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Perilesional sun damage as a diagnostic clue for pigmented actinic keratosis and Bowen’s disease

BACKGROUND: Chronic sun damage in the background is common in pigmented actinic keratoses and Bowen’s disease (pAK/BD). While explainable artificial intelligence (AI) demonstrated increased background attention for pAK/BD, humans frequently miss this clue in dermatoscopic images because they tend to...

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Detalles Bibliográficos
Autores principales: Weber, P., Sinz, C., Rinner, C., Kittler, H., Tschandl, P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8518404/
https://www.ncbi.nlm.nih.gov/pubmed/34146354
http://dx.doi.org/10.1111/jdv.17464
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author Weber, P.
Sinz, C.
Rinner, C.
Kittler, H.
Tschandl, P.
author_facet Weber, P.
Sinz, C.
Rinner, C.
Kittler, H.
Tschandl, P.
author_sort Weber, P.
collection PubMed
description BACKGROUND: Chronic sun damage in the background is common in pigmented actinic keratoses and Bowen’s disease (pAK/BD). While explainable artificial intelligence (AI) demonstrated increased background attention for pAK/BD, humans frequently miss this clue in dermatoscopic images because they tend to focus on the lesion. AIM: To analyse whether perilesional sun damage is a robust diagnostic clue for pAK/BD and if teaching this clue to dermatoscopy users improves their diagnostic accuracy. METHODS: We assessed the interrater agreement and the frequency of perilesional sun damage in 220 dermatoscopic images and conducted a reader study with 124 dermatoscopy users. The readers were randomly assigned to one of two online tutorials; one tutorial pointed to perilesional sun damage as a clue to pAK/BD (group A) the other did not (group B). In both groups, we compared the frequencies of correct diagnoses before and after receiving the tutorial. RESULTS: The frequency of perilesional sun damage was higher in pAK/BD than in other types of pigmented skin lesions and interrater agreement was good (kappa = 0.675). The diagnostic accuracy for pAK/BD improved in both groups of readers (group A: +16.1%, 95%‐CI: 9.5–22.7; group B: +13.1%; 95%‐CI: 7.1–19.0; P for both <0.001), but the overall accuracy improved only in group A from (59.1% (95%‐CI: 55.0–63.1) to 63.5% (95%‐CI: 59.5–67.6); P = 0.002). CONCLUSION: Perilesional sun damage is a good clue to differentiate pAK/BD from other pigmented skin lesions in dermatoscopic images, which could be useful for teledermatology. Knowledge of this clue improves the accuracy of dermatoscopy users, which demonstrates that insights from explainable AI can be used to train humans.
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spelling pubmed-85184042021-10-21 Perilesional sun damage as a diagnostic clue for pigmented actinic keratosis and Bowen’s disease Weber, P. Sinz, C. Rinner, C. Kittler, H. Tschandl, P. J Eur Acad Dermatol Venereol Original Articles and Short Reports Oncology BACKGROUND: Chronic sun damage in the background is common in pigmented actinic keratoses and Bowen’s disease (pAK/BD). While explainable artificial intelligence (AI) demonstrated increased background attention for pAK/BD, humans frequently miss this clue in dermatoscopic images because they tend to focus on the lesion. AIM: To analyse whether perilesional sun damage is a robust diagnostic clue for pAK/BD and if teaching this clue to dermatoscopy users improves their diagnostic accuracy. METHODS: We assessed the interrater agreement and the frequency of perilesional sun damage in 220 dermatoscopic images and conducted a reader study with 124 dermatoscopy users. The readers were randomly assigned to one of two online tutorials; one tutorial pointed to perilesional sun damage as a clue to pAK/BD (group A) the other did not (group B). In both groups, we compared the frequencies of correct diagnoses before and after receiving the tutorial. RESULTS: The frequency of perilesional sun damage was higher in pAK/BD than in other types of pigmented skin lesions and interrater agreement was good (kappa = 0.675). The diagnostic accuracy for pAK/BD improved in both groups of readers (group A: +16.1%, 95%‐CI: 9.5–22.7; group B: +13.1%; 95%‐CI: 7.1–19.0; P for both <0.001), but the overall accuracy improved only in group A from (59.1% (95%‐CI: 55.0–63.1) to 63.5% (95%‐CI: 59.5–67.6); P = 0.002). CONCLUSION: Perilesional sun damage is a good clue to differentiate pAK/BD from other pigmented skin lesions in dermatoscopic images, which could be useful for teledermatology. Knowledge of this clue improves the accuracy of dermatoscopy users, which demonstrates that insights from explainable AI can be used to train humans. John Wiley and Sons Inc. 2021-07-03 2021-10 /pmc/articles/PMC8518404/ /pubmed/34146354 http://dx.doi.org/10.1111/jdv.17464 Text en © 2021 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles and Short Reports Oncology
Weber, P.
Sinz, C.
Rinner, C.
Kittler, H.
Tschandl, P.
Perilesional sun damage as a diagnostic clue for pigmented actinic keratosis and Bowen’s disease
title Perilesional sun damage as a diagnostic clue for pigmented actinic keratosis and Bowen’s disease
title_full Perilesional sun damage as a diagnostic clue for pigmented actinic keratosis and Bowen’s disease
title_fullStr Perilesional sun damage as a diagnostic clue for pigmented actinic keratosis and Bowen’s disease
title_full_unstemmed Perilesional sun damage as a diagnostic clue for pigmented actinic keratosis and Bowen’s disease
title_short Perilesional sun damage as a diagnostic clue for pigmented actinic keratosis and Bowen’s disease
title_sort perilesional sun damage as a diagnostic clue for pigmented actinic keratosis and bowen’s disease
topic Original Articles and Short Reports Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8518404/
https://www.ncbi.nlm.nih.gov/pubmed/34146354
http://dx.doi.org/10.1111/jdv.17464
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