OBJECTIVES: Over the past decade, there has been increased demand for patient-centric solutions in studies, such as digital technologies. This evaluation presents results of two teledermatology approaches used in epidemiological studies.

METHODS: We conducted two large (>40,000 adult participants each), cross-sectional, survey studies in the United States, each on the prevalence of a different dermatological condition. Adult participants were asked to submit photographs of their condition to a secure server for clinician evaluation.

For Condition 1, participants used a 3rd-party dermatological application downloaded onto their mobile device (3^rd-party app) to take and submit photographs. For Condition 2, participants used a digital camera or camera on their mobile device (personal device) and then uploaded photographs to a secure Dropbox. We evaluated these approaches on: 1) consent rate, 2) photograph submission rate, 3) photograph quality, and 4) clinician agreement.

RESULTS: A higher percentage of participants consented to upload photographs with the 3^rd-party app vs. personal device (42.1% vs. 33.8%; P=0.005). Among those who consented, photograph submission rate was significantly lower with the 3^rd-party app (47.7% vs. 61.5%; P=0.015) resulting in a similar “realized” consent rate (20.1% vs. 20.8%; P=0.778). Clinicians reported a higher percentage of quality photographs from the 3^rd-party app (95.6% vs. 79.8%; P<0.001) with moderate clinician agreement for both (3^rd-party app: Fleiss κ = 0.52, personal device: Fleiss κ =0.49).

CONCLUSIONS: Both solutions resulted in a low realized consent rate (1 in 5 participants). However, the 3^rd‑party app resulted in better photograph quality but that didn’t translate to higher clinician agreement. Low rates of submission may be attributable to the study design and not relevant for site-based clinical studies. Differences between the two approaches may be attributable to personal anatomical sensitivity of each condition. Further research is needed to understand participants’ sensitivities towards use of digital health technologies.