Diagnostic concordance challenges in dermatology: an internal analysis

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.