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Exploring the feasibility of an artificial intelligence based clinical decision support system for cutaneous melanoma detection in primary care – a mixed method study.
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- Author(s): Helenason, Jonatan (AUTHOR); Ekström, Christoffer (AUTHOR); Falk, Magnus (AUTHOR); Papachristou, Panagiotis (AUTHOR)
- Source:
Scandinavian Journal of Primary Health Care. Mar2024, Vol. 42 Issue 1, p51-60. 10p. - Source:
- Additional Information
- Subject Terms: ARTIFICIAL intelligence tests; MELANOMA treatment; PILOT projects; USER-centered system design; COMPUTER simulation; WORK experience (Employment); CLINICAL decision support systems; ATTITUDES of medical personnel; RESEARCH methodology; INTERVIEWING; PRIMARY health care; SURVEYS; SKIN tumors; DESCRIPTIVE statistics; DERMOSCOPY; THEMATIC analysis; COMPUTER-assisted image analysis (Medicine); DECISION making in clinical medicine; TRUST; TELEMEDICINE
- Abstract: Objective: Skin examination to detect cutaneous melanomas is commonly performed in primary care. In recent years, clinical decision support systems (CDSS) based on artificial intelligence (AI) have been introduced within several diagnostic fields. Setting: This study employs a variety of qualitative and quantitative methodologies to investigate the feasibility of an AI-based CDSS to detect cutaneous melanoma in primary care. Subjects and Design: Fifteen primary care physicians (PCPs) underwent near-live simulations using the CDSS on a simulated patient, and subsequent individual semi-structured interviews were explored with a hybrid thematic analysis approach. Additionally, twenty-five PCPs performed a reader study (diagnostic assessment on the basis of image interpretation) of 18 dermoscopic images, both with and without help from AI, investigating the value of adding AI support to a PCPs decision. Perceived instrument usability was rated on the System Usability Scale (SUS). Results: From the interviews, the importance of trust in the CDSS emerged as a central concern. Scientific evidence supporting sufficient diagnostic accuracy of the CDSS was expressed as an important factor that could increase trust. Access to AI decision support when evaluating dermoscopic images proved valuable as it formally increased the physician's diagnostic accuracy. A mean SUS score of 84.8, corresponding to 'good' usability, was measured. Conclusion: AI-based CDSS might play an important future role in cutaneous melanoma diagnostics, provided sufficient evidence of diagnostic accuracy and usability supporting its trustworthiness among the users. Effective primary care is important for discovering cutaneous melanoma, the deadliest and an increasingly prevalent form of skin cancer. 'Trust', 'usability and user experience', and 'the clinical context' are the qualitative themes that emerged from the qualitative analysis. These areas need to be considered for the successful adoption of AI assisted decision support tools by PCPs. The AI CDSS tool was rated by the PCPs at grade B (average 84.8) on the System Usability Scale (SUS), which is equivalent to 'good' usability. A reader study, (diagnostic assessment on the basis of image interpretation) with 25 PCPs rating dermoscopic images, showed increased value of adding an AI decision support to their clinical assessment. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Scandinavian Journal of Primary Health Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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