Bibliographic record
Abstract
Background The use of artificial intelligence (AI) algorithms for the diagnosis of skin diseases has shown promise in experimental settings but has not yet been 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 in the teledermatology workflow. Objective The aim of this study is to test the performance of and physicians’ preferences regarding 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’s 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=.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 in patient-taken photographs via telemedicine. Conflicts of Interest None declared.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".