Venkatesh Kaushik P, Raza Marium, Kvedar Joseph
Harvard Medical School, Boston, MA, USA.
NPJ Digit Med. 2023 Aug 15;6(1):147. doi: 10.1038/s41746-023-00900-0.
Gregoor et al. evaluated the healthcare implications and costs of an AI-enabled mobile health app for skin cancer detection, involving 18,960 beneficiaries of a Netherlands insurer. They report a 32% increase in claims for premalignant and malignant skin lesions among app users, largely attributed to benign skin lesions and leading to higher annual costs for app users (€64.97) compared to controls (€43.09). Cost-effectiveness analysis showed a comparable cost to dermatologist-based diagnosis alone. This editorial emphasizes the balance in AI-based dermatology between increased access and increased false positives resulting in overutilization. We suggest refining the diagnostic schemas with new referral pathways to capitalize on potential savings. We also discuss the importance of econometric analysis to evaluate the adoption of new technologies, as well as adapting payment models to mitigate the risk of overutilization inherent in AI-based diagnostics such as skin cancer detection.
格雷戈尔等人评估了一款用于皮肤癌检测的人工智能移动健康应用程序对医疗保健的影响和成本，该研究涉及一家荷兰保险公司的18960名受益人。他们报告称，应用程序用户中癌前和恶性皮肤病变的索赔增加了32%，这主要归因于良性皮肤病变，与对照组（43.09欧元）相比，应用程序用户的年度成本更高（64.97欧元）。成本效益分析表明，其成本与仅基于皮肤科医生的诊断相当。这篇社论强调了在基于人工智能的皮肤病学中，增加可及性与增加假阳性导致过度使用之间的平衡。我们建议通过新的转诊途径完善诊断模式，以利用潜在的节省。我们还讨论了计量经济学分析对于评估新技术采用情况的重要性，以及调整支付模式以降低基于人工智能的诊断（如皮肤癌检测）中固有的过度使用风险的重要性。
