Leveraging Artificial Intelligence to Improve the Diversity of Dermatological Skin Color Pathology: Protocol for an Algorithm Development and Validation Study

BackgroundThe paucity of dark skin images in dermatological textbooks and atlases is a reflection of racial injustice in medicine. The underrepresentation of dark skin images makes diagnosing skin pathology in people of color challenging. For conditions such as skin cancer, i...

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Main Authors: Eman Rezk, Mohamed Eltorki, Wael El-Dakhakhni
Format: Article
Language:English
Published: JMIR Publications 2022-03-01
Series:JMIR Research Protocols
Online Access:https://www.researchprotocols.org/2022/3/e34896
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author Eman Rezk
Mohamed Eltorki
Wael El-Dakhakhni
author_facet Eman Rezk
Mohamed Eltorki
Wael El-Dakhakhni
author_sort Eman Rezk
collection DOAJ
description BackgroundThe paucity of dark skin images in dermatological textbooks and atlases is a reflection of racial injustice in medicine. The underrepresentation of dark skin images makes diagnosing skin pathology in people of color challenging. For conditions such as skin cancer, in which early diagnosis makes a difference between life and death, people of color have worse prognoses and lower survival rates than people with lighter skin tones as a result of delayed or incorrect diagnoses. Recent advances in artificial intelligence, such as deep learning, offer a potential solution that can be achieved by diversifying the mostly light-skin image repositories through generating images for darker skin tones. Thus, facilitating the development of inclusive cancer early diagnosis systems that are trained and tested on diverse images that truly represent human skin tones. ObjectiveWe aim to develop and evaluate an artificial intelligence–based skin cancer early detection system for all skin tones using clinical images. MethodsThis study consists of four phases: (1) Publicly available skin image repositories will be analyzed to quantify the underrepresentation of darker skin tones, (2) Images will be generated for the underrepresented skin tones, (3) Generated images will be extensively evaluated for realism and disease presentation with quantitative image quality assessment as well as qualitative human expert and nonexpert ratings, and (4) The images will be utilized with available light-skin images to develop a robust skin cancer early detection model. ResultsThis study started in September 2020. The first phase of quantifying the underrepresentation of darker skin tones was completed in March 2021. The second phase of generating the images is in progress and will be completed by March 2022. The third phase is expected to be completed by May 2022, and the final phase is expected to be completed by September 2022. ConclusionsThis work is the first step toward expanding skin tone diversity in existing image databases to address the current gap in the underrepresentation of darker skin tones. Once validated, the image bank will be a valuable resource that can potentially be utilized in physician education and in research applications. Furthermore, generated images are expected to improve the generalizability of skin cancer detection. When completed, the model will assist family physicians and general practitioners in evaluating skin lesion severity and in efficient triaging for referral to expert dermatologists. In addition, the model can assist dermatologists in diagnosing skin lesions. International Registered Report Identifier (IRRID)DERR1-10.2196/34896
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spelling doaj.art-adc4e84ad59f4daa8fd84b3d96089b552023-08-28T21:01:08ZengJMIR PublicationsJMIR Research Protocols1929-07482022-03-01113e3489610.2196/34896Leveraging Artificial Intelligence to Improve the Diversity of Dermatological Skin Color Pathology: Protocol for an Algorithm Development and Validation StudyEman Rezkhttps://orcid.org/0000-0002-2531-0799Mohamed Eltorkihttps://orcid.org/0000-0001-6978-0015Wael El-Dakhakhnihttps://orcid.org/0000-0001-8617-261X BackgroundThe paucity of dark skin images in dermatological textbooks and atlases is a reflection of racial injustice in medicine. The underrepresentation of dark skin images makes diagnosing skin pathology in people of color challenging. For conditions such as skin cancer, in which early diagnosis makes a difference between life and death, people of color have worse prognoses and lower survival rates than people with lighter skin tones as a result of delayed or incorrect diagnoses. Recent advances in artificial intelligence, such as deep learning, offer a potential solution that can be achieved by diversifying the mostly light-skin image repositories through generating images for darker skin tones. Thus, facilitating the development of inclusive cancer early diagnosis systems that are trained and tested on diverse images that truly represent human skin tones. ObjectiveWe aim to develop and evaluate an artificial intelligence–based skin cancer early detection system for all skin tones using clinical images. MethodsThis study consists of four phases: (1) Publicly available skin image repositories will be analyzed to quantify the underrepresentation of darker skin tones, (2) Images will be generated for the underrepresented skin tones, (3) Generated images will be extensively evaluated for realism and disease presentation with quantitative image quality assessment as well as qualitative human expert and nonexpert ratings, and (4) The images will be utilized with available light-skin images to develop a robust skin cancer early detection model. ResultsThis study started in September 2020. The first phase of quantifying the underrepresentation of darker skin tones was completed in March 2021. The second phase of generating the images is in progress and will be completed by March 2022. The third phase is expected to be completed by May 2022, and the final phase is expected to be completed by September 2022. ConclusionsThis work is the first step toward expanding skin tone diversity in existing image databases to address the current gap in the underrepresentation of darker skin tones. Once validated, the image bank will be a valuable resource that can potentially be utilized in physician education and in research applications. Furthermore, generated images are expected to improve the generalizability of skin cancer detection. When completed, the model will assist family physicians and general practitioners in evaluating skin lesion severity and in efficient triaging for referral to expert dermatologists. In addition, the model can assist dermatologists in diagnosing skin lesions. International Registered Report Identifier (IRRID)DERR1-10.2196/34896https://www.researchprotocols.org/2022/3/e34896
spellingShingle Eman Rezk
Mohamed Eltorki
Wael El-Dakhakhni
Leveraging Artificial Intelligence to Improve the Diversity of Dermatological Skin Color Pathology: Protocol for an Algorithm Development and Validation Study
JMIR Research Protocols
title Leveraging Artificial Intelligence to Improve the Diversity of Dermatological Skin Color Pathology: Protocol for an Algorithm Development and Validation Study
title_full Leveraging Artificial Intelligence to Improve the Diversity of Dermatological Skin Color Pathology: Protocol for an Algorithm Development and Validation Study
title_fullStr Leveraging Artificial Intelligence to Improve the Diversity of Dermatological Skin Color Pathology: Protocol for an Algorithm Development and Validation Study
title_full_unstemmed Leveraging Artificial Intelligence to Improve the Diversity of Dermatological Skin Color Pathology: Protocol for an Algorithm Development and Validation Study
title_short Leveraging Artificial Intelligence to Improve the Diversity of Dermatological Skin Color Pathology: Protocol for an Algorithm Development and Validation Study
title_sort leveraging artificial intelligence to improve the diversity of dermatological skin color pathology protocol for an algorithm development and validation study
url https://www.researchprotocols.org/2022/3/e34896
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AT waeleldakhakhni leveragingartificialintelligencetoimprovethediversityofdermatologicalskincolorpathologyprotocolforanalgorithmdevelopmentandvalidationstudy