Background Several studies have achieved high-level performance of melanoma detection using convolutional neural networks (CNNs). However, few have described the extent to which the implementation of CNNs improves the diagnostic performance of the physicians. Objective This study is aimed at developing a CNN for detecting acral lentiginous melanoma (ALM) and investigating whether its implementation can improve the initial decision for ALM detection made by the physicians. Methods A CNN was trained using 1072 dermoscopic images of acral benign nevi, ALM and intermediate tumours. To investigate whether the implementation of CNN can improve the initial decision for ALM detection, 60 physicians completed a three-stage survey. In Stage I, they were asked for their decisions solely on the basis of dermoscopic images provided to them. In Stage II, they were also provided with clinical information. In Stage III, they were provided with the additional diagnosis and probability predicted by the CNN. Results The accuracy of ALM detection in the participants was 74.7% (95% confidence interval [CI], 72.6-76.8%) in Stage I and 79.0% (95% CI, 76.7-81.2%) in Stage II. In Stage III, it was 86.9% (95% CI, 85.3-88.4%), which exceeds the accuracy delivered in Stage I by 12.2%p (95% CI, 10.1-14.3%p) and Stage II by 7.9%p (95% CI, 6.0-9.9%p). Moreover, the concordance between the participants considerably increased (Fleiss-j of 0.436 [95% CI, 0.437-0.573] in Stage I, 0.506 [95% CI, 0.621-0.749] in Stage II and 0.684 [95% CI, 0.621-0.749] in Stage III). Conclusions Augmented decision-making improved the performance of and concordance between the clinical decisions of a diverse group of experts. This study demonstrates the potential use of CNNs as an adjoining, decision-supporting system for physicians' decisions.
Skin cancer, previously known to be a common disease in Western countries, is becoming more common in Asian countries. Skin cancer differs from other carcinomas in that it is visible to our eyes. Although skin biopsy is essential for the diagnosis of skin cancer, decisions regarding whether or not to conduct a biopsy are made by an experienced dermatologist. From this perspective, it is easy to obtain and store photos using a smartphone, and artificial intelligence technologies developed to analyze these photos can represent a useful tool to complement the dermatologist's knowledge. In addition, the universal use of dermoscopy, which allows for non-invasive inspection of the upper dermal level of skin lesions with a usual 10-fold magnification, adds to the image storage and analysis techniques, foreshadowing breakthroughs in skin cancer diagnosis. Current problems include the inaccuracy of the available technology and resulting legal liabilities. This paper presents a comprehensive review of the clinical applications of artificial intelligence and a discussion on how it can be implemented in the field of cutaneous oncology.
Arrhythmia is the heartbeat losing its regularity or deviating from its average number. Among the types of arrhythmia is atrial fibrillation (AF) and atrial flutter (AFL), which are considered risk factors for development due to high morbidity and mortality. The early detection of AF/AFL is essential because their effects on the heart or complications appear after a considerable time. Electrocardiography (ECG) is a widely used screening method in primary care because of its low cost and convenience. ECG records the heart's electrical activity for a period of time via electrodes attached to the body. Owing to the development of computing power and interest in big data, attempts at deep learning (DL) have increased. The transformer was proposed by Google in 2017 and has achieved state-of-the-art performance in natural language processing. Various transformer-based models have been applied to various tasks beyond natural language processing and have shown promising prospects. However, there have been few cases of vision transformer (ViT) applications in ECG domain. It was difficult to determine whether ViT had sufficient influence in ECG domain. This study determined whether our extensive ECG dataset could make an AF/AFL diagnosis. We also confirmed whether the recently proposed ViT has AF/AFL diagnostic power.
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