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Vidal NY. Commentary on "Artificial Intelligence in Dermatology: A Systematic Review of Its Applications in Melanoma and Keratinocyte Carcinoma Diagnosis" and "Artificial Intelligence for Mohs and Dermatologic Surgery: A Systematic Review and Meta-Analysis". Dermatol Surg 2024; 50:807-808. [PMID: 39159392 DOI: 10.1097/dss.0000000000004380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2024]
Affiliation(s)
- Nahid Y Vidal
- Division of Dermatologic Surgery, Department of Dermatology, Mayo Clinic, Rochester, Minnesota
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Mirza FN, Haq Z, Abdi P, Diaz MJ, Libby TJ. Artificial Intelligence for Mohs and Dermatologic Surgery: A Systematic Review and Meta-Analysis. Dermatol Surg 2024; 50:799-806. [PMID: 38991503 DOI: 10.1097/dss.0000000000004297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
BACKGROUND Over the past decade, several studies have shown that potential of artificial intelligence (AI) in dermatology. However, there has yet to be a systematic review evaluating the usage of AI specifically within the field of Mohs micrographic surgery (MMS). OBJECTIVE In this review, we aimed to comprehensively evaluate the current state, efficacy, and future implications of AI when applied to MMS for the treatment of nonmelanoma skin cancers (NMSC). MATERIALS AND METHODS A systematic review and meta-analysis was conducted following PRISMA guidelines across several databases, including PubMed/MEDLINE, Embase, and Cochrane libraries. A predefined protocol was registered in PROSPERO, with literature search involving specific keywords related to AI and Mohs surgery for NMSC. RESULTS From 23 studies evaluated, our results find that AI shows promise as a prediction tool for precisely identifying NMSC in tissue sections during MMS. Furthermore, high AUC and concordance values were also found across the various usages of AI in MMS, including margin control, surgical recommendations, similarity metrics, and in the prediction of stage and construction complexity. CONCLUSION The findings of this review suggest promising potential for AI to enhance the accuracy and efficiency of Mohs surgery, particularly for NMSC.
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Affiliation(s)
- Fatima N Mirza
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Zaim Haq
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Parsa Abdi
- Memorial University of Newfoundland, Faculty of Medicine, St. Johns, Newfoundland & Labrador, Canada ; and
| | - Michael J Diaz
- University of Florida, College of Medicine, Gainesville, Florida
| | - Tiffany J Libby
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island
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Trager MH, Gordon ER, Breneman A, Weng C, Samie FH. Artificial intelligence for nonmelanoma skin cancer. Clin Dermatol 2024:S0738-081X(24)00100-7. [PMID: 38925444 DOI: 10.1016/j.clindermatol.2024.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
Nonmelanoma skin cancers (NMSCs) are among the top five most common cancers globally. NMSC is an area with great potential for novel application of diagnostic tools including artificial intelligence (AI). In this scoping review, we aimed to describe the applications of AI in the diagnosis and treatment of NMSC. Twenty-nine publications described AI applications to dermatopathology including lesion classification and margin assessment. Twenty-five publications discussed AI use in clinical image analysis, showing that algorithms are not superior to dermatologists and may rely on unbalanced, nonrepresentative, and nontransparent training data sets. Sixteen publications described the use of AI in cutaneous surgery for NMSC including use in margin assessment during excisions and Mohs surgery, as well as predicting procedural complexity. Eleven publications discussed spectroscopy, confocal microscopy, thermography, and the AI algorithms that analyze and interpret their data. Ten publications pertained to AI applications for the discovery and use of NMSC biomarkers. Eight publications discussed the use of smartphones and AI, specifically how they enable clinicians and patients to have increased access to instant dermatologic assessments but with varying accuracies. Five publications discussed large language models and NMSC, including how they may facilitate or hinder patient education and medical decision-making. Three publications pertaining to the skin of color and AI for NMSC discussed concerns regarding limited diverse data sets for the training of convolutional neural networks. AI demonstrates tremendous potential to improve diagnosis, patient and clinician education, and management of NMSC. Despite excitement regarding AI, data sets are often not transparently reported, may include low-quality images, and may not include diverse skin types, limiting generalizability. AI may serve as a tool to increase access to dermatology services for patients in rural areas and save health care dollars. These benefits can only be achieved, however, with consideration of potential ethical costs.
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Affiliation(s)
- Megan H Trager
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
| | - Emily R Gordon
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Alyssa Breneman
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA
| | - Chunhua Weng
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, NY, USA
| | - Faramarz H Samie
- Department of Dermatology, Columbia University Irving Medical Center, New York, NY, USA.
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Liu L, Qu S, Zhao H, Kong L, Xie Z, Jiang Z, Zou P. Global trends and hotspots of ChatGPT in medical research: a bibliometric and visualized study. Front Med (Lausanne) 2024; 11:1406842. [PMID: 38818395 PMCID: PMC11137200 DOI: 10.3389/fmed.2024.1406842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/06/2024] [Indexed: 06/01/2024] Open
Abstract
Objective With the rapid advancement of Chat Generative Pre-Trained Transformer (ChatGPT) in medical research, our study aimed to identify global trends and focal points in this domain. Method All publications on ChatGPT in medical research were retrieved from the Web of Science Core Collection (WoSCC) by Clarivate Analytics from January 1, 2023, to January 31, 2024. The research trends and focal points were visualized and analyzed using VOSviewer and CiteSpace. Results A total of 1,239 publications were collected and analyzed. The USA contributed the largest number of publications (458, 37.145%) with the highest total citation frequencies (2,461) and the largest H-index. Harvard University contributed the highest number of publications (33) among all full-time institutions. The Cureus Journal of Medical Science published the most ChatGPT-related research (127, 10.30%). Additionally, Wiwanitkit V contributed the majority of publications in this field (20). "Artificial Intelligence (AI) and Machine Learning (ML)," "Education and Training," "Healthcare Applications," and "Data Analysis and Technology" emerged as the primary clusters of keywords. These areas are predicted to remain hotspots in future research in this field. Conclusion Overall, this study signifies the interdisciplinary nature of ChatGPT research in medicine, encompassing AI and ML technologies, education and training initiatives, diverse healthcare applications, and data analysis and technology advancements. These areas are expected to remain at the forefront of future research, driving continued innovation and progress in the field of ChatGPT in medical research.
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Affiliation(s)
- Ling Liu
- Nanxishan Hospital of Guangxi Zhuang Autonomous Region (The Second People’s Hospital of Guangxi Zhuang Autonomous Region), Guilin, China
- School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Shenhong Qu
- Department of Otolaryngology-Head and Neck Oncology, The People’s Hospital of Guangxi Zhuang Autonoms Region, Nanning, China
| | - Haiyun Zhao
- Nanxishan Hospital of Guangxi Zhuang Autonomous Region (The Second People’s Hospital of Guangxi Zhuang Autonomous Region), Guilin, China
| | - Lingping Kong
- Nanxishan Hospital of Guangxi Zhuang Autonomous Region (The Second People’s Hospital of Guangxi Zhuang Autonomous Region), Guilin, China
| | - Zhuzhu Xie
- School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Zhichao Jiang
- Hunan Provincial Brain Hospital, The Second People’s Hospital of Hunan Province, Changsha, China
| | - Pan Zou
- Nanxishan Hospital of Guangxi Zhuang Autonomous Region (The Second People’s Hospital of Guangxi Zhuang Autonomous Region), Guilin, China
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Vargas S, Peirano D, Hidalgo L, Droppelmann K, Cardenas C, Navarrete-Dechent C. How well can we predict Mohs micrographic surgery number of stages and reconstruction type? Reply to Shoham et al. Exp Dermatol 2023; 32:2185-2186. [PMID: 36333873 DOI: 10.1111/exd.14704] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/29/2022] [Accepted: 11/03/2022] [Indexed: 12/03/2023]
Affiliation(s)
- Sebastian Vargas
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Dominga Peirano
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Leonel Hidalgo
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Katherine Droppelmann
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Consuelo Cardenas
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cristian Navarrete-Dechent
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Shoham G, Berl A, Shir-Az O, Shabo S, Shalom A. Reply to Vargas, Peirano et al. Exp Dermatol 2023; 32:2183-2184. [PMID: 36336981 DOI: 10.1111/exd.14701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 10/29/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Gon Shoham
- Division of Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Department of Biomedical Engineering, The Iby and Aladar Fleischman Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Ariel Berl
- Department of Plastic Surgery, Meir Medical Center, Kfar Saba, Israel
| | - Ofir Shir-Az
- Department of Plastic Surgery, Meir Medical Center, Kfar Saba, Israel
| | - Sharon Shabo
- Department of Plastic Surgery, Meir Medical Center, Kfar Saba, Israel
| | - Avshalom Shalom
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Plastic Surgery, Meir Medical Center, Kfar Saba, Israel
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Das RK, Kalmar CL, McLawhorn J, Clayton AS, Thayer WP. Effect of a Perioperative Educational Video in Patients Undergoing Mohs Reconstruction: A Randomized Clinical Trial. Ann Plast Surg 2023; 91:656-659. [PMID: 38079312 DOI: 10.1097/sap.0000000000003713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
BACKGROUND Skin cancer is the most common type of cancer in the United States, and most are treated with Mohs micrographic surgery (MMS) by fellowship-trained dermatologic surgeons. Complex reconstruction in cosmetically and functionally sensitive areas often requires a plastic surgery consult. The uncertainty regarding reconstructive options and cosmetic appearance is difficult emotionally and cognitively for patients. OBJECTIVES To improve patient understanding about MMS reconstruction with plastic surgeons, we investigated the utility of a multimedia presentation during perioperative education. METHODS A randomized clinical trial was conducted at a hospital-affiliated outpatient MMS clinic and surgery center in the United States. Patients in the intervention arm were given a tablet or Web site link to watch a multimedia presentation about reconstruction after MMS. All patients were given a questionnaire about their understanding of MMS reconstruction and satisfaction with the reconstructive care they received. RESULTS A total of 46 patients were recruited for the study and completed the questionnaire. Of these patients, 22 were randomized to the test intervention arm, and the remaining 24 were in the control group. Among participants in the test intervention arm, feedback regarding the platform was positive with more than 90% of patients reporting that the video was engaging, useful, and easy to understand. Patient understanding and satisfaction scores in the test intervention arm ranked higher across all domains than those of the control group. CONCLUSIONS This randomized clinical trial showed increases in patient understanding and satisfaction among patients undergoing MMS reconstruction with the implementation of a perioperative educational video.
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Affiliation(s)
- Rishub K Das
- From the Department of Plastic Surgery, Vanderbilt University School of Medicine
| | | | - Justin McLawhorn
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN
| | - Anna S Clayton
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN
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Varghese KJ. Applications for Machine Learning in Mohs Micrographic Surgery: Increased Efficiency and Accuracy. Kans J Med 2023; 16:246. [PMID: 37791019 PMCID: PMC10544879 DOI: 10.17161/kjm.vol16.20947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/25/2023] [Indexed: 10/05/2023] Open
Affiliation(s)
- Kevin J Varghese
- Department of Dermatology, University of Kansas School of Medicine, Kansas City, KS
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Hope RH, Dowdle TS, Hope L, Pruneda C. Mohs micrographic surgery for keratinocyte carcinomas: clinicopathological predictors of the number of stages. Proc AMIA Symp 2023; 36:608-615. [PMID: 37614851 PMCID: PMC10444016 DOI: 10.1080/08998280.2023.2236478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/04/2023] [Accepted: 07/06/2023] [Indexed: 08/25/2023] Open
Abstract
Background The number of Mohs stages needed to remove a keratinocyte carcinoma affects resource use, expenses, and repair complexity. This study aimed to identify clinicopathological predictors associated with increased or decreased stages and areas for further research. Methods A retrospective review was conducted from a single private practice with two Mohs surgeons of 2788 consecutive Mohs cases between January 2017 and December 2021, analyzing the average number of stages taken versus national norms (P = 0.21) and subgroups using unpaired t tests (*<0.05). Results Several tumor features were significantly associated with fewer stages: squamous cell carcinomas, Mohs appropriate use criteria score of 7 or 8, preoperative size <0.25 cm2, tumors on the lips and extremities (including hands/fingers), and smoking. Clinicopathological features significantly associated with more stages included Mohs appropriate use criteria score of 9, recurrent skin cancers, basal cell carcinomas, tumor size of 2.25-3.99 cm2, cancers on ears, solid organ transplant patients, treatment delays >180 days, and patients ≥90 years old. Conclusions Significant predictors exist for both increased and decreased numbers of Mohs micrographic surgery stages required to eradicate a tumor, which may help Mohs surgeons facilitate, plan, and allocate resources more effectively. Areas for further research in Mohs micrographic surgery are identified.
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Affiliation(s)
- Richard H. Hope
- Lubbock Dermatology and Skin Cancer Center, Lubbock, Texas, USA
- Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Travis S. Dowdle
- Sanford School of Medicine, University of South Dakota, Sioux Falls, South Dakota, USA
| | - Landon Hope
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Corley Pruneda
- Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
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