Browsing by Author "Podlipnik, Sebastian"

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    Dermatologist-like explainable AI enhances trust and confidence in diagnosing melanoma
    (2024) Chanda, Tirtha; Hauser, Katja; Hobelsberger, Sarah; Bucher, Tabea-Clara; Garcia, Carina Nogueira; Wies, Christoph; Kittler, Harald; Tschandl, Philipp; Navarrete-Dechent, Cristian; Podlipnik, Sebastian; Chousakos, Emmanouil; Crnaric, Iva; Majstorovic, Jovana; Alhajwan, Linda; Foreman, Tanya; Peternel, Sandra; Sarap, Sergei; Ozdemir, Irem; Barnhill, Raymond L.; Llamas-Velasco, Mar; Poch, Gabriela; Korsing, Soeren; Sondermann, Wiebke; Gellrich, Frank Friedrich; Heppt, Markus V.; Erdmann, Michael; Haferkamp, Sebastian; Drexler, Konstantin; Goebeler, Matthias; Schilling, Bastian; Utikal, Jochen S.; Ghoreschi, Kamran; Froehling, Stefan; Krieghoff-Henning, Eva; Brinker, Titus J.
    Artificial intelligence (AI) systems have been shown to help dermatologists diagnose melanoma more accurately, however they lack transparency, hindering user acceptance. Explainable AI (XAI) methods can help to increase transparency, yet often lack precise, domain-specific explanations. Moreover, the impact of XAI methods on dermatologists' decisions has not yet been evaluated. Building upon previous research, we introduce an XAI system that provides precise and domain-specific explanations alongside its differential diagnoses of melanomas and nevi. Through a three-phase study, we assess its impact on dermatologists' diagnostic accuracy, diagnostic confidence, and trust in the XAI-support. Our results show strong alignment between XAI and dermatologist explanations. We also show that dermatologists' confidence in their diagnoses, and their trust in the support system significantly increase with XAI compared to conventional AI. This study highlights dermatologists' willingness to adopt such XAI systems, promoting future use in the clinic.
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    Position statement of the EADV Artificial Intelligence (AI) Task Force on AI-assisted smartphone apps and web-based services for skin disease
    (2024) Sangers, Tobias E.; Kittler, Harald; Blum, Andreas; Braun, Ralph P.; Barata, Catarina; Cartocci, Alessandra; Combalia, Marc; Esdaile, Ben; Guitera, Pascale; Haenssle, Holger A.; Kvorning, Niels; Lallas, Aimilios; Navarrete-Dechent, Cristian; Navarini, Alexander A.; Podlipnik, Sebastian; Rotemberg, Veronica; Soyer, H. Peter; Tognetti, Linda; Tschandl, Philipp; Malvehy, Josep
    Background: As the use of smartphones continues to surge globally, mobile applications (apps) have become a powerful tool for healthcare engagement. Prominent among these are dermatology apps powered by Artificial Intelligence (AI), which provide immediate diagnostic guidance and educational resources for skin diseases, including skin cancer.Objective: This article, authored by the EADV AI Task Force, seeks to offer insights and recommendations for the present and future deployment of AI-assisted smartphone applications (apps) and web-based services for skin diseases with emphasis on skin cancer detection.Methods: An initial position statement was drafted on a comprehensive literature review, which was subsequently refined through two rounds of digital discussions and meticulous feedback by the EADV AI Task Force, ensuring its accuracy, clarity and relevance.Results: Eight key considerations were identified, including risks associated with inaccuracy and improper user education, a decline in professional skills, the influence of non-medical commercial interests, data security, direct and indirect costs, regulatory approval and the necessity of multidisciplinary implementation. Following these considerations, three main recommendations were formulated: (1) to ensure user trust, app developers should prioritize transparency in data quality, accuracy, intended use, privacy and costs; (2) Apps and web-based services should ensure a uniform user experience for diverse groups of patients; (3) European authorities should adopt a rigorous and consistent regulatory framework for dermatology apps to ensure their safety and accuracy for users.Conclusions: The utilisation of AI-assisted smartphone apps and web-based services in diagnosing and treating skin diseases has the potential to greatly benefit patients in their dermatology journeys. By prioritising innovation, fostering collaboration and implementing effective regulations, we can ensure the successful integration of these apps into clinical practice.
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    Predictive and Prognostic Factors in Melanoma Central Nervous System Metastases-A Cohort Study
    (2024) Serra, Estefania; Abarzua-Araya, Alvaro; Arance, Ana; Martin-Huertas, Roberto; Aya, Francisco; Olondo, Maria Lourdes; Rizo-Potau, Daniel; Malvehy, Josep; Puig, Susana; Carrera, Cristina; Podlipnik, Sebastian
    Simple Summary We conducted a study at the Melanoma Unit of the Hospital Clinic of Barcelona to investigate brain metastases in patients with cutaneous melanoma. We collected data from patients diagnosed between January 1998 and September 2023. Patients with melanoma in situ or those with prior lung or breast cancer were excluded. Our aim was to identify factors associated with the development and survival outcomes of brain metastases. We analyzed patient demographics, tumor characteristics, and survival data. The diagnosis of brain metastases was confirmed using imaging techniques, and biopsies were performed when feasible. Our study followed strict guidelines for reporting observational studies. We found that younger age and larger primary tumor thickness increased the risk of developing brain metastases. Additionally, the presence of ulceration and microscopic satellitosis in the primary tumor were associated with a higher risk. Melanomas located on the trunk had a higher risk compared to those on the extremities. Patients with brain metastases had a median survival of around six months. Neurological symptoms and leptomeningeal involvement were associated with poorer survival outcomes. Higher number of brain lesions and elevated levels of lactate dehydrogenase (LDH) also predicted worse survival. Our findings highlight the importance of early detection and monitoring of melanoma patients, especially those at higher risk of brain metastases. Understanding these factors can aid in personalized treatment approaches and improving patient outcomes.Abstract Background: Melanoma is the cancer with the highest risk of dissemination to the central nervous system (CNS), one of the leading causes of mortality from this cancer. Objective: To identify patients at higher risk of developing CNS metastases and to evaluate associated prognostic factors. Methods: A cohort study (1998-2023) assessed patients who developed CNS melanoma metastases. Multivariate logistic regression was used to identify predictive factors at melanoma diagnosis for CNS metastasis. Cox regression analysis evaluated the CNS-independent metastasis-related variables impacting survival. Results: Out of 4718 patients, 380 (8.05%) developed CNS metastases. Multivariate logistic regression showed that a higher Breslow index, mitotic rate >= 1 mm2, ulceration, and microscopic satellitosis were significant risk factors for CNS metastasis development. Higher patient age and the location of the primary tumor in the upper or lower extremities were protective factors. In survival analysis, post-CNS metastasis, symptomatic disease, prior non-CNS metastases, CNS debut with multiple metastases, elevated LDH levels, and leptomeningeal involvement correlated with poorer survival. Conclusion: Predictive factors in the primary tumor independently associated with brain metastases include microscopic satellitosis, ulceration, higher Breslow index, and trunk location. Prognostic factors for lower survival in CNS disease include symptomatic disease, multiple CNS metastases, and previous metastases from different sites.