{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:26:23Z","timestamp":1788420383413,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,9,15]],"date-time":"2015-09-15T00:00:00Z","timestamp":1442275200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100012746","name":"Waitemata District Health Board","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012746","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A Virtual Lesion Clinic (<jats:styled-content style=\"fixed-case\">VLC<\/jats:styled-content>) using teledermatoscopy was established to improve efficiency of the melanoma referral pathway.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess diagnostic accuracy and to compare wait\u2010times and costs of <jats:styled-content style=\"fixed-case\">VLC<\/jats:styled-content> and conventional clinics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with suspected melanoma referred from primary care into a publicly funded health system attended local skin imaging centres, rather than hospital outpatient clinics. A teledermatologist assessed each lesion choosing specialist assessment\/excision, General Practitioner (<jats:styled-content style=\"fixed-case\">GP<\/jats:styled-content>) follow\u2010up, to re\u2010image in 3\u00a0months, or self\u2010monitoring\/no concern.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>613 skin lesions in 310 patients were evaluated over 12\u00a0months. Median time between receipt of referral and attendance at the <jats:styled-content style=\"fixed-case\">VLC<\/jats:styled-content> was 9\u00a0days compared to 26.5\u00a0days for standard outpatient assessment. Sixty\u2010six percent (404\/613) of lesions were considered benign, and 12% (73\/613) were suspicious for melanoma. Of 129 lesions excised, 98 were skin cancers including 48 histologically confirmed melanomas with one spitzoid tumour of unknown malignant potential (<jats:styled-content style=\"fixed-case\">STUMP<\/jats:styled-content>), i.e. one melanoma per 1.59 suspected lesions biopsied and one melanoma in every 12.8 referred to the service. There were 49 non\u2010melanoma skin cancers (<jats:styled-content style=\"fixed-case\">NMSC<\/jats:styled-content>). Teledermatoscopic diagnosis of melanomas was found to have a positive predictive value (<jats:styled-content style=\"fixed-case\">PPV<\/jats:styled-content>) of 63%. Compared to the conventional clinic, cost reductions from running the <jats:styled-content style=\"fixed-case\">VLC<\/jats:styled-content> for 1\u00a0year were in excess of <jats:styled-content style=\"fixed-case\">NZ<\/jats:styled-content>$364\u00a0000 (or <jats:styled-content style=\"fixed-case\">NZ<\/jats:styled-content>$1174\/patient seen).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">VLC<\/jats:styled-content> offered an efficient, accurate and cost effective way of processing suspected melanoma referrals to the public health system.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.13309","type":"journal-article","created":{"date-parts":[[2015,9,15]],"date-time":"2015-09-15T06:08:30Z","timestamp":1442297310000},"page":"2423-2428","source":"Crossref","is-referenced-by-count":45,"title":["Successful melanoma triage by a virtual lesion clinic (teledermatoscopy)"],"prefix":"10.1111","volume":"29","author":[{"given":"A.T.","family":"Congalton","sequence":"first","affiliation":[{"name":"Department of Cutaneous Oncology Waitemata District Health Board Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.M.","family":"Oakley","sequence":"additional","affiliation":[{"name":"University of Auckland Auckland New Zealand"},{"name":"Department of Dermatology Waikato District Health Board Hamilton New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Rademaker","sequence":"additional","affiliation":[{"name":"University of Auckland Auckland New Zealand"},{"name":"Department of Dermatology Waikato District Health Board Hamilton New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Bramley","sequence":"additional","affiliation":[{"name":"Waitemata District Health Board Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.C.W.","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Cutaneous Oncology Waitemata District Health Board Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,9,15]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2009.05199.x"},{"key":"e_1_2_6_3_1","unstructured":"New Zealand Ministry of Health.Cancer: new registrations and deaths 2011.Wellington:Ministry of Health;2014. 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