JMIR Publications

ABSTRACT

Background:

The use of artificial intelligence (AI) algorithms for the diagnosis of skin diseases has shown promise in experimental settings but has not been yet tested in real-life conditions. The COVID- 19 pandemic led to a worldwide disruption of health systems, increasing the use of telemedicine. There is an opportunity to include AI algorithms into the teledermatology workflow.

Objective:

To test the performance and physicians preferences of an AI algorithm during the evaluation of patients via teledermatology.

Methods:

We performed a prospective study in 340 cases from 281 patients using patient-taken photos during teledermatology encounters. The photos were evaluated by an AI algorithm and the diagnosis was compared with the clinician diagnosis. Physicians also reported whether the AI algorithm was useful or not.

Results:

The balanced (in-distribution) top-1 accuracy of the algorithm (47.6%) was comparable to the dermatologists (49.7%) and residents (47.7%) but superior to the general practitioners (39.7%; P = 0.049). Exposure to the AI algorithm results was considered useful in 11.8% of visits (n = 40) and the teledermatologist correctly modified the real-time diagnosis in 0.6% (n = 2) of cases. Algorithm performance was associated with patient skin type and image quality.

Conclusions:

AI algorithms appear to be a promising tool in the triage and evaluation of lesions with patient-taken photographs via telemedicine.