A deep learning system for differential diagnosis of skin diseases

被引:482
作者
Liu, Yuan [1 ]
Jain, Ayush [1 ]
Eng, Clara [1 ]
Way, David H. [1 ]
Lee, Kang [1 ]
Bui, Peggy [1 ,2 ]
Kanada, Kimberly [3 ]
de Oliveira Marinho, Guilherme [4 ]
Gallegos, Jessica [1 ]
Gabriele, Sara [1 ]
Gupta, Vishakha [1 ]
Singh, Nalini [1 ,5 ]
Natarajan, Vivek [1 ]
Hofmann-Wellenhof, Rainer [6 ]
Corrado, Greg S. [1 ]
Peng, Lily H. [1 ]
Webster, Dale R. [1 ]
Ai, Dennis [1 ]
Huang, Susan J. [3 ]
Liu, Yun [1 ]
Dunn, R. Carter [1 ]
Coz, David [1 ]
机构
[1] Google Hlth, Palo Alto, CA USA
[2] Univ Calif San Francisco, San Francisco, CA 94143 USA
[3] Adv Clin, Deerfield, IL USA
[4] Adecco Staffing, Santa Clara, CA USA
[5] MIT, 77 Massachusetts Ave, Cambridge, MA 02139 USA
[6] Med Univ Graz, Graz, Austria
关键词
PRIMARY-CARE; GLOBAL BURDEN; IMAGE CLASSIFICATION; DERMATOLOGY; PRACTITIONERS; PREVALENCE; CANCER; UPDATE;
D O I
10.1038/s41591-020-0842-3
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
070307 [化学生物学]; 071010 [生物化学与分子生物学];
摘要
A deep learning system able to identify the most common skin conditions may help clinicians in making more accurate diagnoses in routine clinical practice 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.
引用
收藏
页码:900 / +
页数:14
相关论文
共 54 条
[1]
*AG HEALTHC RES QU, 2012, DISTR US PRIM CAR WO
[2]
Cruz-Roa AA, 2013, LECT NOTES COMPUT SC, V8150, P403, DOI 10.1007/978-3-642-40763-5_50
[3]
Awadalla F, 2008, FAM MED, V40, P507
[4]
Comparative Accuracy of Diagnosis by Collective Intelligence of Multiple Physicians vs Individual Physicians [J].
Barnett, Michael L. ;
Boddupalli, Dhruv ;
Nundy, Shantanu ;
Bates, David W. .
JAMA NETWORK OPEN, 2019, 2 (03) :e190096
[5]
Www.derm101.com:: A growing online resource for learning dermatology and dermatopathology [J].
Boeer, Almut ;
Nischal, K. C. .
INDIAN JOURNAL OF DERMATOLOGY VENEREOLOGY & LEPROLOGY, 2007, 73 (02) :138-140
[6]
Deep learning outperformed 136 of 157 dermatologists in a head-to-head dermoscopic melanoma image classification task [J].
Brinker, Titus J. ;
Hekler, Achim ;
Enk, Alexander H. ;
Klode, Joachim ;
Hauschild, Axel ;
Berking, Carola ;
Schilling, Bastian ;
Haferkamp, Sebastian ;
Schadendorf, Dirk ;
Holland-Letz, Tim ;
Utikal, Jochen S. ;
von Kalle, Christof .
EUROPEAN JOURNAL OF CANCER, 2019, 113 :47-54
[7]
Chihara L., 2011, Mathematical Statistics with Resampling and R, DOI DOI 10.1002/9781119505969
[8]
Codella Noel C. F., Skin Lesion Analysis toward Melanoma Detection: A Challenge at the 2017 International Symposium on Biomedical Imaging (Isbi), Hosted by the International Skin Imaging Collaboration (Isic), P168
[9]
Collins GS, 2015, ANN INTERN MED, V162, P55, DOI [10.1111/eci.12376, 10.7326/M14-0698, 10.1038/bjc.2014.639, 10.1186/s12916-014-0241-z, 10.7326/M14-0697, 10.1016/j.jclinepi.2014.11.010, 10.1016/j.eururo.2014.11.025, 10.1136/bmj.g7594, 10.1002/bjs.9736]
[10]
Dermatological image search engines on the Internet: do they work? [J].
Cutrone, M. ;
Grimalt, R. .
JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY, 2007, 21 (02) :175-177