Patient Perspectives on the Use of Artificial Intelligence for Skin Cancer Screening: A Qualitative Study
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Importance: The use of artificial intelligence (AI) is expanding throughout the field of medicine. In dermatology, researchers are evaluating the potential for direct-to-patient and clinician decision-support AI tools to classify skin lesions. Although AI is poised to change how patients engage in health care, patient perspectives remain poorly understood.
Objective: To explore how patients conceptualize AI and perceive the use of AI for skin cancer screening.
Design, Setting, And Participants: A qualitative study using a grounded theory approach to semistructured interview analysis was conducted in general dermatology clinics at the Brigham and Women's Hospital and melanoma clinics at the Dana-Farber Cancer Institute. Forty-eight patients were enrolled. Each interview was independently coded by 2 researchers with interrater reliability measurement; reconciled codes were used to assess code frequency. The study was conducted from May 6 to July 8, 2019.
Main Outcomes And Measures: Artificial intelligence concept, perceived benefits and risks of AI, strengths and weaknesses of AI, AI implementation, response to conflict between human and AI clinical decision-making, and recommendation for or against AI.
Results: Of 48 patients enrolled, 26 participants (54%) were women; mean (SD) age was 53.3 (21.7) years. Sixteen patients (33%) had a history of melanoma, 16 patients (33%) had a history of nonmelanoma skin cancer only, and 16 patients (33%) had no history of skin cancer. Twenty-four patients were interviewed about a direct-to-patient AI tool and 24 patients were interviewed about a clinician decision-support AI tool. Interrater reliability ratings for the 2 coding teams were κ = 0.94 and κ = 0.89. Patients primarily conceptualized AI in terms of cognition. Increased diagnostic speed (29 participants [60%]) and health care access (29 [60%]) were the most commonly perceived benefits of AI for skin cancer screening; increased patient anxiety was the most commonly perceived risk (19 [40%]). Patients perceived both more accurate diagnosis (33 [69%]) and less accurate diagnosis (41 [85%]) to be the greatest strength and weakness of AI, respectively. The dominant theme that emerged was the importance of symbiosis between humans and AI (45 [94%]). Seeking biopsy was the most common response to conflict between human and AI clinical decision-making (32 [67%]). Overall, 36 patients (75%) would recommend AI to family members and friends.
Conclusions And Relevance: In this qualitative study, patients appeared to be receptive to the use of AI for skin cancer screening if implemented in a manner that preserves the integrity of the human physician-patient relationship.
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PMID: 39983116 PMC: 11890126. DOI: 10.2196/50708.
Smola P, Mlozniak I, Wojcieszko M, Zwierczyk U, Kobryn M, Rzepecka E Front Digit Health. 2025; 7:1458685.
PMID: 39931116 PMC: 11808042. DOI: 10.3389/fdgth.2025.1458685.
Backes C, Godot C, Gujer C, Obegi N, Perez A, Gervaix A Digit Health. 2025; 11():20552076241313164.
PMID: 39822303 PMC: 11736744. DOI: 10.1177/20552076241313164.
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PMID: 39808641 PMC: 11731723. DOI: 10.1371/journal.pone.0317276.
Stephens J, Northcott C, Poirier B, Lewis T Digit Health. 2025; 11():20552076241288631.
PMID: 39777065 PMC: 11705357. DOI: 10.1177/20552076241288631.