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Black-Skin Online: Library of medicine as operator for an open access atlas

par Schietse, Bérengère ;Amiel, Alban ;Kints, Benoît ;Van De Leemput, Cécile ;Heenen, Michel ;Lambert, Julien;Seymons, Katia
Référence 11th European Conference of Medical and Health Libraries (23rd – 28th of June: Helsinki, Finland)
Publication Non publié, 2008

Poster de conférence

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Résumé :	Background: Teledermatology is a developing field which has the potential to provide remote dermatology services. Up to now there is no teledermatology service specifically dedicated to black skins whereas, on the one hand, Africa suffers a substantial lack of skin care and, on the other hand, there is an increasing number of dark-skinned patients in Western European countries. A few years ago this lack was identified by the Library of Medicine (of Université Libre de Bruxelles) and the dermatology service of the academic hospital Erasme; together, they launched the project BlackSkin Dermatology Online with the support of federal grants.
	Methods: BlackSkin Dermatology Online is a project funded by the Belgian Federal Government that takes place in two phases, each phase lasting two years. During the first phase, images have been collected from Belgium (existing slides collections owned by Belgian university hospitals) and from Senegal (new photographs collected with the help of a local partner). Simultaneously, a web prototype has been built using open source technology. During the second phase, the specific needs of the target users (medical students, dermatologists, medical practitioners) have been studied. Thus, usability tests have been performed within a usability laboratory and further information has been collected by means of specific questionnaires in order to customize the web interfaces.
	Results: A high quality image bank has been built. Each image is described along specific parameters (morphologic description, ICD10 classification,). This image bank is the core of an open access web prototype which aims to offer retrieval and viewing tools as well as remote services such as image submission or “ask for a diagnosis”. In parallel, users can submit images which go through a peer review process as in any other scientific publication system. Moreover, specific plugins have been developed with an open source content system management. Finally, user testing has lead to the conception of specific validated test protocols. Representative tasks were identified thanks to observations of the usage of the web interface by groups of users and to interviews (search of image, learning, check diagnostic, etc.).
	Discussion: This teledermatology project could be a very helpful tool in providing skin care in Southern regions where populations suffer from a substantial lack of medical services as well as limited means of transportation. At the same time, dermatology relies on the visual inspection of the skin and teledermatology offers such an opportunity for North and South practitioners. User testing has enabled tasks scenarios to be validated, offering the basic framework for similar projects in telemedicine, as retrieval of relevant visual information is of prime importance in medicine. One limitation in our study is linked to the use of open source technology, as this is time consuming and involves the creation of specific plugins at each step of the process. Nevertheless, the originality of our approach resides in the use of usability methods in order to optimize the user-friendliness of the web interface.