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Shah A, Wahood S, Guermazi D, Brem CE, Saliba E. Skin and Syntax: Large Language Models in Dermatopathology. Dermatopathology (Basel) 2024; 11:101-111. [PMID: 38390851 PMCID: PMC10885095 DOI: 10.3390/dermatopathology11010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 02/04/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
This literature review introduces the integration of Large Language Models (LLMs) in the field of dermatopathology, outlining their potential benefits, challenges, and prospects. It discusses the changing landscape of dermatopathology with the emergence of LLMs. The potential advantages of LLMs include a streamlined generation of pathology reports, the ability to learn and provide up-to-date information, and simplified patient education. Existing instances of LLMs encompass diagnostic support, research acceleration, and trainee education. Challenges involve biases, data privacy and quality, and establishing a balance between AI and dermatopathological expertise. Prospects include the integration of LLMs with other AI technologies to improve diagnostics and the improvement of multimodal LLMs that can handle both text and image input. Our implementation guidelines highlight the importance of model transparency and interpretability, data quality, and continuous oversight. The transformative potential of LLMs in dermatopathology is underscored, with an emphasis on a dynamic collaboration between artificial intelligence (AI) experts (technical specialists) and dermatopathologists (clinicians) for improved patient outcomes.
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Affiliation(s)
- Asghar Shah
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI 02903, USA
| | - Samer Wahood
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI 02903, USA
| | - Dorra Guermazi
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI 02903, USA
| | - Candice E Brem
- Section of Dermatopathology, Department of Dermatology, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA 02118, USA
| | - Elie Saliba
- Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, RI 02903, USA
- Department of Dermatology, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut 13-5053, Lebanon
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Mirza FN, Lim RK, Yumeen S, Wahood S, Zaidat B, Shah A, Tang OY, Kawaoka J, Seo SJ, DiMarco C, Muglia J, Goldbach HS, Wisco O, Qureshi AA, Libby TJ. Performance of Three Large Language Models on Dermatology Board Examinations. J Invest Dermatol 2024; 144:398-400. [PMID: 37541614 DOI: 10.1016/j.jid.2023.06.208] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 06/27/2023] [Indexed: 08/06/2023]
Affiliation(s)
- Fatima N Mirza
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
| | - Rachel K Lim
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA; The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Sara Yumeen
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Samer Wahood
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Bashar Zaidat
- Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Asghar Shah
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Oliver Y Tang
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - John Kawaoka
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Su-Jean Seo
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Christopher DiMarco
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Jennie Muglia
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Hayley S Goldbach
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Oliver Wisco
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Abrar A Qureshi
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Tiffany J Libby
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
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Abrantes T, Robbins A, Kahn B, Yumeen S, Bukoski RS, Wisco O, Robinson-Bostom L, Kawaoka J, Libby T, Goldbach H, Imbriano D, Lizbinski L, Tran M, Wahood S, Mehta A, Miner T. Understanding melanoma in situ: Lentigo maligna surgical treatment terminology and guideline adherence, a targeted review. J Am Acad Dermatol 2023; 89:734-744. [PMID: 37307991 DOI: 10.1016/j.jaad.2023.04.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 04/18/2023] [Accepted: 04/25/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Malignant melanoma in-situ, lentigo maligna (MMIS-LM) can be successfully treated with several different surgical techniques; however, the literature is inconsistent in defining them. OBJECTIVE To comprehensively define and describe the national guideline recommended surgical techniques used to treat MMIS-LM to help clarify and standardize this terminology to ensure compliance with the guidelines. METHODS A targeted literature review was performed from 1990 to 2022 focusing on articles that discussed the national guideline recommended surgical techniques of wide local excision, Mohs micrographic surgery (MMS), modified Mohs surgery, and staged excision/Slow-Mohs for MMIS-LM, as well as the related methods of tissue processing. National Comprehensive Cancer Network and American Academy of Dermatology guidelines were reviewed to identify how the techniques need to be employed to be compliant with guideline recommendations. RESULTS We describe the various surgical and tissue processing techniques and discuss advantages and disadvantages of each. LIMITATIONS This paper was styled as a narrative review defining and clarifying terminology and technique and does not investigate these topics more broadly. CONCLUSION Understanding the methodology and terminology for these surgical procedures and tissue processing methods is critical so that both general dermatologists and surgeons can employ these techniques effectively for optimal patient care.
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Affiliation(s)
- Tatiana Abrantes
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
| | - Allison Robbins
- Dermatology Department, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Benjamin Kahn
- Dermatology Department, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Sara Yumeen
- Dermatology Department, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - R Scott Bukoski
- Dermatology Department, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Oliver Wisco
- Dermatology Department, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Leslie Robinson-Bostom
- Dermatology Department, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - John Kawaoka
- Dermatology Department, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Tiffany Libby
- Dermatology Department, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Hayley Goldbach
- Dermatology Department, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Dillon Imbriano
- University of New England, College of Osteopathic Medicine, Biddeford, Maine
| | - Leonardo Lizbinski
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Megan Tran
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Samer Wahood
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Aakash Mehta
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Thomas Miner
- Department of Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
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Robinson JK, Wahood S, Ly S, Kirk J, Yoon J, Sterritt J, Gray E, Kwasny M. Melanoma detection by skin self-examination targeting at-risk women: A randomized controlled trial with telemedicine support for concerning moles. Prev Med Rep 2021; 24:101532. [PMID: 34976609 PMCID: PMC8683880 DOI: 10.1016/j.pmedr.2021.101532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 08/16/2021] [Accepted: 08/22/2021] [Indexed: 12/04/2022] Open
Abstract
Secondary melanoma prevention remains crucial to reduce morbidity and mortality for the 200,000 people in the United States estimated to develop melanoma in 2021. This 3-month randomized controlled trial of online skin self-examination (SSE) education among 1000 at-risk women who received care at Northwestern Medicine in Illinois sought to determine SSE initiation and monthly performance, SSE anxiety and confidence, and health care practitioner (HCP) visits for concerning moles. Positive responses to a personal history of sunburn, a personal or family history of skin cancer, and/or having 10 or more lifetime indoor tanning sessions identified and informed women of their increased risk of melanoma. At one month, 96.2% of women receiving SSE education (SSE women) initiated SSE compared to 48.1% in the active control arm (control) (p < 0.001). More control women sought HCP visits (n = 107) than SSE women (n = 39). Control women seen by HCPs identified benign lesions, especially seborrheic keratosis, more often than SSE women. More atypical nevi (SSE 38.5%, control 8.4%) and melanomas (SSE 25.6%, control 4.7%) were visually identified by SSE women seeing HPCs (p < 0.001). There was no significant difference in SSE anxiety between the control and SSE arms. Confidence increased significantly in the SSE arm whereas there was no change in the control group (p < 0.001). Women checked someone else for concerning moles [315/ 494 (63.8%) of SSE women]. Targeting at-risk women for SSE education may help reduce melanoma mortality, especially in rural communities where incidence and mortality are greater than in urban areas.
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Affiliation(s)
- June K. Robinson
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Samer Wahood
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Sophia Ly
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Jessie Kirk
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Jamie Yoon
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - James Sterritt
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Elizabeth Gray
- Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Mary Kwasny
- Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
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Robinson JK, Wahood S, Stapleton JL. Motives for intentional sunlight exposure among young adult sexual minority men: appearance, relaxation and socialization in a cohort study. Br J Dermatol 2020; 184:563-564. [PMID: 33067803 DOI: 10.1111/bjd.19609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 10/13/2020] [Accepted: 10/13/2020] [Indexed: 11/29/2022]
Affiliation(s)
- J K Robinson
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - S Wahood
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Brown University, Providence, RI, USA
| | - J L Stapleton
- Department of Health, Behavior and Society, University of Kentucky College of Public Health, Lexington, KY, USA
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