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一款基于机器学习的、用于诊断常见皮肤病的决策支持手机应用程序。

A machine learning-based, decision support, mobile phone application for diagnosis of common dermatological diseases.

作者信息

Pangti R, Mathur J, Chouhan V, Kumar S, Rajput L, Shah S, Gupta A, Dixit A, Dholakia D, Gupta S, Gupta S, George M, Sharma V K, Gupta S

机构信息

Department of Dermatology and Venereology, All India Institute of Medical Science, New Delhi, India.

Nurithm Labs Private Limited, Noida, India.

出版信息

J Eur Acad Dermatol Venereol. 2021 Feb;35(2):536-545. doi: 10.1111/jdv.16967. Epub 2020 Nov 12.

Abstract

BACKGROUND

The integration of machine learning algorithms in decision support tools for physicians is gaining popularity. These tools can tackle the disparities in healthcare access as the technology can be implemented on smartphones. We present the first, large-scale study on patients with skin of colour, in which the feasibility of a novel mobile health application (mHealth app) was investigated in actual clinical workflows.

OBJECTIVE

To develop a mHealth app to diagnose 40 common skin diseases and test it in clinical settings.

METHODS

A convolutional neural network-based algorithm was trained with clinical images of 40 skin diseases. A smartphone app was generated and validated on 5014 patients, attending rural and urban outpatient dermatology departments in India. The results of this mHealth app were compared against the dermatologists' diagnoses.

RESULTS

The machine-learning model, in an in silico validation study, demonstrated an overall top-1 accuracy of 76.93 ± 0.88% and mean area-under-curve of 0.95 ± 0.02 on a set of clinical images. In the clinical study, on patients with skin of colour, the app achieved an overall top-1 accuracy of 75.07% (95% CI = 73.75-76.36), top-3 accuracy of 89.62% (95% CI = 88.67-90.52) and mean area-under-curve of 0.90 ± 0.07.

CONCLUSION

This study underscores the utility of artificial intelligence-driven smartphone applications as a point-of-care, clinical decision support tool for dermatological diagnosis for a wide spectrum of skin diseases in patients of the skin of colour.

摘要

背景

机器学习算法在医生决策支持工具中的整合越来越受欢迎。这些工具可以解决医疗保健获取方面的差异,因为该技术可以在智能手机上实施。我们开展了第一项针对有色人种皮肤患者的大规模研究,其中在实际临床工作流程中研究了一种新型移动健康应用程序(移动健康应用)的可行性。

目的

开发一款移动健康应用程序,以诊断40种常见皮肤病,并在临床环境中进行测试。

方法

使用40种皮肤病的临床图像训练基于卷积神经网络的算法。生成了一款智能手机应用程序,并在印度农村和城市门诊皮肤科就诊的5014名患者身上进行了验证。将该移动健康应用程序的结果与皮肤科医生的诊断结果进行比较。

结果

在一项计算机模拟验证研究中,机器学习模型在一组临床图像上的总体top-1准确率为76.93±0.88%、平均曲线下面积为0.95±0.02。在针对有色人种皮肤患者的临床研究中,该应用程序的总体top-1准确率为75.07%(95%CI=73.75-76.36),top-3准确率为89.62%(95%CI=88.67-90.52),平均曲线下面积为0.90±0.07。

结论

本研究强调了人工智能驱动的智能手机应用程序作为一种即时医疗临床决策支持工具,用于诊断有色人种皮肤患者广泛的皮肤病的实用性。

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