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The review characterizes study features that contribute to heterogeneity across population, index tests, and reference standards, evaluates their consistency, and assesses how variability limits reliable synthesis in systematic reviews and adoption in practice. Findings motivate standardized reporting and a tailored STARD approach to improve comparability of outcomes.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/challenges-in-teledermoscopy-diagnostic-outcome-studies-scoping-review-of-heterogeneous-study-characteristics/332691/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/challenges-in-teledermoscopy-diagnostic-outcome-studies-scoping-review-of-heterogeneous-study-characteristics/332691.png","ImageObject",300,407,{"name":92,"@type":93},"Skyler","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-27","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is heterogeneity a problem in teledermoscopy diagnostic outcome studies?","Question",{"text":112,"@type":113},"Heterogeneity across study characteristics prevents systematic reviews from producing a reliable synopsis of diagnostic outcomes, limiting trust, adoption in general practice, and overall health care benefits.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which domains of study characteristics were examined to explain heterogeneity?",{"text":117,"@type":113},"The study grouped characteristics into three domains: population, index test, and reference standard, then assessed variability and consistency across those domains.",{"name":119,"@type":110,"acceptedAnswer":120},"What reporting standard is recommended to improve consistency and comparability?",{"text":121,"@type":113},"Adopting a tailored STARD (Standards for Reporting Diagnostic Accuracy Studies) checklist for teledermoscopy diagnostic outcome studies is recommended, along with a proposed Delphi study to build consensus.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},332691,1790941313,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},2336464648746,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","JMIR DERMATOLOGY van Sinderen et al  \nReview  \nChallenges in Teledermoscopy Diagnostic Outcome Studies: Scoping Review of Heterogeneous Study Characteristics  \n\n| Femke van Sinderen 1,2,3, MSc; Anne P Langermans 1, MSc; Andre W Kushniruk4, Prof Dr; Elizabeth M Borycki4, Prof Dr; Monique M Jaspers1,2, Prof Dr; Linda W Peute1,2, PhD |\n| --- |\n| 1Department of Medical Informatics, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands 2Digital Health, Amsterdam Public Health, Amsterdam, Netherlands\u003Cbr>3Ksyos Health Management Research, Amsterdam, Netherlands\u003Cbr>4School of Health Information Science, University of Victoria, Victoria, BC, Canada\u003Cbr>Corresponding Author:\u003Cbr>Femke van Sinderen, MSc\u003Cbr>Department of Medical Informatics\u003Cbr>Amsterdam UMC location University of Amsterdam Meibergdreef 9\u003Cbr>Amsterdam, 1105 AZ Netherlands\u003Cbr>Phone: 31 205666204\u003Cbr>Email: [f.vansinderen@amsterdamumc.nl](f.vansinderen@amsterdamumc.nl)\u003Cbr>Abstract |\n\nBackground: Teledermoscopy has demonstrated benefits such as decreased costs and enhanced access to dermatology care for skin cancer detection. However, the heterogeneity among teledermoscopy studies hinders the systematic reviews’ synopsis of diagnostic outcomes, impeding trust and adoption in general practice and limiting overall health care benefits.  \nObjective: This study aims to improve understanding and standardization of teledermoscopy diagnostic studies, by identifying and categorizing study characteristics contributing to heterogeneity. Subsequently, the variability and consistency of these characteristics were assessed.  \nMethods: A review of systematic reviews regarding the diagnostic outcomes of teledermoscopy was performed to discern reported study characteristics contributing to heterogeneity. These characteristics were thematically grouped into 3 domains (population, index test, and reference standard), forming a data extraction framework. A scoping review on teledermoscopy diagnostic outcomes studies was performed, guided by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. Data pertaining to study characteristics from included studies were extracted and analyzed through descriptive content analysis. Systematic reviews’ reference lists validated the scoping review query.  \nResults: The literature search yielded 4 systematic reviews, revealing 15 heterogeneous studies across the population, index test, and reference standard domains. The scoping review identified 49 studies, with 27 overlapping with the systematic reviews. Population characteristics varied, with one-third (16/49, 33%) of studies reporting fewer than 100 samples; most studies (41/49, 84%) reported on the type of lesion, and most (20/49, 41%) teledermoscopy consultations took place in secondary care. One-fifth (11/49, 22%) did not describe inclusion or exclusion criteria, or the criteria varied highly. Index test characteristics showed differences in clinical expertise, profession, and training in dermatoscopic photography, and 59%(29/49) did not report on 1 or more index test characteristics. Image quality and clinical information reporting likewise varied. Reference standard characteristics involved teledermatologists’ assessment, but 16 studies did not report teledermatologists’ experience levels. Most studies (26/49, 53%) used histopathology as a gold standard.  \nConclusions: The heterogeneity in the population, index tests, and reference standard domains across teledermoscopy diagnostic outcome studies underscores the need for standardized reporting. This hinders the synopsis of teledermoscopy diagnostic outcomesin systematic reviews and limits the integration of research results into practice. Adopting a (tailored) STARD (Standards for Reporting Diagnostic Accuracy Studies) checklist for teledermoscopy diagnostic outcome studies is recommended to enhance the consistency and comparability of outcomes. We suggest performing","cbCaimfEXltHJuBk","https://ap.wps.com/l/cbCaimfEXltHJuBk","pdf",404051,14,"English","# Abstract\n## Background\n## Objective\n## Methods\n## Results\n## Conclusions\n# Introduction","[{\"question\":\"Why is heterogeneity a problem in teledermoscopy diagnostic outcome studies?\",\"answer\":\"Heterogeneity across study characteristics prevents systematic reviews from producing a reliable synopsis of diagnostic outcomes, limiting trust, adoption in general practice, and overall health care benefits.\"},{\"question\":\"Which domains of study characteristics were examined to explain heterogeneity?\",\"answer\":\"The study grouped characteristics into three domains: population, index test, and reference standard, then assessed variability and consistency across those domains.\"},{\"question\":\"What reporting standard is recommended to improve consistency and comparability?\",\"answer\":\"Adopting a tailored STARD (Standards for Reporting Diagnostic Accuracy Studies) checklist for teledermoscopy diagnostic outcome studies is recommended, along with a proposed Delphi study to build consensus.\"}]","Challenges in Teledermoscopy Diagnostic Outcome Studies - Scoping Review of Heterogeneous Study Characteristics | PDF",1789999094,35]