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AI used for skin cancer checks at London hospital
- xenospn 1y agoWhy go to the hospital at all? Just take the photo at home.
- harvey9 1y agoArticle says medical photographers take the pictures. I'd guess a future iteration will have the app direct the patient to take the pictures.
- onename 1y agoI assume if you get a positive response you will want to speak with doctor about it
- zamadatix 1y agoIf the thermometer says 39 C/102 F I will want to speak with a doctor about it but that doesn't mean I want to go to the hospital every time I want my temperature checked. I suspect it has a lot more to do with these lines: > medical photographers taking photos of suspicious moles and lesions I.e. it might not be ready enough or validated for an average person snapping their own photo and: > The images are then transferred to a desktop computer for greater analysis before the tool determines the result There is more to it than the phone app and it may not be packaged in a way that is currently worthwhile to distribute to home users. Both of these (and other things) may change with time of course.
- charleshn 1y agoAs someone with a phenotype more subject to skin cancer, I have been using an app called SkinVision for years. From my anecdotal experience it tends to flag the same moles as dermatologists do, and they have actual dermatologists review images where the model has low confidence, so overall pretty happy with it. Note that I am not affiliated with them in any way.
- shermantanktop 1y agoLooks like it’s not available in the US unfortunately.
- asdefghyk 1y agoInteresting information snipped from their website .... I'm in Australia so will try it out. Yes specifically says its not available in US About SkinVision SkinVision was founded in 2012 and provides a mobile phone application, which supports individuals with the early detection of the most common forms of skin cancer (melanoma, squamous cell carcinoma, basal cell carcinoma, and precancerous actinic keratosis). SkinVision is the first CE marked skin cancer application based on extensive clinical trials, conducted in partnership with Erasmus Medical Center (EMC) and the university clinic of Ludwig Maximilian University (LMU). Research shows the app has a sensitivity of 95% and a specificity of 78%. The SkinVision app is commercially available worldwide on iOS and Android except for a few countries, such as the United States and Canada. SkinVision is based in Amsterdam, the Netherlands. The SkinVision Service is a Medical Device and is registered with the Australian Therapeutic Goods Administration (TGA).
- ajb 1y agoBecause you don't know what the lighting is, what the sensor is, and what kind of shit the camera app and ISP are doing to the image without telling you I recently tried to show some images to a vet. Something in my phone fucked up the amount of red in the image, making them useless (guess what, figuring out how much blood is present is pretty important for medical applications) Probably at some point we will all have a separate medical camera with specified response and with a specified led illuminator. Apple will probably get their phone certified in some medical camera mode. Right now I don't think phone cameras can be trusted Not all applications need accurate colour, (no idea about cancer checks) but some really do.
- darrenf 1y ago4 years ago I had my partner take photos of moles that had changed colour on my back. I used the MySkinDoctor app https://www.myskindoctor.co.uk/ https://www.myskindoctor.co.uk/ to send them to my consultant dermatologist (who, at the time, I had never met -- having just moved to a new area). Upon review they arranged for an in-person appointment and I was seen within a week or so. All through the NHS. So yes, taking the photo at home is perfectly doable. I still went to hospital though.
- graemep 1y agoI develop the backend for that. Nice to hear it worked well for you.
- ipsum2 1y agoGoogle announced this in 2021, but never released it AFAICT: https://blog.google/technology/health/ai-dermatology-preview-io-2021/ https://blog.google/technology/health/ai-dermatology-preview...
- stubish 1y agoOne of the problems with these sorts of machine learning applications, including this exact use case elsewhere, is that they have been extremely sensitive to the imaging equipment used. Train it on a dataset of images from one source and it is only accurate on images from that source. Possibly only accurate on images from the exact same device. For home use, it needs a huge training set of images taken by all sorts of devices in all sorts of lighting conditions. And then the system will need to be improved until the error rates become useful.
- instagib 1y agoCertain skin cancer detection methods necessitate direct contact with the affected area to identify any abnormalities.
- floppydiscen 1y agoThis would be such a beautiful use of AI
- ProllyInfamous 1y agoI last heard it's a pretty darn helpful tool, from a radiologist acquaintence/undergrad friend (who works from home in USA).
- amarcheschi 1y agoI'm attending a course with some goat professors, that aim to teach this kind of things. Chances are, given it's a small course you won't produce anything of real value, but the aim should be to analyze 3 datasets from 3 different neurodegenerative diseases, find some common markers and eventually make a ml model to better diagnose people with these diseases. It's not exactly easy, but given it's a real world problem it's extremely motivating (we've been also allowed to use a university vm with 3tb of ram and that's nice)
- andy99 1y agoNo, it's a horrible use, relying on something entirely unreliable to make medical diagnoses. All the AI safety people who pretend to worry about killer robots or whatever should actually be up in arms about these kind of uses, but you can see where actual priorities lie. The best use of AI in medicine would be to automate away administrative bloat to let people get proper medical care.
- jxjnskkzxxhx 1y agoWhat if it was really reliable? Would you still be against it?
- andy99 1y agoThe question doesn't make sense imo because it, meaning neural network or other ML computer vision classification, doesn't have a mechanism to be trustworthy. It's just looking for shortcuts with predictive power, it's not reasoning, doesn't have a world model, it's just an equation that mostly works, etc, all the stuff we know about ML. It's not just about validation set performance, you could change the lighting or some camera feature or something, have some unusual mole shape, and suddenly get completely different performance. It can't be "trusted" the way a person can, even if they are less accurate. These limitations are often acceptable but I think as long as it works how it does, denying someone a person looking at them in favor of a statistical stereotype should be the last thing we do. I can see if this was in a third world country and the alternative was nothing, but in the developed world the alternative is less profit or fewer administrators. We should strongly reject outsourcing the actual medical care part of healthcare to AI as an efficiency measure.
- andy99 1y ago99% accuracy in diagnosing benign case This is meaningless. The only thing that matters in this kind of application is false negative rate at some acceptable false positive rate. I assume whoever is working on this knows that, so this is mostly a criticism of the article. That said, this is a horrible use of AI.
- greazy 1y agoI went searching for more. The tool is called DERM by Skin Analytics. They have more info on stats: https://skin-analytics.com/ai-pathways/derm-performance/ https://skin-analytics.com/ai-pathways/derm-performance/ A few peer reviewed pubs down the bottom of the page
- frereubu 1y agoWhat do you mean by this being a "horrible" use of AI? (Although as another commenter has mentioned, this should more properly be called ML).
- jampekka 1y agoIt's quite easy to correctly classify 100% of benign cases as benign.
- cmcaleer 1y agoIf it's so easy, then why do people die from having lesions misdiagnosed as benign? Even if the success rate of the human eye was in the 99.5%+ range, why not have an extra sanity check from an AI model?
- dijksterhuis 1y ago> If it's so easy, then why do people die from having lesions misdiagnosed as benign? You're confusing False Negatives with True Negatives. For Non-Benign (Positive) vs. Benign (Negative) classification: * True Positive Rate (TPR): non-benign classified as non-benign. * False Positive Rate (FPR): benign misclassified as non-benign. * True Negative Rate (TNR): benign classified as benign. * False Negative Rate (FNR): non-benign misclassified as benign. > It's quite easy to correctly classify 100% of benign cases as benign. You can engineer a 100% TNR if you just classify everything as the "benign" negative class. The FNR is going to be 100% too, but that doesn't matter -- you correctly classified 100% of benign cases as benign. > why do people die from having lesions misdiagnosed as benign? Because the FNR is not 0%. FNR is important. You probably want a decent TPR in there as well. And FPR can be very important too, depending on how life-changing/painful/invasive the treatment for a positive case is!
- greazy 1y agoThis is ML. I guess AI term can apply here but I think it's a bit disingenuous to advertise as such. People will conflate the term with llm chat bots. https://skin-analytics.com/wp-content/uploads/2024/06/Artificial-intelligence-in-cutaneous-lesions-where-do-we-stand-and-what-is-next.pdf https://skin-analytics.com/wp-content/uploads/2024/06/Artifi...
- verst 1y agoWhat is AI to you? Neural nets only? LLMs? I still have my textbook from almost 20 years ago: "Artificial Intelligence: A modern" by Peter Norvig. Lots of topics covered as AI there that surely do not meet your definition.
- consp 1y agoAI is buzzword bingo and has been since introduced to computing in the 60's. Just clasify the method used as what it is to a supposedly educated crowd. There is no need to classify a marketing term. And yes, for that book it's also just marketing.
- greazy 1y agoAgreed, AI is a marketing term. Use the underlying methods and technology.
- greazy 1y agoI've relented, I accept now that AI is an umbrella term to represent many different methods, algorithms and technologies. Modern day usage of AI is heavily conflated with generative AI such as LLMs and Text-to-* generation systems. My preference, as someone who works in a very closely relate field to the article, is that science should stay away from non-specific terms like AI. I've had my director approach me seeking grant ideas on using AI. It didn't go down very well when I suggested we should try to use image recognition to automate data entry. That seemed 'old', they wanted a chat bot to do... something.
- ircshotty 1y agoAnecdotally, when I had a potential skin cancer checked at a London hospital they were completely ill-prepared. When I came back to Australia, it was checked and immediately removed as an obvious melanoma. Perhaps the idea of Comparative Advantage also applies to healthcare between countries with natural variances to types of disease?
- frereubu 1y agoBeing a pasty Brit, going to Australia was a real eye opener in how much more on the ball they were about skin cancer, not just in medical terms but culturally. We're getting better here (I was there more than a decade ago) but it's still seen as quite amusing when people get sunburnt here.
- femto 1y agoAwareness started in the 1980s in Australia with Sid the Seagull: https://www.youtube.com/watch?v=tGgn5nwYtj0 https://www.youtube.com/watch?v=tGgn5nwYtj0 https://www.abc.net.au/btn/classroom/sun-safety-campaign/103147456 https://www.abc.net.au/btn/classroom/sun-safety-campaign/103...
- qq66 1y agoSadly, a friend of mine died from this type of problem. He traveled from Ghana to Jordan and fell ill in Jordan, the Jordanian doctors didn't diagnose it as malaria in time to save him because Jordan doesn't have malaria. I'm sure it would have been obvious to a Ghanaian doctor.
- Scoundreller 1y agoFriend did a lot of work in Africa. Got back to the US and starts getting symptomatic and says to himself “I think I got malaria”. Goes to the biggest university hospital nearby he can find. Was initially dismissed but waited it out for the infectious diseases specialist and they quickly agreed with his self-diagnosis. They kept them in hospital for a few days so a parade of clinical students/residents could come by for the specialist to say: “this man has malaria”
- timewizard 1y ago> The hospital gets about 7,000 urgent skin cancer referrals each year, but only 5% turn out to be cancer. It seems to be that you could be doing a _much_ better job of filtering this pipeline before it gets to this point. How can so many _urgent_ cases end up being negative? They're using AI to solve a problem that probably shouldn't exist.
- RobinL 1y agoThe referral is just because a non expert can't be sure. The cost of the referral is relatively small, but the cost of getting it wrong is large. Someone I know recently had a referral - it's pretty light touch, you just get a prompt appointment, and they do a minor op to remove the mole, and send it to the lab for testing. Luckily in their case, it wasn't cancer. But nothing in the process seemed weird, it was just the way of the GP escalating it because they couldn't be sure. Hypothetically, if the AI had been able to diagnose with higher certainty than the GP, all of this could have been avoided, so definitely room for improvement.
- alistairSH 1y agoDo all cases in the UK start with a GP? No ability to go straight to a dermatologist? And are all dermatologists based out of hospitals? In the US, we'd just go straight to a dermatologist, who would either remove it on the spot, or for a location that's liable to scar badly, refer to a specialist surgeon. For somebody fair skinned with lots of sun damage like myself, it's an annual "ritual".
- mattlondon 1y agoMost UK health stuff starts with a GP appointment. Even for private health care, you usually see a GP first (could be a private GP or NHS, in-person or video) and they then refer you to the next thing whatever that may be. ( N.B. that a NHS GP can give you a referral that you use for private treatment) There are some things you can just straight up book an appointment for yourself without a referral from a GP, but 95% of the time you start with a GP. No idea specifically about dermatologists, but my expectation would be that would be the sort of thing that would need a referral for. Perhaps for some "non-medical" procedures and 100% for cosmetic procedures you don't need a referral, but anything even tangentially close to The C Word would almost certainly be sending you down the normal channels.
- rplnt 1y agoThis doesn't seem like nothing new? I remember a talk about this being done some 12+ years ago. Just without the AI label to generate hype.
- Legend2440 1y agoThere has been talk about this pretty much since CNNs got good at object recognition ~2012. But healthcare is a rather conservative industry (for good reason) so it has taken a while to build confidence in the technology and get regulatory approval.
- osn9363739 1y agoYeah - I don't recall which company (maybe johnson & johnson) it was but my aunt worked for one that produced a portable machine that used a camera to check moles and used some sort of algorithm to give a predicted score. This was 20ish years ago. I remember she brought it to my grandparents and we had fun checking everyones moles for the day.
- madduci 1y agoThis reminds me of Machine Learning techniques being used at the Policlinico of Bari in collaboration with the Politecnico of Bari, detective cancer, more than 10 years ago
- lamename 1y ago> "At the moment that technology is limited because you need a dermoscopic lens which the public wouldn't necessarily have access to, but I'm sure with time the technology will advance and we will have effective apps that patients can access from the comfort of their own home."