array:23 [
  "pii" => "S1578219008703263"
  "issn" => "15782190"
  "doi" => "10.1016/S1578-2190(08)70326-3"
  "estado" => "S300"
  "fechaPublicacion" => "2008-10-01"
  "aid" => "70326"
  "copyright" => "Academia Española de Dermatología y Venereología and Elsevier España, S.L."
  "copyrightAnyo" => "2008"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "rev"
  "cita" => "Actas Dermosifiliogr. 2008;99:586-97"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2578
    "formatos" => array:3 [
      "EPUB" => 46
      "HTML" => 1556
      "PDF" => 976
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S1578219008703275"
    "issn" => "15782190"
    "doi" => "10.1016/S1578-2190(08)70327-5"
    "estado" => "S300"
    "fechaPublicacion" => "2008-10-01"
    "aid" => "70327"
    "copyright" => "Academia Española de Dermatología y Venereología and Elsevier España, S.L."
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Actas Dermosifiliogr. 2008;99:598-607"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 40647
      "formatos" => array:3 [
        "EPUB" => 77
        "HTML" => 2838
        "PDF" => 37732
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Practical dermatology</span>"
      "titulo" => "Diagnosis and Treatment of Livedo Reticularis on the Legs"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "598"
          "paginaFinal" => "607"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Livedo Reticularis de las Piernas&#58; Metodolog&#237;a de Diagn&#243;stico y Tratamiento"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "C&#46; Herrero, A&#46; Guilabert, J&#46;M&#46; Mascar&#243;-Galy"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Herrero"
            ]
            1 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Guilabert"
            ]
            2 => array:2 [
              "nombre" => "J&#46;M&#46;"
              "apellidos" => "Mascar&#243;-Galy"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219008703275?idApp=UINPBA000044"
    "url" => "/15782190/0000009900000008/v1_201304241439/S1578219008703275/v1_201304241439/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S1578219008703251"
    "issn" => "15782190"
    "doi" => "10.1016/S1578-2190(08)70325-1"
    "estado" => "S300"
    "fechaPublicacion" => "2008-10-01"
    "aid" => "70325"
    "copyright" => "Academia Espa&#241;ola de Dermatolog&#237;a y Venereolog&#237;a and Elsevier Espa&#241;a&#44; S&#46;L&#46;"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Actas Dermosifiliogr. 2008;99:583-5"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2188
      "formatos" => array:3 [
        "EPUB" => 57
        "HTML" => 1318
        "PDF" => 813
      ]
    ]
    "en" => array:8 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Opinion article</span>"
      "titulo" => "The Inappropriateness of the Term <span class="elsevierStyleItalic">Hand Eczema</span>"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "583"
          "paginaFinal" => "585"
        ]
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "F&#46; Heras-Mendaza, L&#46; Conde-Salazar"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "Heras-Mendaza"
            ]
            1 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Conde-Salazar"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219008703251?idApp=UINPBA000044"
    "url" => "/15782190/0000009900000008/v1_201304241439/S1578219008703251/v1_201304241439/en/main.assets"
  ]
  "en" => array:14 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Review article</span>"
    "titulo" => "Telemedicine and Teledermatology &#40;II&#41;&#58; Current State of Research on Dermatology Teleconsultations"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "586"
        "paginaFinal" => "597"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "G&#46; Romero, P&#46; Cortina, E&#46; Vera"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "G&#46;"
            "apellidos" => "Romero"
            "email" => array:1 [
              0 => "gromeroa&#64;meditex&#46;es"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor1"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "P&#46;"
            "apellidos" => "Cortina"
          ]
          2 => array:2 [
            "nombre" => "E&#46;"
            "apellidos" => "Vera"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:1 [
            "entidad" => "Unidad de Dermatolog&#237;a&#44; Hospital General de Ciudad Real&#44; Ciudad Real&#44; Spain"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor1"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Correspondence&#58; C&#47; Castillo de Caracuel&#44; 30&#44; 13005 Ciudad Real&#44; Spain&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Telemedicina y Teledermatolog&#237;a &#40;II&#41;&#58; Estado Actual de la Investigaci&#243;n en Teleconsulta Dermatol&#243;gica"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaAceptado" => "2008-04-03"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key words"
          "identificador" => "xpalclavsec84288"
          "palabras" => array:10 [
            0 => "telemedicine"
            1 => "teleconsultation"
            2 => "teledermatology"
            3 => "store-and-forward systems"
            4 => "real-time systems"
            5 => "reproducibility of results"
            6 => "validation studies"
            7 => "outcomes assessment"
            8 => "costs analysis"
            9 => "personal satisfaction"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec84287"
          "palabras" => array:10 [
            0 => "telemedicina"
            1 => "teleconsulta"
            2 => "teledermatolog&#237;a"
            3 => "sistemas de almacenamiento"
            4 => "sistemas en tiempo real"
            5 => "reproducibilidad de los resultados"
            6 => "estudios de validaci&#243;n"
            7 => "an&#225;lisis de resultados"
            8 => "an&#225;lisis de costes"
            9 => "satisfacci&#243;n personal"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">The rapid increase in the use of telemedicine makes a critical appraisal of these services essential&#46; This article reviews the current evidence from studies of teledermatology with sufficiently rigorous methodology to allow reasonable conclusions to be drawn&#46; The review is organized according to areas of research in teledermatology&#58; reliability of diagnosis and management&#44; accuracy&#44; outcomes&#44; costs&#44; and satisfaction&#46; The conclusion of this review is that teledermatology has been shown to be feasible and reliable but that it has a long way to go before maturing as a medical technology in daily practice&#46; The largest body of evidence relates to the reliabity of diagnosis and management&#44; but although numerous studies have been performed&#44; many have marked methodological shortcomings&#46; Accuracy studies have been conducted in skin oncology with appropriate methodology that show an accuracy comparable to that of face-to-face consultations&#46; Studies of health outcomes should be designed such that a faithful assessment of the final outcomes&#44; costs&#44; and satisfaction with teledermatology systems can be carried out&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">El r&#225;pido incremento en el desarrollo de los servicios en telemedicina hace crucial su evaluaci&#243;n cr&#237;tica&#46; Este art&#237;culo revisa la evidencia actual en art&#237;culos de investigaci&#243;n en teledermatolog&#237;a con la suficiente calidad metodol&#243;gica como para alcanzar conclusiones razonables&#46; La revisi&#243;n se organiza analizando las &#225;reas de investigaci&#243;n en teledermatolog&#237;a&#58; fiabilidad en el diagn&#243;stico y el manejo&#44; validez&#44; resultados&#44; costes y satisfacci&#243;n&#46; Las conclusiones de la misma indican que la teledermatolog&#237;a ha demostrado ser factible y fiable pero que est&#225; lejos de alcanzar su madurez como tecnolog&#237;a m&#233;dica para su pr&#225;ctica habitual&#46; El cuerpo de evidencia con mayor desarrollo es el &#225;rea de fiabilidad en el diagn&#243;stico y el manejo&#44; donde existen un gran n&#250;mero de estudios&#44; aunque muchos de ellos adolecen de importantes defectos metodol&#243;gicos&#46; Existen estudios de validez en oncolog&#237;a cut&#225;nea con metodolog&#237;a correcta que muestran unos resultados comparables con la consulta presencial&#46; Se hace preciso el dise&#241;o de estudios en resultados de salud que permitan un an&#225;lisis fidedigno de resultados finales&#44; costes y satisfacci&#243;n de los sistemas de teledermatolog&#237;a&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:106 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Telemedicina y teledermatolog&#237;a &#40;I&#41;&#58; concepto y aplicaciones"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2008"
                        "volumen" => "99"
                        "paginaInicial" => "506"
                        "paginaFinal" => "522"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "Telemedicine&#58; fad or future&#63;"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1995"
                        "volumen" => "345"
                        "paginaInicial" => "73"
                        "paginaFinal" => "74"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teleconsulting&#58; a practical account of pitfalls&#44; problems and promise&#46; Experience from the TEAM project group"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "1996"
                        "volumen" => "2"
                        "numero" => "Suppl 1"
                        "paginaInicial" => "1"
                        "paginaFinal" => "3"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fear&#44; loathing&#44; dermatology&#44; and telemedicine"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [ …1]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1997"
                        "volumen" => "133"
                        "paginaInicial" => "151"
                        "paginaFinal" => "155"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Publication output in telemedicine during the period January 1964 to July 2003"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1258/135763304773391495"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2004"
                        "volumen" => "10"
                        "paginaInicial" => "72"
                        "paginaFinal" => "77"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Telemedicine for the Medicare population&#58; pediatric&#44; obstetric&#44; and clinician-indirect home interventions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Evid Rep Technol Assess &#40;Summ&#41;"
                        "fecha" => "2001"
                        "volumen" => "24"
                        "numero" => "Suppl"
                        "paginaInicial" => "1"
                        "paginaFinal" => "32"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatology research review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [ …1]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-4632.2004.02427.x"
                      "Revista" => array:7 [
                        "tituloSerie" => "Int J Dermatol"
                        "fecha" => "2006"
                        "volumen" => "45"
                        "paginaInicial" => "220"
                        "paginaFinal" => "229"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1552526008000319"
                          "estado" => "S300"
                          "issn" => "15525260"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Maturity of teledermatology evaluation research&#58; a systematic literature review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2133.2006.07627.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2007"
                        "volumen" => "156"
                        "paginaInicial" => "412"
                        "paginaFinal" => "419"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A systematic review of the efficacy of telemedicine for making diagnostic and management decisions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1258/135763302320272167"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2002"
                        "volumen" => "8"
                        "paginaInicial" => "197"
                        "paginaFinal" => "209"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Systematic review of evidence for the benefits of telemedicine"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2002"
                        "volumen" => "8"
                        "numero" => "Suppl 1"
                        "paginaInicial" => "1"
                        "paginaFinal" => "30"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessing telemedicine&#58; a systematic review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "CMAJ"
                        "fecha" => "2001"
                        "volumen" => "165"
                        "paginaInicial" => "765"
                        "paginaFinal" => "771"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673605678890"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Telemedicine for the Medicare Population&#58; Update"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Evid Rep Technol Assess &#40;Full Rep&#41;"
                        "fecha" => "2006"
                        "volumen" => "131"
                        "paginaInicial" => "1"
                        "paginaFinal" => "41"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ten years of teledermatology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Stud Health Technol Inform"
                        "fecha" => "2006"
                        "volumen" => "124"
                        "paginaInicial" => "362"
                        "paginaFinal" => "367"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Has teledermatology in the U&#46;K&#46; finally failed&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2133.2007.07750.x"
                      "Revista" => array:5 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2007"
                        "volumen" => "156"
                        "paginaInicial" => "411"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatolog&#237;a&#46; Resultados de evaluaci&#243;n"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Monogr Dermatol"
                        "fecha" => "2006"
                        "volumen" => "19"
                        "paginaInicial" => "356"
                        "paginaFinal" => "363"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Present and future of telemedicine"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [ …1]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2006"
                        "volumen" => "127"
                        "paginaInicial" => "335"
                        "paginaFinal" => "336"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "R&#233;plica&#58; Resultados preliminares de DERMATEL&#58; estudio aleatorizado prospectivo comparando modalidades de teledermatolog&#237;a s&#237;ncrona y as&#237;ncrona"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2007"
                        "volumen" => "98"
                        "paginaInicial" => "506"
                        "paginaFinal" => "507"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Whited JD&#46; Summary of the status of Teledermatology Research&#46; ATA&#59; 2005&#46; Available from&#58; <a class="elsevierStyleInterRef" href="http://www.atmeda.org/">http&#58;&#47;&#47;www&#46;atmeda&#46;org</a>"
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The rational clinical examination&#46; A primer on the precision and accuracy of the clinical examination"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [ …1]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "1992"
                        "volumen" => "267"
                        "paginaInicial" => "2638"
                        "paginaFinal" => "2644"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Investigation methods in clinical cardiology&#46; IV&#46; Clinical measurements in cardiology&#58; validity and errors of measurements"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Cardiol"
                        "fecha" => "1997"
                        "volumen" => "50"
                        "paginaInicial" => "117"
                        "paginaFinal" => "128"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fiabilidad de la teleconsulta en Dermatolog&#237;a&#46; Doctoral Thesis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [ …1]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2007"
                        "editorial" => "Facultad de Medicina"
                        "editorialLocalizacion" => "Universidad Complutense de Madrid"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatology and in-person examinations&#58; a comparison of patient and physician perceptions and diagnostic agreement"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1998"
                        "volumen" => "134"
                        "paginaInicial" => "471"
                        "paginaFinal" => "476"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reliability of dermatology teleconsultations with the use of teleconferencing technology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "1997"
                        "volumen" => "37"
                        "numero" => "3 Pt 1"
                        "paginaInicial" => "398"
                        "paginaFinal" => "402"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Kvedar JC&#46; Teledermatology&#46; e-medicine&#59; 2005&#46; Disponible en&#58; <a class="elsevierStyleInterRef" href="http://www.emedicine.com/derm/topic527.htm">http&#58;&#47;&#47;www&#46;emedicine&#46;com&#47;derm&#47;topic527&#46;htm</a>"
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of teleconsultations and face-to-face consultations&#58; preliminary results of a United Kingdom multicentre teledermatology study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "1998"
                        "volumen" => "139"
                        "paginaInicial" => "81"
                        "paginaFinal" => "87"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reliability and accuracy of dermatologists&#8217; clinic-based and digital image consultations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:8 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "1999"
                        "volumen" => "41"
                        "numero" => "5 Pt 1"
                        "paginaInicial" => "693"
                        "paginaFinal" => "702"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1552526009020135"
                          "estado" => "S300"
                          "issn" => "15525260"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnostic accuracy and clinical management by realtime teledermatology&#46; Results from the Northern Ireland arms of the UK Multicentre Teledermatology Trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "1998"
                        "volumen" => "4"
                        "paginaInicial" => "95"
                        "paginaFinal" => "100"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1474442209702996"
                          "estado" => "S300"
                          "issn" => "14744422"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Telemedicine evaluation of cutaneous diseases&#58; a blinded comparative study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [ …5]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "1998"
                        "volumen" => "38"
                        "paginaInicial" => "27"
                        "paginaFinal" => "31"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Digital imaging and teledermatology&#58; educational and diagnostic applications of a portable digital imaging system for the trainee dermatologist"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Dermatol"
                        "fecha" => "1997"
                        "volumen" => "22"
                        "paginaInicial" => "163"
                        "paginaFinal" => "165"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluating a telemedicine system to assist in the management of dermatology referrals"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [ …5]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2001"
                        "volumen" => "144"
                        "paginaInicial" => "328"
                        "paginaFinal" => "333"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Accuracy and reliability of store-and-forward teledermatology&#58; preliminary results from the St George Teledermatology Project"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Australas J Dermatol"
                        "fecha" => "2001"
                        "volumen" => "42"
                        "paginaInicial" => "247"
                        "paginaFinal" => "251"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib32"
              "etiqueta" => "32&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A comparative study of teleconsultations versus face-to-face consultations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2001"
                        "volumen" => "7"
                        "paginaInicial" => "257"
                        "paginaFinal" => "265"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib33"
              "etiqueta" => "33&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The substitution of digital images for dermatologic physical examination"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1997"
                        "volumen" => "133"
                        "paginaInicial" => "161"
                        "paginaFinal" => "167"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib34"
              "etiqueta" => "34&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A portable digital imaging system in dermatology&#58; diagnostic and educational applications"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "1997"
                        "volumen" => "3"
                        "numero" => "Suppl 1"
                        "paginaInicial" => "81"
                        "paginaFinal" => "83"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib35"
              "etiqueta" => "35&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatology in the nursing home"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1997"
                        "volumen" => "133"
                        "paginaInicial" => "171"
                        "paginaFinal" => "174"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib36"
              "etiqueta" => "36&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment of the accuracy of low-cost store-and-for-ward teledermatology consultation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [ …5]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2000"
                        "volumen" => "42"
                        "numero" => "5 Pt 1"
                        "paginaInicial" => "776"
                        "paginaFinal" => "783"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib37"
              "etiqueta" => "37&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The reliability of diagnosis using store-and-forward teledermatology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1258/135763303769211247"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2003"
                        "volumen" => "9"
                        "paginaInicial" => "249"
                        "paginaFinal" => "252"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib38"
              "etiqueta" => "38&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A comparison of teledermatology using store-and-forward methodology alone&#44; and in combination with Web camera videoconferencing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1258/135763305774472097"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2005"
                        "volumen" => "11"
                        "paginaInicial" => "354"
                        "paginaFinal" => "360"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib39"
              "etiqueta" => "39&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnostic accuracy and image quality using a digital camera for teledermatology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/107830299312005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Telemed J"
                        "fecha" => "1999"
                        "volumen" => "5"
                        "paginaInicial" => "257"
                        "paginaFinal" => "263"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib40"
              "etiqueta" => "40&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatoscopy in Switzerland&#58; a preliminary evaluation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2000"
                        "volumen" => "42"
                        "numero" => "5 Pt 1"
                        "paginaInicial" => "770"
                        "paginaFinal" => "775"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib41"
              "etiqueta" => "41&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Digital teledermatology for skin tumours&#58; a preliminary assessment using a receiver operating characteristics &#40;ROC&#41; analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "1999"
                        "volumen" => "5"
                        "numero" => "Suppl 1"
                        "paginaInicial" => "S57"
                        "paginaFinal" => "S58"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib42"
              "etiqueta" => "42&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An assessment of the potential effect of a teledermatology system"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [ …1]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2000"
                        "volumen" => "6"
                        "numero" => "Suppl 1"
                        "paginaInicial" => "S74"
                        "paginaFinal" => "S76"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib43"
              "etiqueta" => "43&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatology&#95;high technology or not&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "1998"
                        "volumen" => "4"
                        "numero" => "Suppl 1"
                        "paginaInicial" => "31"
                        "paginaFinal" => "32"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            43 => array:3 [
              "identificador" => "bib44"
              "etiqueta" => "44&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A pilot trial of digital imaging in skin cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "1998"
                        "volumen" => "4"
                        "paginaInicial" => "108"
                        "paginaFinal" => "112"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            44 => array:3 [
              "identificador" => "bib45"
              "etiqueta" => "45&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reliability of telemedicine in evaluating skin tumors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [ …5]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/tmj.1.1998.4.5"
                      "Revista" => array:6 [
                        "tituloSerie" => "Telemed J"
                        "fecha" => "1998"
                        "volumen" => "4"
                        "paginaInicial" => "5"
                        "paginaFinal" => "9"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            45 => array:3 [
              "identificador" => "bib46"
              "etiqueta" => "46&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnostic accuracy of teledermatology&#58; results of a preliminary study in New Zealand"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "N Z Med J"
                        "fecha" => "1997"
                        "volumen" => "110"
                        "paginaInicial" => "51"
                        "paginaFinal" => "53"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            46 => array:3 [
              "identificador" => "bib47"
              "etiqueta" => "47&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatoscopy in daily routine-results of the first 100 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Probl Dermatol"
                        "fecha" => "2003"
                        "volumen" => "32"
                        "paginaInicial" => "207"
                        "paginaFinal" => "212"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            47 => array:3 [
              "identificador" => "bib48"
              "etiqueta" => "48&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Can we safely diagnose pigmented lesions from stored video images&#63; A diagnostic comparison between clinical examination and stored video images of pigmented lesions removed for histology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Clin Exp Dermatol"
                        "fecha" => "2001"
                        "volumen" => "26"
                        "paginaInicial" => "84"
                        "paginaFinal" => "87"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1474442207701783"
                          "estado" => "S300"
                          "issn" => "14744422"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            48 => array:3 [
              "identificador" => "bib49"
              "etiqueta" => "49&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of an asynchronous teleconsultation system for diagnosis of skin cancer and other skin diseases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/15305620050503843"
                      "Revista" => array:6 [
                        "tituloSerie" => "Telemed J E Health"
                        "fecha" => "2000"
                        "volumen" => "6"
                        "paginaInicial" => "379"
                        "paginaFinal" => "384"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            49 => array:3 [
              "identificador" => "bib50"
              "etiqueta" => "50&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Can we use video images to triage pigmented lesions&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [ …5]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2001"
                        "volumen" => "145"
                        "paginaInicial" => "904"
                        "paginaFinal" => "910"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            50 => array:3 [
              "identificador" => "bib51"
              "etiqueta" => "51&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reliability of Web-based teledermatology consultations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1258/1357633042614339"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2004"
                        "volumen" => "10"
                        "paginaInicial" => "25"
                        "paginaFinal" => "28"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            51 => array:3 [
              "identificador" => "bib52"
              "etiqueta" => "52&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatology&#58; an intraobserver diagnostic correlation study&#44; Part II"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [ …5]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cutis"
                        "fecha" => "2003"
                        "volumen" => "71"
                        "paginaInicial" => "476"
                        "paginaFinal" => "480"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            52 => array:3 [
              "identificador" => "bib53"
              "etiqueta" => "53&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Jumping into the future using teledermoscopy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [ …5]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Skinmed"
                        "fecha" => "2002"
                        "volumen" => "1"
                        "paginaInicial" => "20"
                        "paginaFinal" => "24"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            53 => array:3 [
              "identificador" => "bib54"
              "etiqueta" => "54&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of store and forward method of teledermatology with face-to-face consultation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Ayub Med Coll Abbottabad"
                        "fecha" => "2003"
                        "volumen" => "15"
                        "paginaInicial" => "34"
                        "paginaFinal" => "36"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            54 => array:3 [
              "identificador" => "bib55"
              "etiqueta" => "55&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of skin biopsy triage decisions in 49 patients with pigmented lesions and skin neoplasms&#58; store-and-forward teledermatology vs face-to-face dermatology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archderm.140.5.525"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "2004"
                        "volumen" => "140"
                        "paginaInicial" => "525"
                        "paginaFinal" => "528"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            55 => array:3 [
              "identificador" => "bib56"
              "etiqueta" => "56&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Potential effect of patientassisted teledermatology on outpatient referral rates"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1258/135763303771005216"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2003"
                        "volumen" => "9"
                        "paginaInicial" => "321"
                        "paginaFinal" => "327"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            56 => array:3 [
              "identificador" => "bib57"
              "etiqueta" => "57&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Store-and-for-ward teledermatology in skin cancer triage&#58; experience and evaluation of 2009 teleconsultations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archderm.143.4.479"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "2007"
                        "volumen" => "143"
                        "paginaInicial" => "479"
                        "paginaFinal" => "484"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            57 => array:3 [
              "identificador" => "bib58"
              "etiqueta" => "58&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatoscopy as a triage system for pigmented lesions&#58; a pilot study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2230.2005.02000.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Dermatol"
                        "fecha" => "2006"
                        "volumen" => "31"
                        "paginaInicial" => "13"
                        "paginaFinal" => "18"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            58 => array:3 [
              "identificador" => "bib59"
              "etiqueta" => "59&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Feasibility of a two-step teledermatologic approach for the management of patients with multiple pigmented skin lesions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [ …5]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1524-4725.2007.33144.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatol Surg"
                        "fecha" => "2007"
                        "volumen" => "33"
                        "paginaInicial" => "686"
                        "paginaFinal" => "692"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            59 => array:3 [
              "identificador" => "bib60"
              "etiqueta" => "60&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Digital dermoscopy in clinical practise&#58; a three-centre analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1600-0846.2007.00219.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Skin Res Technol"
                        "fecha" => "2007"
                        "volumen" => "13"
                        "paginaInicial" => "133"
                        "paginaFinal" => "142"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            60 => array:3 [
              "identificador" => "bib61"
              "etiqueta" => "61&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatology in Hong Kong&#58; a cost-effective method to provide service to the elderly patients living in institutions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Dermatol"
                        "fecha" => "2000"
                        "volumen" => "39"
                        "paginaInicial" => "774"
                        "paginaFinal" => "778"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            61 => array:3 [
              "identificador" => "bib62"
              "etiqueta" => "62&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teleconsulta prequir&#250;rgica en pacientes con c&#225;ncer de piel"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Monogr Dermatol"
                        "fecha" => "2006"
                        "volumen" => "19"
                        "paginaInicial" => "378"
                        "paginaFinal" => "385"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            62 => array:3 [
              "identificador" => "bib63"
              "etiqueta" => "63&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatology versus consultations &#8212; a comparative study of 120 consultations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00105-005-0904-y"
                      "Revista" => array:6 [
                        "tituloSerie" => "Hautarzt"
                        "fecha" => "2005"
                        "volumen" => "56"
                        "paginaInicial" => "942"
                        "paginaFinal" => "948"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            63 => array:3 [
              "identificador" => "bib64"
              "etiqueta" => "64&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An evaluation of the role of a store-and-forward teledermatology system in skin cancer diagnosis and management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2230.2005.01735.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Dermatol"
                        "fecha" => "2005"
                        "volumen" => "30"
                        "paginaInicial" => "209"
                        "paginaFinal" => "214"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            64 => array:3 [
              "identificador" => "bib65"
              "etiqueta" => "65&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "How dermatologists perceive CRT displays and silver halide prints of transparency-based images&#58; a comparison study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Biol Photogr"
                        "fecha" => "1994"
                        "volumen" => "62"
                        "paginaInicial" => "135"
                        "paginaFinal" => "137"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            65 => array:3 [
              "identificador" => "bib66"
              "etiqueta" => "66&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A comparison of JPEG and FIF compression of color medical images for dermatology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Comput Med Imaging Graph"
                        "fecha" => "1994"
                        "volumen" => "18"
                        "paginaInicial" => "339"
                        "paginaFinal" => "342"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            66 => array:3 [
              "identificador" => "bib67"
              "etiqueta" => "67&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Primary care physicians as gatekeepers in managed care&#46; Primary care physicians&#8217; and dermatologists&#8217; skills at secondary prevention of skin cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1996"
                        "volumen" => "132"
                        "paginaInicial" => "1030"
                        "paginaFinal" => "1038"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            67 => array:3 [
              "identificador" => "bib68"
              "etiqueta" => "68&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatology as a filtering system in pigmented lesion clinics"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1258/1357633054893364"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2005"
                        "volumen" => "11"
                        "paginaInicial" => "298"
                        "paginaFinal" => "303"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            68 => array:3 [
              "identificador" => "bib69"
              "etiqueta" => "69&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Adv Dermatol"
                        "fecha" => "1997"
                        "volumen" => "12"
                        "paginaInicial" => "19"
                        "paginaFinal" => "45"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            69 => array:3 [
              "identificador" => "bib70"
              "etiqueta" => "70&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Resultados preliminares de DERMATEL&#58; estudio aleatorizado prospectivo comparando modalidades de teledermatolog&#237;a s&#237;ncrona y as&#237;ncrona"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2006"
                        "volumen" => "97"
                        "paginaInicial" => "630"
                        "paginaFinal" => "636"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            70 => array:3 [
              "identificador" => "bib71"
              "etiqueta" => "71&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatoscopia en el cribado de lesiones pigmentadas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Monogr Dermatol"
                        "fecha" => "2006"
                        "volumen" => "19"
                        "paginaInicial" => "386"
                        "paginaFinal" => "392"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            71 => array:3 [
              "identificador" => "bib72"
              "etiqueta" => "72&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multicentre randomised control trial comparing real time teledermatology with conventional outpatient dermatological care&#58; societal cost-benefit analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2000"
                        "volumen" => "320"
                        "paginaInicial" => "1252"
                        "paginaFinal" => "1256"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1552526009021281"
                          "estado" => "S300"
                          "issn" => "15525260"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            72 => array:3 [
              "identificador" => "bib73"
              "etiqueta" => "73&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A cost-minimization analysis of the societal costs of realtime teledermatology compared with conventional care&#58; results from a randomized controlled trial in New Zealand"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2001"
                        "volumen" => "7"
                        "paginaInicial" => "233"
                        "paginaFinal" => "238"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            73 => array:3 [
              "identificador" => "bib74"
              "etiqueta" => "74&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A randomized controlled trial assessing the health economics of realtime teledermatology compared with conventional care&#58; an urban versus rural perspective"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2001"
                        "volumen" => "7"
                        "paginaInicial" => "108"
                        "paginaFinal" => "118"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            74 => array:3 [
              "identificador" => "bib75"
              "etiqueta" => "75&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An economic analysis of a store and forward teledermatology consult system"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/153056203772744671"
                      "Revista" => array:6 [
                        "tituloSerie" => "Telemed J E Health"
                        "fecha" => "2003"
                        "volumen" => "9"
                        "paginaInicial" => "351"
                        "paginaFinal" => "360"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            75 => array:3 [
              "identificador" => "bib76"
              "etiqueta" => "76&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A randomized controlled trial to assess the clinical effectiveness of both realtime and store-and-forward teledermatology compared with conventional care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2000"
                        "volumen" => "6"
                        "numero" => "Suppl 1"
                        "paginaInicial" => "S1"
                        "paginaFinal" => "S3"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            76 => array:3 [
              "identificador" => "bib77"
              "etiqueta" => "77&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Telemedicine in dermatology&#58; a randomised controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Health Technol Assess"
                        "fecha" => "2006"
                        "volumen" => "10"
                        "paginaInicial" => "iii"
                        "paginaFinal" => "iv"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            77 => array:3 [
              "identificador" => "bib78"
              "etiqueta" => "78&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teleconferencing technology for dermatology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [ …1]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "1998"
                        "volumen" => "39"
                        "paginaInicial" => "136"
                        "paginaFinal" => "137"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673608610028"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            78 => array:3 [
              "identificador" => "bib79"
              "etiqueta" => "79&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatology in the Waikato region of New Zealand"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [ …3]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2001"
                        "volumen" => "7"
                        "numero" => "Suppl 2"
                        "paginaInicial" => "59"
                        "paginaFinal" => "61"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            79 => array:3 [
              "identificador" => "bib80"
              "etiqueta" => "80&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnostic value of written referral and&#47;or images for skin lesions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [ …5]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1258/135763306776738620"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2006"
                        "volumen" => "12"
                        "paginaInicial" => "151"
                        "paginaFinal" => "158"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            80 => array:3 [
              "identificador" => "bib81"
              "etiqueta" => "81&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermoscopy&#8212;results of a multicentre study on 43 pigmented skin lesions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [ …6]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2000"
                        "volumen" => "6"
                        "paginaInicial" => "132"
                        "paginaFinal" => "137"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1552526010021928"
                          "estado" => "S300"
                          "issn" => "15525260"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            81 => array:3 [
              "identificador" => "bib82"
              "etiqueta" => "82&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Cornwall dermatology electronic referral and image-transfer project"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "1999"
                        "volumen" => "5"
                        "numero" => "Suppl 1"
                        "paginaInicial" => "S85"
                        "paginaFinal" => "S86"
                        "link" => array:1 [
                          0 => array:2 [ …2]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            82 => array:3 [
              "identificador" => "bib83"
              "etiqueta" => "83&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A feasibility study of realtime teledermatology in Finland"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [ …4]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2000"
                        "volumen" => "6"
                        "paginaInicial" => "102"
                        "paginaFinal" => "107"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            83 => array:3 [
              "identificador" => "bib84"
              "etiqueta" => "84&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Realtime teleconsultations versus face-to-face consultations in dermatology&#58; immediate and sixmonth outcome"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1258/135763303322225526"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2003"
                        "volumen" => "9"
                        "paginaInicial" => "204"
                        "paginaFinal" => "209"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            84 => array:3 [
              "identificador" => "bib85"
              "etiqueta" => "85&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatology in practice"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Dermatol"
                        "fecha" => "2003"
                        "volumen" => "28"
                        "paginaInicial" => "356"
                        "paginaFinal" => "359"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            85 => array:3 [
              "identificador" => "bib86"
              "etiqueta" => "86&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatology&#39;s impact on time to intervention among referrals to a dermatology consult service"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/15305620260353207"
                      "Revista" => array:6 [
                        "tituloSerie" => "Telemed J E Health"
                        "fecha" => "2002"
                        "volumen" => "8"
                        "paginaInicial" => "313"
                        "paginaFinal" => "321"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            86 => array:3 [
              "identificador" => "bib87"
              "etiqueta" => "87&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatology as a tool for communication between general practitioners and dermatologists"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2001"
                        "volumen" => "7"
                        "paginaInicial" => "193"
                        "paginaFinal" => "198"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            87 => array:3 [
              "identificador" => "bib88"
              "etiqueta" => "88&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patient cost-benefits of realtime teledermatology-a comparison of data from Northern Ireland and New Zealand"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2000"
                        "volumen" => "6"
                        "paginaInicial" => "97"
                        "paginaFinal" => "101"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            88 => array:3 [
              "identificador" => "bib89"
              "etiqueta" => "89&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of general practitioner&#39;s time investment during a store-and-forward teledermatology consultation"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijmedinf.2007.04.004"
                      "Revista" => array:7 [
                        "tituloSerie" => "Int J Med Inform"
                        "fecha" => "2007"
                        "volumen" => "76"
                        "paginaInicial" => "S384"
                        "paginaFinal" => "S391"
                        "link" => array:1 [ …1]
                        "itemHostRev" => array:3 [ …3]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            89 => array:3 [
              "identificador" => "bib90"
              "etiqueta" => "90&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Store-and-forward teledermatology results in similar clinical outcomes to conventional clinic-based care"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1258/135763307779701185"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2007"
                        "volumen" => "13"
                        "paginaInicial" => "26"
                        "paginaFinal" => "30"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            90 => array:3 [
              "identificador" => "bib91"
              "etiqueta" => "91&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatolog&#237;a en la asistencia de pacientes con c&#225;ncer de piel"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Monogr Dermatol"
                        "fecha" => "2006"
                        "volumen" => "19"
                        "paginaInicial" => "364"
                        "paginaFinal" => "371"
                        "itemHostRev" => array:3 [ …3]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            91 => array:3 [
              "identificador" => "bib92"
              "etiqueta" => "92&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Economic evaluation of interactive teledermatology compared with conventional care"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/tmj.2006.0035"
                      "Revista" => array:6 [
                        "tituloSerie" => "Telemed J E Health"
                        "fecha" => "2007"
                        "volumen" => "13"
                        "paginaInicial" => "91"
                        "paginaFinal" => "99"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            92 => array:3 [
              "identificador" => "bib93"
              "etiqueta" => "93&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A cost-minimization analysis of a realtime teledermatology service in northern Norway"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2000"
                        "volumen" => "6"
                        "paginaInicial" => "273"
                        "paginaFinal" => "277"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            93 => array:3 [
              "identificador" => "bib94"
              "etiqueta" => "94&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Limitations of patient satisfaction studies in telehealthcare&#58; a systematic review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/15305620152814700"
                      "Revista" => array:6 [
                        "tituloSerie" => "Telemed J E Health"
                        "fecha" => "2001"
                        "volumen" => "7"
                        "paginaInicial" => "293"
                        "paginaFinal" => "316"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            94 => array:3 [
              "identificador" => "bib95"
              "etiqueta" => "95&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patient satisfaction with teledermatology&#58; quantitative and qualitative results from a randomized controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1258/135763304322764167"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "2004"
                        "volumen" => "10"
                        "paginaInicial" => "29"
                        "paginaFinal" => "33"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            95 => array:3 [
              "identificador" => "bib96"
              "etiqueta" => "96&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patient and clinician satisfaction with a store-and-forward teledermatology consult system"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/tmj.2004.10.422"
                      "Revista" => array:6 [
                        "tituloSerie" => "Telemed J E Health"
                        "fecha" => "2004"
                        "volumen" => "10"
                        "paginaInicial" => "422"
                        "paginaFinal" => "431"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            96 => array:3 [
              "identificador" => "bib97"
              "etiqueta" => "97&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patient satisfaction with realtime teledermatology in Northern Ireland"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "1998"
                        "volumen" => "4"
                        "paginaInicial" => "36"
                        "paginaFinal" => "40"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            97 => array:3 [
              "identificador" => "bib98"
              "etiqueta" => "98&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluaci&#243;n cualitativa en teledermatolog&#237;a&#58; Resultados del proyecto piloto en telemedicina 2000"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2004"
                        "volumen" => "95"
                        "paginaInicial" => "289"
                        "paginaFinal" => "294"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            98 => array:3 [
              "identificador" => "bib99"
              "etiqueta" => "99&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Systematic review of studies of patient satisfaction with telemedicine"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2000"
                        "volumen" => "320"
                        "paginaInicial" => "1517"
                        "paginaFinal" => "1520"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            99 => array:3 [
              "identificador" => "bib100"
              "etiqueta" => "100&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment of patients&#8217; acceptance of and satisfaction with teledermatology"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Med Syst"
                        "fecha" => "2004"
                        "volumen" => "28"
                        "paginaInicial" => "575"
                        "paginaFinal" => "579"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            100 => array:3 [
              "identificador" => "bib101"
              "etiqueta" => "101&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patient and referring provider satisfaction with teledermatology"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2002"
                        "volumen" => "47"
                        "paginaInicial" => "68"
                        "paginaFinal" => "72"
                        "link" => array:1 [ …1]
                        "itemHostRev" => array:3 [ …3]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            101 => array:3 [
              "identificador" => "bib102"
              "etiqueta" => "102&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Web-based teledermatology consult system&#58; preliminary results from the first 100 cases"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Stud Health Technol Inform"
                        "fecha" => "1999"
                        "volumen" => "64"
                        "paginaInicial" => "179"
                        "paginaFinal" => "184"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            102 => array:3 [
              "identificador" => "bib103"
              "etiqueta" => "103&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatology in a capitated delivery system using distributed information architecture&#58; design and development"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/107830299311925"
                      "Revista" => array:6 [
                        "tituloSerie" => "Telemed J"
                        "fecha" => "1999"
                        "volumen" => "5"
                        "paginaInicial" => "357"
                        "paginaFinal" => "366"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            103 => array:3 [
              "identificador" => "bib104"
              "etiqueta" => "104&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatology&#58; an intraobserver diagnostic correlation study&#44; part I"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Cutis"
                        "fecha" => "2003"
                        "volumen" => "71"
                        "paginaInicial" => "399"
                        "paginaFinal" => "403"
                        "link" => array:1 [ …1]
                        "itemHostRev" => array:3 [ …3]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            104 => array:3 [
              "identificador" => "bib105"
              "etiqueta" => "105&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teledermatology in the Highlands of Scotland"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Telemed Telecare"
                        "fecha" => "1996"
                        "volumen" => "2"
                        "numero" => "Suppl 1"
                        "paginaInicial" => "7"
                        "paginaFinal" => "9"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            105 => array:3 [
              "identificador" => "bib106"
              "etiqueta" => "106&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Integrating service development with evaluation in telehealthcare&#58; an ethnographic study"
                      "autores" => array:1 [
                        0 => array:2 [ …2]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmj.327.7425.1205"
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2003"
                        "volumen" => "327"
                        "paginaInicial" => "1205"
                        "paginaFinal" => "1209"
                        "link" => array:1 [ …1]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000009900000008/v1_201304241439/S1578219008703263/v1_201304241439/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "6224"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Review article"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15782190/0000009900000008/v1_201304241439/S1578219008703263/v1_201304241439/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219008703263?idApp=UINPBA000044"
]
Share
Journal Information
Vol. 99. Issue 8.
Pages 586-597 (October 2008)
Share
Share
Download PDF
More article options
Vol. 99. Issue 8.
Pages 586-597 (October 2008)
Review article
Full text access
Telemedicine and Teledermatology (II): Current State of Research on Dermatology Teleconsultations
Telemedicina y Teledermatología (II): Estado Actual de la Investigación en Teleconsulta Dermatológica
Visits
6873
G. Romero
Corresponding author
gromeroa@meditex.es

Correspondence: C/ Castillo de Caracuel, 30, 13005 Ciudad Real, Spain.
, P. Cortina, E. Vera
Unidad de Dermatología, Hospital General de Ciudad Real, Ciudad Real, Spain
This item has received
Article information
Abstract
Bibliography
Download PDF
Statistics
Abstract

The rapid increase in the use of telemedicine makes a critical appraisal of these services essential. This article reviews the current evidence from studies of teledermatology with sufficiently rigorous methodology to allow reasonable conclusions to be drawn. The review is organized according to areas of research in teledermatology: reliability of diagnosis and management, accuracy, outcomes, costs, and satisfaction. The conclusion of this review is that teledermatology has been shown to be feasible and reliable but that it has a long way to go before maturing as a medical technology in daily practice. The largest body of evidence relates to the reliabity of diagnosis and management, but although numerous studies have been performed, many have marked methodological shortcomings. Accuracy studies have been conducted in skin oncology with appropriate methodology that show an accuracy comparable to that of face-to-face consultations. Studies of health outcomes should be designed such that a faithful assessment of the final outcomes, costs, and satisfaction with teledermatology systems can be carried out.

Key words:
telemedicine
teleconsultation
teledermatology
store-and-forward systems
real-time systems
reproducibility of results
validation studies
outcomes assessment
costs analysis
personal satisfaction
Resumen

El rápido incremento en el desarrollo de los servicios en telemedicina hace crucial su evaluación crítica. Este artículo revisa la evidencia actual en artículos de investigación en teledermatología con la suficiente calidad metodológica como para alcanzar conclusiones razonables. La revisión se organiza analizando las áreas de investigación en teledermatología: fiabilidad en el diagnóstico y el manejo, validez, resultados, costes y satisfacción. Las conclusiones de la misma indican que la teledermatología ha demostrado ser factible y fiable pero que está lejos de alcanzar su madurez como tecnología médica para su práctica habitual. El cuerpo de evidencia con mayor desarrollo es el área de fiabilidad en el diagnóstico y el manejo, donde existen un gran número de estudios, aunque muchos de ellos adolecen de importantes defectos metodológicos. Existen estudios de validez en oncología cutánea con metodología correcta que muestran unos resultados comparables con la consulta presencial. Se hace preciso el diseño de estudios en resultados de salud que permitan un análisis fidedigno de resultados finales, costes y satisfacción de los sistemas de teledermatología.

Palabras clave:
telemedicina
teleconsulta
teledermatología
sistemas de almacenamiento
sistemas en tiempo real
reproducibilidad de los resultados
estudios de validación
análisis de resultados
análisis de costes
satisfacción personal
Full text is only aviable in PDF
References
[1.]
G. Romero, J.A. Garrido, M. García-Arpa.
Telemedicina y teledermatología (I): concepto y aplicaciones.
Actas Dermosifiliogr, 99 (2008), pp. 506-522
[2.]
Telemedicine: fad or future?.
Lancet, 345 (1995), pp. 73-74
[3.]
K. Freeman, J. Wynn-Jones, S. Groves-Phillips, L. Lewis.
Teleconsulting: a practical account of pitfalls, problems and promise. Experience from the TEAM project group.
J Telemed Telecare, 2 (1996), pp. 1-3
[4.]
D.A. Perednia.
Fear, loathing, dermatology, and telemedicine.
Arch Dermatol, 133 (1997), pp. 151-155
[5.]
P.L. Moser, H. Hauffe, I.H. Lorenz, M. Hager, W. Tiefenthaler, H.M. Lorenz, et al.
Publication output in telemedicine during the period January 1964 to July 2003.
J Telemed Telecare, 10 (2004), pp. 72-77
[6.]
W. Hersh, J. Wallace, P. Patterson, S. Shapiro, D. Kraemer, G. Eilers, et al.
Telemedicine for the Medicare population: pediatric, obstetric, and clinician-indirect home interventions.
Evid Rep Technol Assess (Summ), 24 (2001), pp. 1-32
[7.]
J.D. Whited.
Teledermatology research review.
Int J Dermatol, 45 (2006), pp. 220-229
[8.]
N. Eminovic, N.F. de Keizer, P.J. Bindels, A. Hasman.
Maturity of teledermatology evaluation research: a systematic literature review.
Br J Dermatol, 156 (2007), pp. 412-419
[9.]
W. Hersh, M. Helfand, J. Wallace, D. Kraemer, P. Patterson, S. Shapiro, et al.
A systematic review of the efficacy of telemedicine for making diagnostic and management decisions.
J Telemed Telecare, 8 (2002), pp. 197-209
[10.]
D. Hailey, R. Roine, A. Ohinmaa.
Systematic review of evidence for the benefits of telemedicine.
J Telemed Telecare, 8 (2002), pp. 1-30
[11.]
R. Roine, A. Ohinmaa, D. Hailey.
Assessing telemedicine: a systematic review of the literature.
CMAJ, 165 (2001), pp. 765-771
[12.]
W. Hersh, D. Hickam, S. Severance, T. Dana, K. Krages, M. Helfand.
Telemedicine for the Medicare Population: Update.
Evid Rep Technol Assess (Full Rep), 131 (2006), pp. 1-41
[13.]
N. Eminovic, N.F. de Keizer, P.J. Bindels, A. Hasman.
Ten years of teledermatology.
Stud Health Technol Inform, 124 (2006), pp. 362-367
[14.]
J.S. English, D.J. Eedy.
Has teledermatology in the U.K. finally failed?.
Br J Dermatol, 156 (2007), pp. 411
[15.]
A. Ruiz de Casas, L. Ferrándiz, D. Moreno-Ramírez, A. Nieto-García.
Teledermatología. Resultados de evaluación.
Monogr Dermatol, 19 (2006), pp. 356-363
[16.]
M.A. Ramos.
Present and future of telemedicine.
Med Clin (Barc), 127 (2006), pp. 335-336
[17.]
B. Hernández-Machín, J. Suárez-Hernández.
Réplica: Resultados preliminares de DERMATEL: estudio aleatorizado prospectivo comparando modalidades de teledermatología síncrona y asíncrona.
Actas Dermosifiliogr, 98 (2007), pp. 506-507
[18.]
Whited JD. Summary of the status of Teledermatology Research. ATA; 2005. Available from: http://www.atmeda.org
[19.]
D.L. Sackett.
The rational clinical examination. A primer on the precision and accuracy of the clinical examination.
JAMA, 267 (1992), pp. 2638-2644
[20.]
J. Latour, V. Abraira, J.B. Cabello, S.J. López.
Investigation methods in clinical cardiology. IV. Clinical measurements in cardiology: validity and errors of measurements.
Rev Esp Cardiol, 50 (1997), pp. 117-128
[21.]
G. Romero.
Fiabilidad de la teleconsulta en Dermatología. Doctoral Thesis.
Facultad de Medicina, (2007),
[22.]
M.H. Lowitt, I.I. Kessler, C.L. Kauffman, F.J. Hooper, E. Siegel, J.W. Burnett.
Teledermatology and in-person examinations: a comparison of patient and physician perceptions and diagnostic agreement.
Arch Dermatol, 134 (1998), pp. 471-476
[23.]
C.M. Phillips, W.A. Burke, A. Shechter, D. Stone, D. Balch, S. Gustke.
Reliability of dermatology teleconsultations with the use of teleconferencing technology.
J Am Acad Dermatol, 37 (1997), pp. 398-402
[24.]
Kvedar JC. Teledermatology. e-medicine; 2005. Disponible en: http://www.emedicine.com/derm/topic527.htm
[25.]
E. Gilmour, S.M. Campbell, M.A. Loane, A. Esmail, C.E. Griffiths, M.O. Roland, et al.
Comparison of teleconsultations and face-to-face consultations: preliminary results of a United Kingdom multicentre teledermatology study.
Br J Dermatol, 139 (1998), pp. 81-87
[26.]
J.D. Whited, R.P. Hall, D.L. Simel, M.E. Foy, K.M. Stechuchak, R.J. Drugge, et al.
Reliability and accuracy of dermatologists’ clinic-based and digital image consultations.
J Am Acad Dermatol, 41 (1999), pp. 693-702
[27.]
M.A. Loane, R. Corbett, S.E. Bloomer, D.J. Eedy, H.E. Gore, C. Mathews, et al.
Diagnostic accuracy and clinical management by realtime teledermatology. Results from the Northern Ireland arms of the UK Multicentre Teledermatology Trial.
J Telemed Telecare, 4 (1998), pp. 95-100
[28.]
J.L. Lesher Jr, L.S. Davis, F.W. Gourdin, D. English, W.O. Thompson.
Telemedicine evaluation of cutaneous diseases: a blinded comparative study.
J Am Acad Dermatol, 38 (1998), pp. 27-31
[29.]
C.C. Lyon, P.V. Harrison.
Digital imaging and teledermatology: educational and diagnostic applications of a portable digital imaging system for the trainee dermatologist.
Clin Exp Dermatol, 22 (1997), pp. 163-165
[30.]
P. Taylor, P. Goldsmith, K. Murray, D. Harris, A. Barkley.
Evaluating a telemedicine system to assist in the management of dermatology referrals.
Br J Dermatol, 144 (2001), pp. 328-333
[31.]
A.C. Lim, I.B. Egerton, A. See, S.P. Shumack.
Accuracy and reliability of store-and-forward teledermatology: preliminary results from the St George Teledermatology Project.
Australas J Dermatol, 42 (2001), pp. 247-251
[32.]
E.J. Nordal, D. Moseng, B. Kvammen, M.L. Lochen.
A comparative study of teleconsultations versus face-to-face consultations.
J Telemed Telecare, 7 (2001), pp. 257-265
[33.]
J.C. Kvedar, R.A. Edwards, E.R. Menn, M. Mofid, E. González, J. Dover, et al.
The substitution of digital images for dermatologic physical examination.
Arch Dermatol, 133 (1997), pp. 161-167
[34.]
C.C. Lyon, P.V. Harrison.
A portable digital imaging system in dermatology: diagnostic and educational applications.
J Telemed Telecare, 3 (1997), pp. 81-83
[35.]
B.D. Zelickson, L. Homan.
Teledermatology in the nursing home.
Arch Dermatol, 133 (1997), pp. 171-174
[36.]
W.A. High, M.S. Houston, S.D. Calobrisi, L.A. Drage, M.T. McEvoy.
Assessment of the accuracy of low-cost store-and-for-ward teledermatology consultation.
J Am Acad Dermatol, 42 (2000), pp. 776-783
[37.]
M.F. Du Moulin, Y.I. Bullens-Goessens, C.J. Henquet, D.E. Brunenberg, D.P. Bruyn-Geraerds, R.A. Winkens, et al.
The reliability of diagnosis using store-and-forward teledermatology.
J Telemed Telecare, 9 (2003), pp. 249-252
[38.]
M. Baba, D. Seckin, S. Kapdagli.
A comparison of teledermatology using store-and-forward methodology alone, and in combination with Web camera videoconferencing.
J Telemed Telecare, 11 (2005), pp. 354-360
[39.]
E.A. Krupinski, B. LeSueur, L. Ellsworth, N. Levine, R. Hansen, N. Silvis, et al.
Diagnostic accuracy and image quality using a digital camera for teledermatology.
Telemed J, 5 (1999), pp. 257-263
[40.]
R.P. Braun, M. Meier, F. Pelloni, A.A. Ramelet, M. Schilling, B. Tapernoux, et al.
Teledermatoscopy in Switzerland: a preliminary evaluation.
J Am Acad Dermatol, 42 (2000), pp. 770-775
[41.]
K. Lewis, E. Gilmour, P.V. Harrison, S. Patefield, Y. Dickinson, D. Manning, et al.
Digital teledermatology for skin tumours: a preliminary assessment using a receiver operating characteristics (ROC) analysis.
J Telemed Telecare, 5 (1999), pp. S57-S58
[42.]
P. Taylor.
An assessment of the potential effect of a teledermatology system.
J Telemed Telecare, 6 (2000), pp. S74-S76
[43.]
P.V. Harrison, B. Kirby, Y. Dickinson, R. Schofield.
Teledermatology_high technology or not?.
J Telemed Telecare, 4 (1998), pp. 31-32
[44.]
J.D. Whited, B.J. Mills, R.P. Hall, R.J. Drugge, J.M. Grichnik, D.L. Simel.
A pilot trial of digital imaging in skin cancer.
J Telemed Telecare, 4 (1998), pp. 108-112
[45.]
C.M. Phillips, W.A. Burke, M.H. Allen, D. Stone, J.L. Wilson.
Reliability of telemedicine in evaluating skin tumors.
Telemed J, 4 (1998), pp. 5-9
[46.]
A.M. Oakley, D.R. Astwood, M. Loane, M.B. Duffill, M. Rademaker, R. Wootton.
Diagnostic accuracy of teledermatology: results of a preliminary study in New Zealand.
N Z Med J, 110 (1997), pp. 51-53
[47.]
B. Coras, A. Glaessl, J. Kinateder, W. Klovekorn, R. Braun, U. Lepski, et al.
Teledermatoscopy in daily routine-results of the first 100 cases.
Curr Probl Dermatol, 32 (2003), pp. 207-212
[48.]
V.M. Jolliffe, D.W. Harris, S.J. Whittaker.
Can we safely diagnose pigmented lesions from stored video images? A diagnostic comparison between clinical examination and stored video images of pigmented lesions removed for histology.
Clin Exp Dermatol, 26 (2001), pp. 84-87
[49.]
C.M. Barnard, M.E. Goldyne.
Evaluation of an asynchronous teleconsultation system for diagnosis of skin cancer and other skin diseases.
Telemed J E Health, 6 (2000), pp. 379-384
[50.]
V.M. Jolliffe, D.W. Harris, R. Morris, P. Wallacet, S.J. Whittaker.
Can we use video images to triage pigmented lesions?.
Br J Dermatol, 145 (2001), pp. 904-910
[51.]
M.O. Oztas, E. Calikoglu, K. Baz, A. Birol, M. Onder, T. Calikoglu, et al.
Reliability of Web-based teledermatology consultations.
J Telemed Telecare, 10 (2004), pp. 25-28
[52.]
H.S. Pak, D. Harden, D. Cruess, M.L. Welch, R. Poropatich.
Teledermatology: an intraobserver diagnostic correlation study, Part II.
Cutis, 71 (2003), pp. 476-480
[53.]
D. Piccolo, K. Peris, S. Chimenti, G. Argenziano, H.P. Soyer.
Jumping into the future using teledermoscopy.
Skinmed, 1 (2002), pp. 20-24
[54.]
E. Rashid, O. Ishtiaq, S. Gilani, A. Zafar.
Comparison of store and forward method of teledermatology with face-to-face consultation.
J Ayub Med Coll Abbottabad, 15 (2003), pp. 34-36
[55.]
M. Shapiro, W.D. James, R. Kessler, F.C. Lazorik, K.A. Katz, J. Tam, et al.
Comparison of skin biopsy triage decisions in 49 patients with pigmented lesions and skin neoplasms: store-and-forward teledermatology vs face-to-face dermatology.
Arch Dermatol, 140 (2004), pp. 525-528
[56.]
N. Eminovic, L. Witkamp, A.C. Ravelli, J.D. Bos, T.W. van den Akker, M.T. Bousema, et al.
Potential effect of patientassisted teledermatology on outpatient referral rates.
J Telemed Telecare, 9 (2003), pp. 321-327
[57.]
D. Moreno-Ramírez, L. Ferrándiz, A. Nieto-García, R. Carrasco, P. Moreno-Álvarez, R. Galdeano, et al.
Store-and-for-ward teledermatology in skin cancer triage: experience and evaluation of 2009 teleconsultations.
Arch Dermatol, 143 (2007), pp. 479-484
[58.]
D. Moreno-Ramírez, L. Ferrándiz, R. Galdeano, F.M. Camacho.
Teledermatoscopy as a triage system for pigmented lesions: a pilot study.
Clin Exp Dermatol, 31 (2006), pp. 13-18
[59.]
A. Di Stefani, I. Zalaudek, G. Argenziano, S. Chimenti, H.P. Soyer.
Feasibility of a two-step teledermatologic approach for the management of patients with multiple pigmented skin lesions.
Dermatol Surg, 33 (2007), pp. 686-692
[60.]
U. Wollina, M. Burroni, R. Torricelli, S. Gilardi, G. Dell’Eva, C. Helm, et al.
Digital dermoscopy in clinical practise: a three-centre analysis.
Skin Res Technol, 13 (2007), pp. 133-142
[61.]
H.H. Chan, J. Woo, W.M. Chan, M. Hjelm.
Teledermatology in Hong Kong: a cost-effective method to provide service to the elderly patients living in institutions.
Int J Dermatol, 39 (2000), pp. 774-778
[62.]
L. Ferrándiz, F. Vásquez, D. Moreno-Ramírez.
Teleconsulta prequirúrgica en pacientes con cáncer de piel.
Monogr Dermatol, 19 (2006), pp. 378-385
[63.]
F.E. Herrmann, K. Sonnichsen, A. Blum.
Teledermatology versus consultations — a comparative study of 120 consultations.
Hautarzt, 56 (2005), pp. 942-948
[64.]
R. Mahendran, M.J. Goodfield, R.A. Sheehan-Dare.
An evaluation of the role of a store-and-forward teledermatology system in skin cancer diagnosis and management.
Clin Exp Dermatol, 30 (2005), pp. 209-214
[65.]
R.H. Schosser, C.A. Sneiderman, T.G. Pearson.
How dermatologists perceive CRT displays and silver halide prints of transparency-based images: a comparison study.
J Biol Photogr, 62 (1994), pp. 135-137
[66.]
C. Sneiderman, R. Schosser, T.G. Pearson.
A comparison of JPEG and FIF compression of color medical images for dermatology.
Comput Med Imaging Graph, 18 (1994), pp. 339-342
[67.]
B. Gerbert, T. Maurer, T. Berger, S. Pantilat, S.J. McPhee, M. Wolff, et al.
Primary care physicians as gatekeepers in managed care. Primary care physicians’ and dermatologists’ skills at secondary prevention of skin cancer.
Arch Dermatol, 132 (1996), pp. 1030-1038
[68.]
D. Moreno-Ramírez, L. Ferrándiz, A.P. Bernal, R.C. Durán, J.J. Martín, F. Camacho.
Teledermatology as a filtering system in pigmented lesion clinics.
J Telemed Telecare, 11 (2005), pp. 298-303
[69.]
A.E. Burdick, B. Berman.
Teledermatology.
Adv Dermatol, 12 (1997), pp. 19-45
[70.]
G. Romero, M. García, E. Vera, C. Martínez, P. Cortina, P. Sánchez, et al.
Resultados preliminares de DERMATEL: estudio aleatorizado prospectivo comparando modalidades de teledermatología síncrona y asíncrona.
Actas Dermosifiliogr, 97 (2006), pp. 630-636
[71.]
L. Ferrándiz, J. Domínguez, D. Moreno-Ramírez.
Teledermatoscopia en el cribado de lesiones pigmentadas.
Monogr Dermatol, 19 (2006), pp. 386-392
[72.]
R. Wootton, S.E. Bloomer, R. Corbett, D.J. Eedy, N. Hicks, H.E. Lotery, et al.
Multicentre randomised control trial comparing real time teledermatology with conventional outpatient dermatological care: societal cost-benefit analysis.
BMJ, 320 (2000), pp. 1252-1256
[73.]
M.A. Loane, A. Oakley, M. Rademaker, N. Bradford, P. Fleischl, P. Kerr, et al.
A cost-minimization analysis of the societal costs of realtime teledermatology compared with conventional care: results from a randomized controlled trial in New Zealand.
J Telemed Telecare, 7 (2001), pp. 233-238
[74.]
M.A. Loane, S.E. Bloomer, R. Corbett, D.J. Eedy, C. Evans, N. Hicks, et al.
A randomized controlled trial assessing the health economics of realtime teledermatology compared with conventional care: an urban versus rural perspective.
J Telemed Telecare, 7 (2001), pp. 108-118
[75.]
J.D. Whited, S. Datta, R.P. Hall, M.E. Foy, L.E. Marbrey, S.C. Grambow, et al.
An economic analysis of a store and forward teledermatology consult system.
Telemed J E Health, 9 (2003), pp. 351-360
[76.]
M.A. Loane, S.E. Bloomer, R. Corbett, D.J. Eedy, N. Hicks, H.E. Lotery, et al.
A randomized controlled trial to assess the clinical effectiveness of both realtime and store-and-forward teledermatology compared with conventional care.
J Telemed Telecare, 6 (2000), pp. S1-S3
[77.]
I.R. Bowns, K. Collins, S.J. Walters, A.J. McDonagh.
Telemedicine in dermatology: a randomised controlled trial.
Health Technol Assess, 10 (2006), pp. iii-iv
[78.]
R.S. Kalish.
Teleconferencing technology for dermatology.
J Am Acad Dermatol, 39 (1998), pp. 136-137
[79.]
A. Oakley, M. Rademaker, M. Duffill.
Teledermatology in the Waikato region of New Zealand.
J Telemed Telecare, 7 (2001), pp. 59-61
[80.]
A.M. Oakley, F. Reeves, J. Bennett, S.H. Holmes, H. Wickham.
Diagnostic value of written referral and/or images for skin lesions.
J Telemed Telecare, 12 (2006), pp. 151-158
[81.]
D. Piccolo, J. Smolle, G. Argenziano, I.H. Wolf, R. Braun, L. Cerroni, et al.
Teledermoscopy—results of a multicentre study on 43 pigmented skin lesions.
J Telemed Telecare, 6 (2000), pp. 132-137
[82.]
H. White, D. Gould, W. Mills, L. Brendish.
The Cornwall dermatology electronic referral and image-transfer project.
J Telemed Telecare, 5 (1999), pp. S85-S86
[83.]
H. Lamminen, M.L. Tuomi, J. Lamminen, H. Uusitalo.
A feasibility study of realtime teledermatology in Finland.
J Telemed Telecare, 6 (2000), pp. 102-107
[84.]
H. Granlund, C.J. Thoden, C. Carlson, K. Harno.
Realtime teleconsultations versus face-to-face consultations in dermatology: immediate and sixmonth outcome.
J Telemed Telecare, 9 (2003), pp. 204-209
[85.]
R.B. Mallett.
Teledermatology in practice.
Clin Exp Dermatol, 28 (2003), pp. 356-359
[86.]
J.D. Whited, R.P. Hall, M.E. Foy, L.E. Marbrey, S.C. Grambow, T.K. Dudley, et al.
Teledermatology's impact on time to intervention among referrals to a dermatology consult service.
Telemed J E Health, 8 (2002), pp. 313-321
[87.]
T.W. Van den Akker, C.H. Reker, A. Knol, J. Post, J. Wilbrink, J.P. Van der Veen.
Teledermatology as a tool for communication between general practitioners and dermatologists.
J Telemed Telecare, 7 (2001), pp. 193-198
[88.]
A.M. Oakley, P. Kerr, M. Duffill, M. Rademaker, P. Fleischl, N. Bradford, et al.
Patient cost-benefits of realtime teledermatology-a comparison of data from Northern Ireland and New Zealand.
J Telemed Telecare, 6 (2000), pp. 97-101
[89.]
R.M. Berghout, N. Eminovic, N.F. de Keizer, E. Birnie.
Evaluation of general practitioner's time investment during a store-and-forward teledermatology consultation.
Int J Med Inform, 76 (2007), pp. S384-S391
[90.]
H. Pak, C.A. Triplett, J.H. Lindquist, S.C. Grambow, J.D. Whited.
Store-and-forward teledermatology results in similar clinical outcomes to conventional clinic-based care.
J Telemed Telecare, 13 (2007), pp. 26-30
[91.]
D. Moreno, L. Ferrándiz, A. Ruiz, F. Camacho.
Teledermatología en la asistencia de pacientes con cáncer de piel.
Monogr Dermatol, 19 (2006), pp. 364-371
[92.]
A.W. Armstrong, D.J. Dorer, N.E. Lugn, J.C. Kvedar.
Economic evaluation of interactive teledermatology compared with conventional care.
Telemed J E Health, 13 (2007), pp. 91-99
[93.]
T.S. Bergmo.
A cost-minimization analysis of a realtime teledermatology service in northern Norway.
J Telemed Telecare, 6 (2000), pp. 273-277
[94.]
T.L. Williams, C.R. May, A. Esmail.
Limitations of patient satisfaction studies in telehealthcare: a systematic review of the literature.
Telemed J E Health, 7 (2001), pp. 293-316
[95.]
K. Collins, S. Walters, I. Bowns.
Patient satisfaction with teledermatology: quantitative and qualitative results from a randomized controlled trial.
J Telemed Telecare, 10 (2004), pp. 29-33
[96.]
J.D. Whited, R.P. Hall, M.E. Foy, L.E. Marbrey, S.C. Grambow, T.K. Dudley, et al.
Patient and clinician satisfaction with a store-and-forward teledermatology consult system.
Telemed J E Health, 10 (2004), pp. 422-431
[97.]
M.A. Loane, S.E. Bloomer, R. Corbett, D.J. Eedy, H.E. Gore, C. Mathews, et al.
Patient satisfaction with realtime teledermatology in Northern Ireland.
J Telemed Telecare, 4 (1998), pp. 36-40
[98.]
J. Artiles Sánchez, J. Suárez-Hernández, P. Serrano, C. Vázquez, B. Duque, C. Cuevas.
Evaluación cualitativa en teledermatología: Resultados del proyecto piloto en telemedicina 2000.
Actas Dermosifiliogr, 95 (2004), pp. 289-294
[99.]
F. Mair, P. Whitten.
Systematic review of studies of patient satisfaction with telemedicine.
BMJ, 320 (2000), pp. 1517-1520
[100.]
G. Demiris, S.M. Speedie, L.L. Hicks.
Assessment of patients’ acceptance of and satisfaction with teledermatology.
J Med Syst, 28 (2004), pp. 575-579
[101.]
M.A. Weinstock, F.Q. Nguyen, P.M. Risica.
Patient and referring provider satisfaction with teledermatology.
J Am Acad Dermatol, 47 (2002), pp. 68-72
[102.]
H.S. Pak, M. Welch, R. Poropatich.
Web-based teledermatology consult system: preliminary results from the first 100 cases.
Stud Health Technol Inform, 64 (1999), pp. 179-184
[103.]
J.C. Kvedar, E.R. Menn, S. Baradagunta, O. Smulders-Meyer, E. González.
Teledermatology in a capitated delivery system using distributed information architecture: design and development.
Telemed J, 5 (1999), pp. 357-366
[104.]
H.S. Pak, D. Harden, D. Cruess, M.L. Welch, R. Poropatich.
Teledermatology: an intraobserver diagnostic correlation study, part I.
Cutis, 71 (2003), pp. 399-403
[105.]
D.H. Jones, C. Crichton, A. Macdonald, S. Potts, D. Sime, J. Toms, et al.
Teledermatology in the Highlands of Scotland.
J Telemed Telecare, 2 (1996), pp. 7-9
[106.]
T. Finch, C. May, F. Mair, M. Mort, L. Gask.
Integrating service development with evaluation in telehealthcare: an ethnographic study.
BMJ, 327 (2003), pp. 1205-1209
Copyright © 2008. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
Download PDF
Idiomas
Actas Dermo-Sifiliográficas
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?