02532nas a2200253 4500000000100000008004100001260001300042653002500055653002000080653001600100653002000116653001100136653002700147653003000174653002400204653002600228653001700254100001700271245011000288300001000398490000700408520184900415022001402264 2010 d c2010 Aug10aCooperative Behavior10aData Collection10aDermatology10aElectronic Mail10aHumans10aQuality of Health Care10aReferral and Consultation10aRemote Consultation10aRetrospective Studies10aTelemedicine1 aKanthraj G R00aAuthors' willingness for second-opinion teledermatology in difficult-to-manage cases: 'an online survey'. a961-60 v243 a

BACKGROUND: Expert non-availability for an instant difficult-to-manage case may limit the online discussion group to provide second-opinion teledermatology for registered dermatologists. Author-based second-opinion teledermatology (AST) is proposed and assessment of authors' response to answer queries and their willingness to participate in teledermatology consultation is analysed.

MATERIALS AND METHODS: Authors of 292 articles from seven non-open access dermatology and three general medical journals addressing difficult-to-manage cases from June 2007 to December 2008 participated in this online dermatology authors' survey. Authors' response to reprint requests, answer literature queries and willingness to offer second-opinion teledermatology were the main outcome measures. Perceived views were also documented.

RESULTS: The scores for reprints requests vs. received were (chi(2) = 13.57, n = 292), P = 0.000. The scores for articles read, analysed and literature queries sent vs. authors answered were (chi(2) = 11.09, n = 190), P = 0.001. The scores for authors responded to reprints vs. willing to offer second-opinion teledermatology consultation were (chi(2) = 5.65, n = 190), P = 0.017 and authors responded to reprint requests, answered queries and willing to offer second-opinion (chi(2) = 5.65, n = 190), P = 0.017.

CONCLUSION: A dermatologist obtains literature, answered queries and constructive suggestions with additional informative material and pools second-opinions from the authors using their e-mail to deliver quality health care. AST is an alternative to online discussion group for second-opinion teledermatology practice in difficult-to-manage cases. Uniform international laws are to be framed to facilitate telemedicine care for a difficult-to-manage case.

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