Autonomous AI Expands Dermatology Capacity in Skin Cancer Pathways

skin cancer pathways artificial intelligence

Autonomous artificial intelligence (AI) in urgent skin cancer pathways can increase clinical capacity for dermatologists, according to a study presented at the annual meeting of the European Academy of Dermatology and Venereology, held from Sept. 30 to Oct. 3 in Vienna.

Lucy Thomas, M.B.Ch.B., from Imperial College London, and colleagues implemented class III artificial intelligence as a medical device (AIaMD) across two hospital sites. Sequential validation was applied (dermoscopic confirmation and image quality assessment), followed by hierarchical classification prioritizing higher-risk diagnoses. Cases classified as benign were discharged autonomously, without clinician review, while high-risk cases were triaged to assessment by a teledermatologist (TD). To assess diagnostic performance, outcomes were compared with face-to-face (F2F), TD-only, and AI-assisted TD pathways.

Overall, 8,391 patients were managed via the autonomous pathway; consent for autonomous decision-making was 86 percent. The researchers found that autonomous AIaMD discharge was 37 and 32 percent at sites 1 and 2, respectively, with actual discharge rates of 31 and 25 percent, respectively, after exclusions; TD discharged an additional 24 and 25 percent, respectively. Routine follow-up was reduced with autonomous AIaMD versus standard TD (12 versus 27 percent), while the biopsy rate was reduced compared with conventional F2F care (26 to 29 versus 43 percent). False negatives were rare; no adverse outcomes were identified within available follow-up. Compared with the F2F pathways, estimated clinician time savings were 2,851 hours, representing a 62 percent gain in clinical capacity.

“We believe the greatest value of autonomous AI lies not in the technology itself, but in the specialist capacity it unlocks,” Thomas said in a statement.

The study was partly supported by a grant from La Roche-Posay (L’Oreal Dermatological Beauty).

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