Novel Approach to Improving Specialist Access in Underserved Populations with Suspicious Oral Lesions

Late detection and specialist referral result in poor oral cancer outcomes globally. High-risk LRMU populations usually do not have access to oral medicine specialists, a specialty of dentistry, whose expertise includes the identification, treatment, and management of oral cancers. To overcome this...

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Main Authors: James Nguyen, Susan Yang, Anastasya Melnikova, Mary Abouakl, Kairong Lin, Thair Takesh, Cherie Wink, Anh Le, Diana Messadi, Kathryn Osann, Petra Wilder-Smith
Format: Article
Language:English
Published: MDPI AG 2023-01-01
Series:Current Oncology
Subjects:
Online Access:https://www.mdpi.com/1718-7729/30/1/80
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author James Nguyen
Susan Yang
Anastasya Melnikova
Mary Abouakl
Kairong Lin
Thair Takesh
Cherie Wink
Anh Le
Diana Messadi
Kathryn Osann
Petra Wilder-Smith
author_facet James Nguyen
Susan Yang
Anastasya Melnikova
Mary Abouakl
Kairong Lin
Thair Takesh
Cherie Wink
Anh Le
Diana Messadi
Kathryn Osann
Petra Wilder-Smith
author_sort James Nguyen
collection DOAJ
description Late detection and specialist referral result in poor oral cancer outcomes globally. High-risk LRMU populations usually do not have access to oral medicine specialists, a specialty of dentistry, whose expertise includes the identification, treatment, and management of oral cancers. To overcome this access barrier, there is an urgent need for novel, low-cost tele-health approaches to expand specialist access to low-resource, remote and underserved individuals. The goal of this study was to compare the diagnostic accuracy of remote versus in-person specialist visits using a novel, low-cost telehealth platform consisting of a smartphone-based, remote intraoral camera and custom software application. A total of 189 subjects with suspicious oral lesions requiring biopsy (per the standard of care) were recruited and consented. Each subject was examined, and risk factors were recorded twice: once by an on-site specialist, and again by an offsite specialist. A novel, low-cost, smartphone-based intraoral camera paired with a custom software application were utilized to perform synchronous remote video/still imaging and risk factor assessment by the off-site specialist. Biopsies were performed at a later date following specialist recommendations. The study’s results indicated that on-site specialist diagnosis showed high sensitivity (94%) and moderate specificity (72%) when compared to histological diagnosis, which did not significantly differ from the accuracy of remote specialist telediagnosis (sensitivity: 95%; specificity: 84%). These preliminary findings suggest that remote specialist visits utilizing a novel, low-cost, smartphone-based telehealth tool may improve specialist access for low-resource, remote and underserved individuals with suspicious oral lesions.
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spelling doaj.art-e10529a0b87d4c74a20a4bdea7047d4b2023-11-30T21:49:59ZengMDPI AGCurrent Oncology1198-00521718-77292023-01-013011046105310.3390/curroncol30010080Novel Approach to Improving Specialist Access in Underserved Populations with Suspicious Oral LesionsJames Nguyen0Susan Yang1Anastasya Melnikova2Mary Abouakl3Kairong Lin4Thair Takesh5Cherie Wink6Anh Le7Diana Messadi8Kathryn Osann9Petra Wilder-Smith10Beckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USABeckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USABeckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USABeckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USABeckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USABeckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USABeckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USADepartment of Oral and Maxillofacial Surgery/Pharmacology, University of Pennsylvania, Philadelphia, PA 19104, USAUCLA School of Dentistry, University of California Los Angeles, Los Angeles, CA 90095, USASchool of Medicine, University of California Irvine, Irvine, CA 92617, USABeckman Laser Institute and Medical Clinic, University of California Irvine School of Medicine, Irvine, CA 92612, USALate detection and specialist referral result in poor oral cancer outcomes globally. High-risk LRMU populations usually do not have access to oral medicine specialists, a specialty of dentistry, whose expertise includes the identification, treatment, and management of oral cancers. To overcome this access barrier, there is an urgent need for novel, low-cost tele-health approaches to expand specialist access to low-resource, remote and underserved individuals. The goal of this study was to compare the diagnostic accuracy of remote versus in-person specialist visits using a novel, low-cost telehealth platform consisting of a smartphone-based, remote intraoral camera and custom software application. A total of 189 subjects with suspicious oral lesions requiring biopsy (per the standard of care) were recruited and consented. Each subject was examined, and risk factors were recorded twice: once by an on-site specialist, and again by an offsite specialist. A novel, low-cost, smartphone-based intraoral camera paired with a custom software application were utilized to perform synchronous remote video/still imaging and risk factor assessment by the off-site specialist. Biopsies were performed at a later date following specialist recommendations. The study’s results indicated that on-site specialist diagnosis showed high sensitivity (94%) and moderate specificity (72%) when compared to histological diagnosis, which did not significantly differ from the accuracy of remote specialist telediagnosis (sensitivity: 95%; specificity: 84%). These preliminary findings suggest that remote specialist visits utilizing a novel, low-cost, smartphone-based telehealth tool may improve specialist access for low-resource, remote and underserved individuals with suspicious oral lesions.https://www.mdpi.com/1718-7729/30/1/80oral cancerscreeningspecialist accesstelehealthunderserved populations
spellingShingle James Nguyen
Susan Yang
Anastasya Melnikova
Mary Abouakl
Kairong Lin
Thair Takesh
Cherie Wink
Anh Le
Diana Messadi
Kathryn Osann
Petra Wilder-Smith
Novel Approach to Improving Specialist Access in Underserved Populations with Suspicious Oral Lesions
Current Oncology
oral cancer
screening
specialist access
telehealth
underserved populations
title Novel Approach to Improving Specialist Access in Underserved Populations with Suspicious Oral Lesions
title_full Novel Approach to Improving Specialist Access in Underserved Populations with Suspicious Oral Lesions
title_fullStr Novel Approach to Improving Specialist Access in Underserved Populations with Suspicious Oral Lesions
title_full_unstemmed Novel Approach to Improving Specialist Access in Underserved Populations with Suspicious Oral Lesions
title_short Novel Approach to Improving Specialist Access in Underserved Populations with Suspicious Oral Lesions
title_sort novel approach to improving specialist access in underserved populations with suspicious oral lesions
topic oral cancer
screening
specialist access
telehealth
underserved populations
url https://www.mdpi.com/1718-7729/30/1/80
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