Diagnostic concordance challenges in dermatology

an internal analysis

Authors

DOI:

https://doi.org/10.1590/ce.v30i0.98057pt

Keywords:

Clinical Diagnosis, Skin Diseases, Skin Neoplasms, Health Care Levels, Primary Health Care

Abstract

Objective: Evaluate the degree of diagnostic agreement in dermatology among primary and intermediate care doctors compared to tertiary care dermatologists.

Method: A prospective and descriptive study that analyzed secondary data from patients on first outpatient consultation in the dermatology service of a hospital in Catanduva (SP) – Brazil, between September 2023 and February 2024. The data collection of patients' medical records was referred from primary to intermediate care. The diagnostic sensitivity, positive predictive value, and the Kappa accuracy index were calculated.

Results: The most prevalent diseases were malignant neoplasms (23.89%) and psoriasis (11.50%). Diagnostic agreement among doctors of different levels was low, with Kappa coefficients ranging from 0.0204 to 0.776.

Conclusion: The findings indicate that although some diagnoses are carried out with accuracy, there is a need for improvement in dermatology training for primary care doctors, especially in relation to neoplastic conditions.

Author Biographies

Ana Luiza Peris Tamburus, Centro Universitário Padre Albino, Catanduva, SP, Brasil.

Medical Student. Padre Albino University Center, Catanduva, SP, Brazil.  

Vitória Zanqueta Marcello, Padre Albino University Center

Medical student at Padre Albino University Center, Catanduva, SP, Brazil.

Laura Ramos Baleotti, Centro Universitário Padre Albino, Catanduva, SP, Brasil.

Doctor. Padre Albino University Center, Catanduva, SP, Brazil.

Paulo Henrique Chaves de Oliveira, Centro Universitário Padre Albino, Catanduva, SP, Brasil.

Medical student at Padre Albino University Center, Catanduva, SP, Brazil.  

Samuel Alcantara de Amorim, Centro Universitário Padre Albino, Catanduva, SP, Brasil.

Medical Student. Padre Albino University Center, Catanduva, SP, Brazil.

Janaína Cappi Moraes Braz, Centro Universitário Padre Albino, Catanduva, SP, Brasil.

Doctor. Professor at Padre Albino University Center, Catanduva, SP, Brazil.

Bruna Somílio da Fonseca, Centro Universitário Padre Albino, Catanduva, SP, Brasil.

Physician. PhD student in Evolutionary Genetics and Molecular Biology. Professor at the Padre Albino University Center, Catanduva, São Paulo, Brazil.

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Published

2025-06-05

How to Cite

Tamburus, A. L. P., Marcello, V. Z., Baleotti, L. R., de Oliveira, P. H. C., de Amorim, S. A., Braz, J. C. M., & da Fonseca, B. S. (2025). Diagnostic concordance challenges in dermatology: an internal analysis. Cogitare Enfermagem, 30. https://doi.org/10.1590/ce.v30i0.98057pt

Issue

Vol. 30 (2025)

Section

ORIGINAL ARTICLE

License

Copyright (c) 2025 Ana Luiza Peris Tamburus, Vitória Zanqueta Marcello, Laura Ramos Baleotti, Paulo Henrique Chaves de Oliveira, Samuel Alcantara de Amorim, Janaína Cappi Moraes Braz, Bruna Somílio da Fonseca

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