| 1. |
- Al-Ali, Fatima, et al.
(författare)
-
Attitudes Towards Artificial Intelligence Among Dermatologists Working in Saudi Arabia.
- 2023
-
Ingår i: Dermatology practical & conceptual. - : Mattioli1885. - 2160-9381. ; 13:1
-
Tidskriftsartikel (refereegranskat)abstract
- Artificial intelligence (AI) and its applications are among the most discussed modern technologies today. Despite the rapidly expanding use of AI in medicine, and specifically in dermatology, only a few studies have studied the attitude of physicians toward AI.To recognize the attitudes towards AI among dermatologists in the Kingdom of Saudi Arabia.A cross-sectional survey was done among dermatologists in Saudi Arabia. Questionnaires were distributed through several online channels.Overall, 103 dermatologists filled out the survey. The majority saw very strong or strong potential for AI in the automated detection of skin diseases based on dermatological clinical images (50.9%), dermoscopic images (66.6%) and within dermatopathology (66.6%). In regard to results of attitudes towards AI, 56.6% and 52. 8% agreed that AI will revolutionize medicine and dermatology, respectively. However, many of the respondents disagreed that AI will replace physicians (41.5%) and human dermatologists (39.6%) in the future. Age did not impact the overall attitude of dermatologists.Dermatologists in Saudi Arabia showed an optimistic attitude towards AI in dermatology and medicine. However, dermatologists believe that AI will not replace humans in the future.
|
|
| 2. |
|
|
| 3. |
- Fougelberg, Julia, et al.
(författare)
-
Dermoscopic Findings in Intraepidermal Carcinoma: an Interobserver Agreement Study
- 2023
-
Ingår i: Dermatology Practical & Conceptual. - : Mattioli1885. - 2160-9381. ; 13:1
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: A wide range of descriptive terms have been used for dermoscopic findings in intraepidermal carcinoma (IEC) and the clinical diagnostic accuracy of IEC can be challenging. Furthermore, dermoscopic findings in IEC have only rarely been evaluated in fair-skinned populations.Objectives: To measure the interobserver agreement between dermatologists for dermoscopic findings in IEC. Furthermore, to describe the frequency of these findings in a predominantly fair-skinned population. Methods: One hundred dermoscopic images of histopathologically verified IECs were collected. The 11 most common dermoscopic findings described in previous studies were re-defined in a new terminology in a pre-study consensus meeting. Images were assessed by eight experienced international dermoscopists. The frequency of findings and the interobserver agreement was analyzed.Results: Scales (83%), dotted/glomerular vessels (77%), pinkish-white areas (73%) and hemorrhage (46%) were the most commonly present dermoscopic findings. Pigmented structures were found in 32% and shiny white structures (follicular or stromal) in 54% of the IEC. Vascular structures (vessels and/or hemorrhage) could be seen in 89% of the lesions. Overall, the interobserver agreement for the respective dermoscopic findings was poor to moderate, with the highest kappa values noted for scales (0.55) and hemorrhage (0.54) and the lowest for pinkish-white areas (0.015).Conclusion: Our results confirm those of previous studies on dermoscopy in IEC, including the frequency of pigmented structures despite the fair-skinned population. The interobserver agreement was relatively low. The proposed new terminology and our findings can hopefully serve as a guideline for researchers, teachers and students on how to identify IEC.
|
|
| 4. |
- Giannopoulos, Filippos, et al.
(författare)
-
Methotrexate Use for Patients with Psoriasis and Risk of Cutaneous Squamous Cell Carcinoma: A Nested Case-control Study.
- 2021
-
Ingår i: Acta dermato-venereologica. - : Medical Journals Sweden AB. - 1651-2057. ; 101:1
-
Tidskriftsartikel (refereegranskat)abstract
- An association between methotrexate use and risk of cutaneous squamous cell carcinoma has been reported in patients with rheumatoid and psoriatic arthritis. A nested case-control study was performed to investigate if methotrexate use among patients with psoriasis was associated with increased risk of cutaneous squamous cell carcinoma. Data were obtained from Swedish egisters and included 623 patients with psoriasis and a first cutaneous squamous cell carcinoma from 2010 to 2016. Ten randomly selected patients with psoriasis were matched on age and sex to each case. Among cases, 160 (26%) were ever-users of metho-trexate. The corresponding number among the controls was 1,370 (22%), yielding an unadjusted odds ratio (OR) of 1.23 (95% confidence interval (95% CI) 1.02-1.49); p=0.034. After adjusting for use of other immunosuppressive drugs the association was close to unity (OR 1.09; 95% CI 0.89-1.34); p=0.39. The slightly increased risk of cutaneous squamous cell carcinoma associated with methotrexate-exposure in patients with psoriasis does not seem to be associated with metho-trexate, but rather with disease severity, other anti-psoriatic treatments, and ultraviolet (UV) exposure.
|
|
| 5. |
- Gillstedt, Martin, 1977, et al.
(författare)
-
Ability to Predict Melanoma Within 5 Years Using Registry Data and a Convolutional Neural Network: A Proof of Concept Study
- 2022
-
Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 102
-
Tidskriftsartikel (refereegranskat)abstract
- Research relating to machine learning algorithms, including convolutional neural networks, has increased during the past 5 years. The aim of this pilot study was to investigate how accurately a convolutional neural network, trained on Swedish registry data, could perform in predicting cutaneous invasive and in situ melanoma (CMM) within 5 years. A cohort of 1,208,393 individuals was used. Registry data ranged from 4 July 2005 to 31 December 2011, predicting CMM between 1 January 2012 and 31 December 2016. A convolutional neural network with one-dimensional convolutions with respect to time was trained using healthcare databases and registers. The algorithm was trained on 23,886 individuals. Validation was performed on a hold out validation set including 6,000 individuals. After training and validation, the convolutional neural network was evaluated on a test set (1,000 individuals with an CMM occurring within 5 years and 5,000 without). The area under the receiver-operating characteristic curve was 0.59 (95% confidence interval (95% CI) 0.57???0.61). The point on the receiver-operating characteristic curve where sensitivity equalled specificity had a value of 56% (sensitivity 95% CI 53???60% and specificity 95% CI 55???58%). Albeit at an early stage, this pilot investigation demonstrates potential usefulness for machine learning algorithms in predicting melanoma risk.
|
|
| 6. |
|
|
| 7. |
- Gillstedt, Martin, 1977, et al.
(författare)
-
Evaluation of Melanoma Thickness with Clinical Close-up and Dermoscopic Images Using a Convolutional Neural Network
- 2022
-
Ingår i: Acta dermato-venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 102
-
Tidskriftsartikel (refereegranskat)abstract
- Convolutional neural networks (CNNs) have shown promise in discriminating between invasive and in situ melanomas. The aim of this study was to analyse how a CNN model, integrating both clinical close-up and dermoscopic images, performed compared with 6 in-dependent dermatologists. The secondary aim was to address which clinical and dermoscopic features derma-tologists found to be suggestive of invasive and in situ melanomas, respectively. A retrospective investigation was conducted including 1,578 cases of paired images of invasive (n = 728, 46.1%) and in situ melanomas (n = 850, 53.9%). All images were obtained from the Department of Dermatology and Venereology at Sahl-grenska University Hospital and were randomized to a training set (n = 1,078), a validation set (n = 200) and a test set (n = 300). The area under the receiver operating characteristics curve (AUC) among the der-matologists ranged from 0.75 (95% confidence in-terval 0.70-0.81) to 0.80 (95% confidence interval 0.75-0.85). The combined dermatologists' AUC was 0.80 (95% confidence interval 0.77-0.86), which was significantly higher than the CNN model (0.73, 95% confidence interval 0.67-0.78, p = 0.001). Three of the dermatologists significantly outperformed the CNN. Shiny white lines, atypical blue-white structures and polymorphous vessels displayed a moderate interob-server agreement, and these features also correlated with invasive melanoma. Prospective trials are needed to address the clinical usefulness of CNN models in this setting.
|
|
| 8. |
|
|
| 9. |
|
|
| 10. |
- Inci, Rahime, 1985, et al.
(författare)
-
Porokeratosis is one of the most common genodermatoses and is associated with an increased risk of keratinocyte cancer and melanoma
- 2023
-
Ingår i: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 37:2, s. 420-427
-
Tidskriftsartikel (refereegranskat)abstract
- Background Porokeratosis is a clinically heterogeneous group of keratinization disorders with a genetic background mainly affecting the mevalonate pathway, which is involved in the synthesis of cholesterol, an essential component for the formation of the extracellular lipid lamellae in the stratum corneum. Porokeratosis is reportedly associated with an increased risk of keratinocyte cancer, but to date, no large epidemiological studies have been conducted to further address this association. Objectives The first objective was to characterize a cohort of patients diagnosed with porokeratosis at the Department of Dermatology and Venereology, Sahlgrenska University Hospital (SU), Gothenburg, Sweden. The second objective was to conduct a nationwide registry-based cohort study to investigate the association, if any, between porokeratosis and the cutaneous malignancies squamous cell carcinoma (SCC), basal cell carcinoma (BCC) and melanoma. Methods For the SU cohort, the hospital registry was searched for patients with a diagnosis of porokeratosis recorded between 2016 and 2020. Clinical data were extracted from the records of the identified patients. For the nationwide cohort, national registries were searched to identify patients with a diagnosis of porokeratosis between 2001 and 2020. A tenfold control cohort was formed by Statistics Sweden. The data was cross-referenced with the Swedish Cancer Register to study the associations between porokeratosis and SCC, BCC and melanoma. Results Disseminated superficial actinic porokeratosis was the most common clinical type among the 108 patients in the SU cohort. In the nationwide search, 2277 patients with porokeratosis were identified (prevalence 1/4132). Porokeratosis was associated with an increased risk for SCC, BCC and melanoma with hazard ratios (95% CI) of 4.3 (3.4-5.4), 2.42 (1.97-2.98) and 1.83 (1.18-2.82), respectively, in the patient cohort, compared to the matched control group. Conclusion Porokeratosis is a common genodermatosis, and it is associated with an enhanced risk of skin cancer.
|
|
| 11. |
|
|
| 12. |
- Johansson Backman, Eva, et al.
(författare)
-
Curettage vs. cryosurgery for superficial basal cell carcinoma: a prospective, randomised and controlled trial.
- 2022
-
Ingår i: Journal of the European Academy of Dermatology and Venereology : JEADV. - : Wiley. - 1468-3083 .- 0926-9959. ; 36:10, s. 1758-1765
-
Tidskriftsartikel (refereegranskat)abstract
- Basal cell carcinoma (BCC) is the most common cancer in the world and has a rising incidence. Current guidelines for low-risk BCC including superficial BCC (sBCC) recommend several treatment options including destructive treatment methods, such as cryosurgery with or without prior curettage or curettage and electrodesiccation. Curettage only (i.e. without subsequent cryosurgery or electrodesiccation) is a simple and quick destructive treatment method used for many benign skin lesions but has not been sufficiently evaluated for the treatment of sBCCs.The objective was to compare the effectiveness of curettage vs. cryosurgery for sBCCs in terms of overall clinical clearance rates after 1 year as well as wound healing times.A single-centre non-inferiority clinical trial was conducted. Non-facial sBCCs with a diameter of 5-20mm were randomised to either cryosurgery using one freeze-thaw cycle or curettage. At follow-up visits, treatment areas were evaluated regarding the presence of residual tumour after 3-6months and recurrence after 1year. Further, wound healing times were assessed.In total, 228 sBCCs in 97 patients were included in the analysis. At 3-6months, no residual tumours were seen in any of the treated areas. After 1 year, the clinical clearance rates for curettage and cryosurgery were 95.7% and 100%, respectively (P=0.060). However, the non-inferiority analysis was inconclusive. Wound healing times were shorter for curettage (4weeks) compared to cryosurgery (5weeks; P<0.0001). Overall, patient satisfaction at 1 year was high.Both treatment methods showed high clinical clearance rates after 1 year, whilst curettage reduced the wound healing time.
|
|
| 13. |
- Jägerström, Sara, et al.
(författare)
-
Lipid droplets interact with mitochondria using SNAP23.
- 2009
-
Ingår i: Cell biology international. - : Wiley. - 1095-8355 .- 1065-6995. ; 33:9, s. 934-40
-
Tidskriftsartikel (refereegranskat)abstract
- Triglyceride-containing lipid droplets (LD) are dynamic organelles stored on demand in all cells. These droplets grow through a fusion process mediated by SNARE proteins, including SNAP23. The droplets have also been shown to be highly motile and interact with other cell organelles, including peroxisomes and the endoplasmic reticulum. We have used electron and confocal microscopy to demonstrate that LD form complexes with mitochondria in NIH 3T3 fibroblasts. Using an in vitro system of purified LD and mitochondria, we also show the formation of the LD-mitochondria complex, in which cytosolic factors are involved. Moreover, the presence of LD markers in mitochondria isolated by subcellular fractionations is demonstrated. Finally, ablation of SNAP23 using siRNA reduced complex formation and beta oxidation, which suggests that the LD-mitochondria complex is functional in the cell.
|
|
| 14. |
- Lindberg, Jenny, et al.
(författare)
-
Bör individualiserad utbildning för läkarstudenter eftersträvas?
- 2024
-
Ingår i: Läkartidningen. - 0023-7205. ; 121:9-10
-
Tidskriftsartikel (refereegranskat)abstract
- Vi upplever en ökad efterfrågan på anpassad utbildning från studenter på läkarprogrammet, exempelvis att avstå från obligatoriska moment eller delta i modifierad form. I denna artikel behandlar vi önskemål om anpassning av utbildningen på grund av moraliska, religiösa eller andra personliga övertygelser. Läkarprogrammet syftar till att studenterna ska uppnå gemensamma examensmål. Vid omfattande anpassning riskerar utbildning och examination att inte bli likvärdig för alla studenter. Anpassningar är också ofta resurskrävande. Vi efterfrågar en nationell samsyn och stöd till lärosätena avseende hur frågan om individuell anpassning ska hanteras.
|
|
| 15. |
- Myers, L., et al.
(författare)
-
Variable neurodevelopmental and morphological phenotypes of carriers with 12q12 duplications
- 2020
-
Ingår i: Molecular Genetics & Genomic Medicine. - : Wiley. - 2324-9269. ; 8:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background Variable size deletions affecting 12q12 have been found in individuals with neurodevelopmental disorders (NDDs) and distinct facial and physical features. For many genetic loci affected by deletions in individuals with NDDs, reciprocal duplications have been described. However, for the 12q12 region, there are no detailed descriptions of duplication cases in the literature. Methods We report a phenotypic description of a family with monozygotic twins diagnosed with NDDs, carrying a 9 Mb duplication at 12q12, and five other individuals with overlapping duplications ranging from 4.54 Mb up to 15.16 Mb. Results The duplication carriers had language delays, cognitive delays, and were diagnosed with autism spectrum disorder. Additionally, distinct facial features (e.g., high foreheads, deeply set eyes, short palpebral fissures, small ears, high nasal bridges, abnormalities of the nose tip, thin lips), large feet, and abnormalities in the digits were noted. We also describe incomplete penetrance of the NDD phenotypes among the individuals with 12q12 duplication. Conclusion This case series expands our knowledge on this rare genetic aberration and suggests that large 12q12 duplications may increase the risk for developing NDDs.
|
|
| 16. |
- Paoli, John, 1975, et al.
(författare)
-
Hyperspectral Imaging for Non-invasive Diagnostics of Melanocytic Lesions.
- 2022
-
Ingår i: Acta dermato-venereologica. - : Medical Journals Sweden AB. - 1651-2057 .- 0001-5555. ; 102
-
Tidskriftsartikel (refereegranskat)abstract
- Malignant melanoma poses a clinical diagnostic problem, since a large number of benign lesions are excised to find a single melanoma. This study assessed the accuracy of a novel non-invasive diagnostic technology, hyperspectral imaging, for melanoma detection. Lesions were imaged prior to excision and histopathological analysis. A deep neural network algorithm was trained twice to distinguish between histopathologically verified malignant and benign melanocytic lesions and to classify the separate subgroups. Furthermore, 2 different approaches were used: a majority vote classification and a pixel-wise classification. The study included 325 lesions from 285 patients. Of these, 74 were invasive melanoma, 88 melanoma in situ, 115 dysplastic naevi, and 48 non-dysplastic naevi. The study included a training set of 358,800 pixels and a validation set of 7,313 pixels, which was then tested with a training set of 24,375 pixels. The majority vote classification achieved high overall sensitivity of 95% and a specificity of 92% (95% confidence interval (95% CI) 0.024-0.029) in differentiating malignant from benign lesions. In the pixel-wise classification, the overall sensitivity and specificity were both 82% (95% CI 0.005-0.005). When divided into 4 subgroups, the diagnostic accuracy was lower. Hyperspectral imaging provides high sensitivity and specificity in distinguishing between naevi and melanoma. This novel method still needs further validation.
|
|
| 17. |
|
|
| 18. |
- Paoli, John, 1975, et al.
(författare)
-
Nonsurgical Options for the Treatment of Basal Cell Carcinoma.
- 2019
-
Ingår i: Dermatology practical & conceptual. - : Mattioli1885. - 2160-9381. ; 9:2, s. 75-81
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this review article is to summarize the effectiveness, potential adverse events, and indications of the main nonsurgical treatment alternatives for basal cell carcinoma.An extensive literature review was carried out. The most relevant articles were discussed and selected by the authors in order to provide a brief but evidence-based overview of the most common nonsurgical methods used for treating basal cell carcinoma.Although surgery and Mohs micrographic surgery are often considered the optimal treatment options for basal cell carcinoma, these tumors can also be treated successfully with destructive techniques (eg, curettage alone, cryosurgery, or electrodesiccation), photodynamic therapy, topical drugs (eg, 5-fluorouracil, imiquimod, or ingenol mebutate), radiotherapy, or hedgehog pathway inhibitors. When choosing between these alternatives, physicians must take into consideration the tumor's size, location, and histopathological subtype. Special care should be taken when treating recurrent tumors. Furthermore, physician experience is of great importance when using destructive techniques. Finally, patient preference, potential adverse events, and cosmetic outcome should also be considered.Dermatologists and physicians treating basal cell carcinoma should have knowledge of and experience with the large arsenal of therapeutic alternatives available for the successful, safe, and individualized management of patients with basal cell carcinoma.
|
|
| 19. |
- Papachristou, Panagiotis, et al.
(författare)
-
Evaluation of an artificial intelligence-based decision support for the detection of cutaneous melanoma in primary care: a prospective real-life clinical trial
- 2024
-
Ingår i: BRITISH JOURNAL OF DERMATOLOGY. - : OXFORD UNIV PRESS. - 0007-0963 .- 1365-2133. ; 191:1, s. 125-133
-
Tidskriftsartikel (refereegranskat)abstract
- Background Use of artificial intelligence (AI), or machine learning, to assess dermoscopic images of skin lesions to detect melanoma has, in several retrospective studies, shown high levels of diagnostic accuracy on par with - or even outperforming - experienced dermatologists. However, the enthusiasm around these algorithms has not yet been matched by prospective clinical trials performed in authentic clinical settings. In several European countries, including Sweden, the initial clinical assessment of suspected skin cancer is principally conducted in the primary healthcare setting by primary care physicians, with or without access to teledermoscopic support from dermatology clinics.Objectives To determine the diagnostic performance of an AI-based clinical decision support tool for cutaneous melanoma detection, operated by a smartphone application (app), when used prospectively by primary care physicians to assess skin lesions of concern due to some degree of melanoma suspicion.Methods This prospective multicentre clinical trial was conducted at 36 primary care centres in Sweden. Physicians used the smartphone app on skin lesions of concern by photographing them dermoscopically, which resulted in a dichotomous decision support text regarding evidence for melanoma. Regardless of the app outcome, all lesions underwent standard diagnostic procedures (surgical excision or referral to a dermatologist). After investigations were complete, lesion diagnoses were collected from the patients' medical records and compared with the app's outcome and other lesion data.Results In total, 253 lesions of concern in 228 patients were included, of which 21 proved to be melanomas, with 11 thin invasive melanomas and 10 melanomas in situ. The app's accuracy in identifying melanomas was reflected in an area under the receiver operating characteristic (AUROC) curve of 0.960 [95% confidence interval (CI) 0.928-0.980], corresponding to a maximum sensitivity and specificity of 95.2% and 84.5%, respectively. For invasive melanomas alone, the AUROC was 0.988 (95% CI 0.965-0.997), corresponding to a maximum sensitivity and specificity of 100% and 92.6%, respectively.Conclusions The clinical decision support tool evaluated in this investigation showed high diagnostic accuracy when used prospectively in primary care patients, which could add significant clinical value for primary care physicians assessing skin lesions for melanoma. We investigated the diagnostic performance of an AI-based decision support in the form of a mobile app to detect melanoma when used by primary care physicians. The app proved to have high levels of diagnostic accuracy in distinguishing melanomas from other skin lesions. We conclude that it appears to be a potentially valuable diagnostic aid for the primary care physician in the assessment of skin lesions of concern.
|
|
| 20. |
- Polesie, Sam, et al.
(författare)
-
A systematic review investigating at what proportion clinical images are shared in prospective randomized controlled trials involving patients with psoriasis and biological agents.
- 2023
-
Ingår i: The Journal of dermatological treatment. - 1471-1753. ; 34:1
-
Tidskriftsartikel (refereegranskat)abstract
- For many patients including those with psoriasis, scientific manuscripts comprising clinical outcomes including psoriasis area severity index (PASI) and/or physician global assessment (PGA) may be difficult to understand. However, most patients can relate to images at baseline and follow-up, particularly for dermatological diseases. This study aimed to assess the proportion of shared clinical images in psoriasis trials. A systematic review adhering to the PRISMA guidelines was performed. The review was limited to randomized controlled trials, and among these, only investigations involving biological agents for treatment of psoriasis were included. The Embase, MEDLINE and Scopus databases were searched for eligible studies published from inception to October 26, 2021. In total, 152 studies were included. When combining these, 62,871 patients were randomized. Overall, 203 images were shared depicting 60 patients in the manuscripts yielding an overall sharing rate of 0.1%. Patient images are seldom incorporated in clinical trial manuscripts which impairs interpretation for patients. Inclusion of image material would strengthen the patients' perspective and understanding on what treatment effects that can be expected. As such, this systematic review should be an invitation to the pharmaceutical industry, other sponsors, and editorial offices to improve easy transfer of information to patients using image data.
|
|
| 21. |
- Polesie, Sam, et al.
(författare)
-
A systematic review investigating the proportion of clinical images shared in prospective randomized controlled trials involving patients with atopic dermatitis and systemic pharmacotherapy
- 2024
-
Ingår i: Journal of dermatological treatment. - 0954-6634 .- 1471-1753. ; 35
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: For individuals with atopic dermatitis (AD), interpreting scientific papers that present clinical outcomes including the Eczema Area and Severity Index (EASI) and Investigators Global Assessment may be difficult. When compared to tabulated data and graphs, images from before and after treatment are often far more meaningful to these patients that ultimately will be candidates for the treatment. This systematic review focused on determining the frequency of clinical image sharing in AD research. Materials and methods: Conducted in accordance with PRISMA guidelines, the review concentrated on randomized controlled trials that investigated predefined and available systemic treatments for AD. The search was performed in the MEDLINE database for studies published from the inception until 21 December 2023. Results: The review included 60 studies, encompassing 17,799 randomized patients. Across these studies, 16 images representing 6 patients were shared in the manuscripts, leading to a sharing rate of 0.3‰. Conclusions: The almost missing inclusion of patient images in clinical trial publications hinders patient understanding. Adding images to scientific manuscripts could significantly improve patients’ comprehension of potential treatment outcomes. This review highlights the need for authors, the pharmaceutical industry, study sponsors, and publishers to enhance and promote patient information through increased use of visual data.
|
|
| 22. |
- Polesie, Sam, et al.
(författare)
-
Assessment of melanoma thickness based on dermoscopy images: an open, web-based, international, diagnostic study
- 2022
-
Ingår i: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 36:11, s. 2002-2007
-
Tidskriftsartikel (refereegranskat)abstract
- Background Preoperative assessment of whether a melanoma is invasive or in situ (MIS) is a common task that might have important implications for triage, prognosis and the selection of surgical margins. Several dermoscopic features suggestive of melanoma have been described, but only a few of these are useful in differentiating MIS from invasive melanoma. Objective The primary aim of this study was to evaluate how accurately a large number of international readers, individually as well as collectively, were able to discriminate between MIS and invasive melanomas as well as estimate the Breslow thickness of invasive melanomas based on dermoscopy images. The secondary aim was to compare the accuracy of two machine learning convolutional neural networks (CNNs) and the collective reader response. Methods We conducted an open, web-based, international, diagnostic reader study using an online platform. The online challenge opened on 10 May 2021 and closed on 19 July 2021 (71 days) and was advertised through several social media channels. The investigation included, 1456 dermoscopy images of melanomas (788 MIS; 474 melanomas <= 1.0 mm and 194 >1.0 mm). A test set comprising 277 MIS and 246 invasive melanomas was used to compare readers and CNNs. Results We analysed 22 314 readings by 438 international readers. The overall accuracy (95% confidence interval) for melanoma thickness was 56.4% (55.7%-57.0%), 63.4% (62.5%-64.2%) for MIS and 71.0% (70.3%-72.1%) for invasive melanoma. Readers accurately predicted the thickness in 85.9% (85.4%-86.4%) of melanomas <= 1.0 mm (including MIS) and in 70.8% (69.2%-72.5%) of melanomas >1.0 mm. The reader collective outperformed a de novo CNN but not a pretrained CNN in differentiating MIS from invasive melanoma. Conclusions Using dermoscopy images, readers and CNNs predict melanoma thickness with fair to moderate accuracy. Readers most accurately discriminated between thin (<= 1.0 mm including MIS) and thick melanomas (>1.0 mm).
|
|
| 23. |
- Polesie, Sam, et al.
(författare)
-
Attitudes Toward Artificial Intelligence Within Dermatopathology: An International Online Survey.
- 2020
-
Ingår i: Frontiers in medicine. - : Frontiers Media SA. - 2296-858X. ; 7
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Artificial intelligence (AI) has recently surfaced as a research topic in dermatology and dermatopathology. In a recent survey, dermatologists were overall positive toward a development with an increased use of AI, but little is known about the corresponding attitudes among pathologists working with dermatopathology. The objective of this investigation was to make an inventory of these attitudes. Participants and Methods: An anonymous and voluntary online survey was prepared and distributed to pathologists who regularly analyzed dermatopathology slides/images. The survey consisted of 39 question divided in five sections; (1) AI as a topic in pathology; (2) previous exposure to AI as a topic in general; (3) applications for AI in dermatopathology; (4) feelings and attitudes toward AI and (5) self-reported tech-savviness and demographics. The survey opened on March 13, 2020 and closed on May 5, 2020. Results: Overall, 718 responders (64.1% females) representing 91 countries were analyzed. While 81.5% of responders were aware of AI as an emerging topic in pathology, only 18.8% had either good or excellent knowledge about AI. In terms of diagnosis classification, 42.6% saw strong or very strong potential for automated suggestion of skin tumor diagnoses. The corresponding figure for inflammatory skin diseases was 23.0% (Padj < 0.0001). For specific applications, the highest potential was considered for automated detection of mitosis (79.2%), automated suggestion of tumor margins (62.1%) and immunostaining evaluation (62.7%). The potential for automated suggestion of immunostaining (37.6%) and genetic panels (48.3%) were lower. Age did not impact the overall attitudes toward AI. Only 6.0% of the responders agreed or strongly agreed that the human pathologist will be replaced by AI in the foreseeable future. For the entire group, 72.3% agreed or strongly agreed that AI will improve dermatopathology and 84.1% thought that AI should be a part of medical training. Conclusions: Pathologists are generally optimistic about the impact and potential benefit of AI in dermatopathology. The highest potential is expected for narrow specified tasks rather than a global automated suggestion of diagnoses. There is a strong need for education about AI and its use within dermatopathology.
|
|
| 24. |
|
|
| 25. |
- Polesie, Sam, et al.
(författare)
-
Can Dermoscopy Be Used to Predict if a Melanoma Is In Situ or Invasive?
- 2021
-
Ingår i: Dermatology Practical & Conceptual. - : Mattioli1885. - 2160-9381. ; 11:3
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The preoperative prediction of whether melanomas are invasive or in situ can influence initial management. Objectives: This study evaluated the accuracy rate, interobserver concordance, sensitivity and specificity in determining if a melanoma is invasive or in situ, as well as the ability to predict invasive melanoma thickness based on clinical and dermoscopic images. Methods: In this retrospective, single-center investigation, 7 dermatologists independently reviewed clinical and dermoscopic images of melanomas to predict if they were invasive or in situ and, if invasive, their Breslow thickness. Fleiss' and Cohen's kappa (kappa) were used for interobserver concordance and agreement with histopathological diagnosis. Results: We included 184 melanomas (110 invasive and 74 in situ). Diagnostic accuracy ranged from 67.4% to 76.1%. Accuracy rates for in situ and invasive melanomas were 57.5% (95% confidence interval [I], 53.1%-61.8%) and 81.7% (95% CI, 78.8%-84.4%), respectively. Interobserver concordance was moderate (kappa = 0.47; 95% CI, 0.44-0.51). Sensitivity for predicting invasiveness ranged from 63.6% to 91.8% for 7 observers, while specificity was 32.4%-82.4%. For all correctly predicted invasive melanomas, agreement between predictions and correct thickness over or under 1.0 mm was moderate (kappa = 0.52; 95% CI, 0.45-0.58). All invasive melanomas incorrectly predicted by any observer as in situ had a thickness <1.0 mm. All 32 melanomas >1.0 mm were correctly predicted to be invasive by all observers. Conclusions: Accuracy rates for predicting thick melanomas were excellent, melanomas inaccurately predicted as in situ were all thin, and interobserver concordance for predicting in situ or invasive melanomas was moderate. Preoperative dermoscopy of suspected melanomas is recommended for choosing appropriate surgical margins.
|
|
