Fig 1.
Patient flow for clinical images taken by primary care physicians and possible outcomes and suggested management.
If the lesion was suspected to be benign, the management suggested it is to reassess the lesion in 12 months. If the lesion was suspected to be malignant, the management would depend if the PCP had access to the dermoscopy image. If yes, the image would be sent to a dermatologist (Teledermoscopy). If not, the PCP would have to send the patient for in-person dermoscopy.
Fig 2.
CAD system pathways developed to provide outputs for clinical and dermoscopy images to primary care physicians.
Table 1.
General view of clinical and dermoscopic algorithms development.
Fig 3.
Possible clinical and dermoscopy algorithms outputs and suggested care for each scenario: The second tab was entitled: “Understanding the Heat Map”, with a brief explanation on how to interpret the Heat Map.
The third tab has a short text about how uncertainty is inherent to AI algorithms and the fourth and last tab “Who we are” describes the multidisciplinary work group that developed the algorithm. More information about these tabs can be found in S2 File.
Fig 4.
Receiver Operating Characteristic Curve (ROC) for clinical and dermoscopic images algorithms.
Graphics on the right represent the same curves as the left, with zoomed in at the top left.
Table 2.
Performance of the algorithms in validation and in test steps.