International inter-rater agreement in scoring acne severity utilizing cloud-based image sharing of mobile phone photographs

Negar Foolad, Jennifer N. Ornelas, Ashley K. Clark, Ifrah Ali, Victoria Sharon, Luluah Al Mubarak, Andrés Lopez, Ali Alikhan, Bishr Al Dabagh, Alireza Firooz, Smita Awasthi, Yu Liu, Chin Shang Li, Raja K. Sivamani

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Background: Cloud-based image sharing technology allows facilitated sharing of images. Cloud-based image sharing technology has not been well-studied for acne assessments or treatment preferences, among international evaluators. We evaluated inter-rater variability of acne grading and treatment recommendations among an international group of dermatologists that assessed photographs. Methods: This is a prospective, single visit photographic study to assess inter-rater agreement of acne photographs shared through an integrated mobile device, cloud-based, and HIPAA-compliant platform. Inter-rater agreements for global acne assessment and acne lesion counts were evaluated by the Kendall's coefficient of concordance while correlations between treatment recommendations and acne severity were calculated by Spearman's rank correlation coefficient. Results: There was good agreement for the evaluation of inflammatory lesions (KCC = 0.62, P < 0.0001), noninflammatory lesions (KCC = 0.62, P < 0.0001), and the global acne grading system score (KCC = 0.69, P < 0.0001). Topical retinoid, oral antibiotic, and isotretinoin treatment preferences correlated with photographic based acne severity. Conclusions: Our study supports the use of mobile phone based photography and cloud-based image sharing for acne assessment. Cloud-based sharing may facilitate acne care and research among international collaborators.

Original languageEnglish (US)
JournalInternational Journal of Dermatology
StateAccepted/In press - 2017

ASJC Scopus subject areas

  • Dermatology


Dive into the research topics of 'International inter-rater agreement in scoring acne severity utilizing cloud-based image sharing of mobile phone photographs'. Together they form a unique fingerprint.

Cite this