International Inter-Rater Agreement in Scoring Acne Severity Utilizing Cloud-Based Image Sharing of Mobile Phone Photographs Publisher Pubmed



Foolad N¹ ; Ornelas JN² ; Clark AK² ; Ali I² ; Sharon VR^{1, 3} ; Al Mubarak L⁴ ; Lopez A⁵ ; Alikhan A⁶ ; Al Dabagh B⁷ ; Firooz A⁸ ; Awasthi S¹ ; Liu Y⁹ ; Li CS¹⁰ ; Sivamani RK¹
Source: International Journal of Dermatology Published:2017

Abstract

Background: Cloud-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. Methods: This 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. Results: There 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. Conclusions: Our 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. © 2017 The International Society of Dermatology