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Evaluation of an ar...
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Papachristou, PanagiotisKarolinska Institutet
(författare)
Evaluation of an artificial intelligence-based decision support for the detection of cutaneous melanoma in primary care: a prospective real-life clinical trial
- Artikel/kapitelEngelska2024
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LIBRIS-ID:oai:gup.ub.gu.se/336072
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https://gup.ub.gu.se/publication/336072URI
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https://doi.org/10.1093/bjd/ljae021DOI
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-201695URI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:155125983URI
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Funding Agencies|Region Ostergotland, Sweden; AIDA network (MedTech4Health)
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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.
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Biuppslag (personer, institutioner, konferenser, titlar ...)
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Söderholm, MyLinköpings universitet,Institutionen för hälsa, medicin och vård,Medicinska fakulteten,Region Östergötland, Vårdcentralen Ekholmen(Swepub:liu)n/a
(författare)
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Pallon, JonLund Univ, Sweden; Reg Kronoberg, Sweden
(författare)
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Taloyan, MarinaKarolinska Institutet
(författare)
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Polesie, SamGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för dermatologi och venereologi,Institute of Clinical Sciences, Department of Dermatology and Venereology,Sahlgrens Univ Hosp, Sweden; Univ Gothenburg, Sweden(Swepub:gu)xpolsa
(författare)
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Paoli, John,1975Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för dermatologi och venereologi,Institute of Clinical Sciences, Department of Dermatology and Venereology,Sahlgrens Univ Hosp, Sweden; Univ Gothenburg, Sweden(Swepub:gu)xpaojo
(författare)
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Anderson, ChrisLinköpings universitet,Avdelningen för cellbiologi,Medicinska fakulteten,Region Östergötland, Hudkliniken i Östergötland(Swepub:liu)chran78
(författare)
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Falk, MagnusLinköpings universitet,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Region Östergötland, Vårdcentralen Kärna(Swepub:liu)magfa32
(författare)
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Karolinska InstitutetInstitutionen för hälsa, medicin och vård
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:BRITISH JOURNAL OF DERMATOLOGY: OXFORD UNIV PRESS0007-09631365-2133
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