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Nat Med ; 26(6): 900-908, 2020 06.
Article in English | MEDLINE | ID: mdl-32424212

ABSTRACT

Skin conditions affect 1.9 billion people. Because of a shortage of dermatologists, most cases are seen instead by general practitioners with lower diagnostic accuracy. We present a deep learning system (DLS) to provide a differential diagnosis of skin conditions using 16,114 de-identified cases (photographs and clinical data) from a teledermatology practice serving 17 sites. The DLS distinguishes between 26 common skin conditions, representing 80% of cases seen in primary care, while also providing a secondary prediction covering 419 skin conditions. On 963 validation cases, where a rotating panel of three board-certified dermatologists defined the reference standard, the DLS was non-inferior to six other dermatologists and superior to six primary care physicians (PCPs) and six nurse practitioners (NPs) (top-1 accuracy: 0.66 DLS, 0.63 dermatologists, 0.44 PCPs and 0.40 NPs). These results highlight the potential of the DLS to assist general practitioners in diagnosing skin conditions.


Subject(s)
Deep Learning , Diagnosis, Differential , Skin Diseases/diagnosis , Acne Vulgaris/diagnosis , Adult , Black or African American , Asian , Carcinoma, Basal Cell/diagnosis , Carcinoma, Squamous Cell/diagnosis , Dermatitis, Seborrheic/diagnosis , Dermatologists , Eczema/diagnosis , Female , Folliculitis/diagnosis , Hispanic or Latino , Humans , Indians, North American , Keratosis, Seborrheic/diagnosis , Male , Melanoma/diagnosis , Middle Aged , Native Hawaiian or Other Pacific Islander , Nurse Practitioners , Photography , Physicians, Primary Care , Psoriasis/diagnosis , Skin Neoplasms/diagnosis , Telemedicine , Warts/diagnosis , White People
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