral lesions. |
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| AbstractList | Late detection and specialist referral result in poor oral cancer outcomes globally. High-risk LRMU populations usually do not have access to oral medicine specialists, a specialty of dentistry, whose expertise includes the identification, treatment, and management of oral cancers. To overcome this access barrier, there is an urgent need for novel, low-cost tele-health approaches to expand specialist access to low-resource, remote and underserved individuals. The goal of this study was to compare the diagnostic accuracy of remote versus in-person specialist visits using a novel, low-cost telehealth platform consisting of a smartphone-based, remote intraoral camera and custom software application. A total of 189 subjects with suspicious oral lesions requiring biopsy (per the standard of care) were recruited and consented. Each subject was examined, and risk factors were recorded twice: once by an on-site specialist, and again by an offsite specialist. A novel, low-cost, smartphone-based intraoral camera paired with a custom software application were utilized to perform synchronous remote video/still imaging and risk factor assessment by the off-site specialist. Biopsies were performed at a later date following specialist recommendations. The study's results indicated that on-site specialist diagnosis showed high sensitivity (94%) and moderate specificity (72%) when compared to histological diagnosis, which did not significantly differ from the accuracy of remote specialist telediagnosis (sensitivity: 95%; specificity: 84%). These preliminary findings suggest that remote specialist visits utilizing a novel, low-cost, smartphone-based telehealth tool may improve specialist access for low-resource, remote and underserved individuals with suspicious oral lesions. Late detection and specialist referral result in poor oral cancer outcomes globally. High-risk LRMU populations usually do not have access to oral medicine specialists, a specialty of dentistry, whose expertise includes the identification, treatment, and management of oral cancers. To overcome this access barrier, there is an urgent need for novel, low-cost tele-health approaches to expand specialist access to low-resource, remote and underserved individuals. The goal of this study was to compare the diagnostic accuracy of remote versus in-person specialist visits using a novel, low-cost telehealth platform consisting of a smartphone-based, remote intraoral camera and custom software application. A total of 189 subjects with suspicious oral lesions requiring biopsy (per the standard of care) were recruited and consented. Each subject was examined, and risk factors were recorded twice: once by an on-site specialist, and again by an offsite specialist. A novel, low-cost, smartphone-based intraoral camera paired with a custom software application were utilized to perform synchronous remote video/still imaging and risk factor assessment by the off-site specialist. Biopsies were performed at a later date following specialist recommendations. The study's results indicated that on-site specialist diagnosis showed high sensitivity (94%) and moderate specificity (72%) when compared to histological diagnosis, which did not significantly differ from the accuracy of remote specialist telediagnosis (sensitivity: 95%; specificity: 84%). These preliminary findings suggest that remote specialist visits utilizing a novel, low-cost, smartphone-based telehealth tool may improve specialist access for low-resource, remote and underserved individuals with suspicious oral lesions.Late detection and specialist referral result in poor oral cancer outcomes globally. High-risk LRMU populations usually do not have access to oral medicine specialists, a specialty of dentistry, whose expertise includes the identification, treatment, and management of oral cancers. To overcome this access barrier, there is an urgent need for novel, low-cost tele-health approaches to expand specialist access to low-resource, remote and underserved individuals. The goal of this study was to compare the diagnostic accuracy of remote versus in-person specialist visits using a novel, low-cost telehealth platform consisting of a smartphone-based, remote intraoral camera and custom software application. A total of 189 subjects with suspicious oral lesions requiring biopsy (per the standard of care) were recruited and consented. Each subject was examined, and risk factors were recorded twice: once by an on-site specialist, and again by an offsite specialist. A novel, low-cost, smartphone-based intraoral camera paired with a custom software application were utilized to perform synchronous remote video/still imaging and risk factor assessment by the off-site specialist. Biopsies were performed at a later date following specialist recommendations. The study's results indicated that on-site specialist diagnosis showed high sensitivity (94%) and moderate specificity (72%) when compared to histological diagnosis, which did not significantly differ from the accuracy of remote specialist telediagnosis (sensitivity: 95%; specificity: 84%). These preliminary findings suggest that remote specialist visits utilizing a novel, low-cost, smartphone-based telehealth tool may improve specialist access for low-resource, remote and underserved individuals with suspicious oral lesions. |
| Author | Le, Anh Melnikova, Anastasya Abouakl, Mary Yang, Susan Takesh, Thair Messadi, Diana Osann, Kathryn Nguyen, James Wilder-Smith, Petra Lin, Kairong Wink, Cherie |
| AuthorAffiliation | 1 Beckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USA 3 UCLA School of Dentistry, University of California Los Angeles, Los Angeles, CA 90095, USA 2 Department of Oral and Maxillofacial Surgery/Pharmacology, University of Pennsylvania, Philadelphia, PA 19104, USA 4 School of Medicine, University of California Irvine, Irvine, CA 92617, USA |
| AuthorAffiliation_xml | – name: 4 School of Medicine, University of California Irvine, Irvine, CA 92617, USA – name: 2 Department of Oral and Maxillofacial Surgery/Pharmacology, University of Pennsylvania, Philadelphia, PA 19104, USA – name: 1 Beckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USA – name: 3 UCLA School of Dentistry, University of California Los Angeles, Los Angeles, CA 90095, USA |
| Author_xml | – sequence: 1 givenname: James surname: Nguyen fullname: Nguyen, James – sequence: 2 givenname: Susan surname: Yang fullname: Yang, Susan – sequence: 3 givenname: Anastasya surname: Melnikova fullname: Melnikova, Anastasya – sequence: 4 givenname: Mary surname: Abouakl fullname: Abouakl, Mary – sequence: 5 givenname: Kairong orcidid: 0000-0002-7011-4981 surname: Lin fullname: Lin, Kairong – sequence: 6 givenname: Thair surname: Takesh fullname: Takesh, Thair – sequence: 7 givenname: Cherie surname: Wink fullname: Wink, Cherie – sequence: 8 givenname: Anh surname: Le fullname: Le, Anh – sequence: 9 givenname: Diana surname: Messadi fullname: Messadi, Diana – sequence: 10 givenname: Kathryn surname: Osann fullname: Osann, Kathryn – sequence: 11 givenname: Petra surname: Wilder-Smith fullname: Wilder-Smith, Petra |
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| CitedBy_id | crossref_primary_10_1111_odi_70034 crossref_primary_10_1007_s00784_023_05347_x crossref_primary_10_3390_cancers17081317 crossref_primary_10_3390_jcm14041118 crossref_primary_10_3389_froh_2025_1649715 crossref_primary_10_3390_cancers15102775 |
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| Keywords | specialist access screening underserved populations telehealth oral cancer |
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| SubjectTerms | Humans oral cancer screening specialist access telehealth Telemedicine - methods underserved populations Vulnerable Populations |
| Title | Novel Approach to Improving Specialist Access in Underserved Populations with Suspicious Oral Lesions |
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| Volume | 30 |
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