Performance of a deep neural network in teledermatology: a single‐centre prospective diagnostic study

Incomplete reporting has been identified as a major source of avoidable waste in biomedical research. Essential information is often not provided in study reports, impeding the identification, critical appraisal, and replication of studies. To improve the quality of reporting of diagnostic accuracy studies, the Standards for Reporting Diagnostic Accuracy (STARD) statement was developed. Here we present STARD 2015, an updated list of 30 essential items that should be included in every report of a diagnostic accuracy study. This update incorporates recent evidence about sources of bias and variability in diagnostic accuracy and is intended to facilitate the use of STARD. As such, STARD 2015 may help to improve completeness and transparency in reporting of diagnostic accuracy studies.

Artificial intelligence (AI) has become a progressively prevalent Research Topic in medicine and is increasingly being applied to dermatology. There is a need to understand this technology's progress to help guide and shape the future for medical care providers and recipients. We reviewed the literature to evaluate the types of publications on the subject, the specific dermatological topics addressed by AI, and the most challenging barriers to its implementation. A substantial number of original articles and commentaries have been published to date and only few detailed reviews exist. Most AI applications focus on differentiating between benign and malignant skin lesions, however; others exist pertaining to ulcers, inflammatory skin diseases, allergen exposure, dermatopathology, and gene expression profiling. Applications commonly analyze and classify images, however, other tools such as risk assessment calculators are becoming increasingly available. Although many applications are technologically feasible, important implementation barriers have been identified including systematic biases, difficulty of standardization, interpretability, and acceptance by physicians and patients alike. This review provides insight into future research needs and possibilities. There is a strong need for clinical investigation in dermatology providing evidence of success overcoming the identified barriers. With these research goals in mind, an appropriate role for AI in dermatology may be achieved in not so distant future.

Diagnosis in dermatology is largely based on contextual factors going far beyond the visual and dermoscopic inspection of a lesion. Diagnostic tools such as the different types of dermoscopy, confocal microscopy and optical coherence tomography (OCT) are available and all of these have shown their importance in improving the dermatologist's ability, especially in the diagnosis of skin cancer. Their use, however, remains limited and time consuming, and optimizing their practice appears to be difficult, requiring extensive pre-processing, lesion segmentation and extraction of domain-specific visual features before classification. Over the last two decades, image recognition has been a matter of interest in a large part of our society and in industry, leading to the development of several techniques such as convolutional processing combined with artificial intelligence or neural networks (CNN/ANN). The aim of the present manuscript is to provide a short overview of the most recent data about CNN in the field of dermatology, mainly in skin cancer detection and its diagnosis.