Deep learning for triaging skin images in the NHS
Research type
Research Study
Full title
Deep learning for effective triaging of skin disease in the NHS
IRAS ID
295351
Contact name
Stephen McKenna
Contact email
Sponsor organisation
University of Dundee
Duration of Study in the UK
4 years, 11 months, 28 days
Research summary
Resource within primary and secondary NHS care cannot meet the demand from increasing numbers of referrals for lesions suspicion of skin cancer, estimated at ~100,000 p.a. for NHS Scotland. Although skin cancer prevalence has increased by 5% per annum for the last quarter century, most referrals requesting a specialist opinion are benign skin lesions. Image-based artificial intelligence (AI) assisting human experts has huge potential to support effective diagnostic triage by GPs, dramatically reducing referrals to secondary care whilst delivering safe care nearer to home and rapidly alleviating patient anxiety. \nTo develop an AI system operating robustly and reliably within NHS referral structures, it is essential to train the system using images representative of those produced in primary care or by patients. Our pilot project developed software able to distinguish benign skin lesions from common skin cancers using preselected and pre-processed image datasets, with clear and limited categories, but these are not truly representative of the distribution of NHS clinical data. \nWe propose to develop a tool of high diagnostic accuracy within a real-world NHS setting. Our primary aim, preventing unnecessary referral of benign skin lesions, requires a robust system with near-zero false negative rate. This AI project will prepare clinical image datasets and use them to develop and validate a prototype designed for integration into existing clinical workflow. This will incorporate deep learning ensembles optimised for high sensitivity with mechanisms to reject low confidence images and to provide visual explanations. \nWe will disseminate technology development and pave the way for subsequent development and integration within the whole NHS, allowing more patients immediate reassurance, and reducing attendance at GPs where one fifth of all appointments are for skin disease. When achieved, this is predicted to reduce dermatology and plastic surgery workloads by 20%, saving £10M per annum for NHS Scotland.
REC name
East of England - Cambridge East Research Ethics Committee
REC reference
21/EE/0160
Date of REC Opinion
23 Jun 2021
REC opinion
Further Information Favourable Opinion