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High Referral Accuracy for Oral Cancers and Oral Potentially Malignant Disorders using Telemedicine

Oral Dis. 2021 Apr 29. doi: 10.1111/odi.13892. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the accuracy of MeMoSA® , a mobile phone application to review images of oral lesions in identifying oral cancers and oral potentially malignant disorders requiring referral.

SUBJECTS AND METHODS: A prospective study of 355 participants, including 280 with oral lesions/variants was conducted. Adults aged ≥18 treated at tertiary referral centres were included. Images of the oral cavity were taken using MeMoSA® . The identification of the presence of lesion/variant and referral decision made using MeMoSA® were compared to clinical oral examination, using Kappa statistics for intra-rater agreement. Sensitivity, specificity, concordance and F1 score were computed. Images were reviewed by an off-site specialist and inter-rater agreement was evaluated. Images from sequential clinical visits were compared to evaluate observable changes in the lesions.

RESULTS: Kappa values comparing MeMoSA® with clinical oral examination in detecting a lesion and referral decision was 0.604 and 0.892 respectively. Sensitivity and specificity for referral decision was 94.0% and 95.5%. Concordance and F1 score were 94.9% and 93.3% respectively. Inter-rater agreement for a referral decision was 0.825. Progression or regression of lesions were systematically documented using MeMoSA® .

CONCLUSION: Referral decisions made through MeMoSA® is highly comparable to clinical examination demonstrating it is a reliable telemedicine tool to facilitate the identification of high-risk lesions for early management.

PMID:33914993 | DOI:10.1111/odi.13892

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