An artificial intelligence system for potential skin cancer has been conditionally recommended for use in the NHS for the next three years while further evidence is collected.
The technology aims to significantly reduce waiting times by efficiently triaging patients with suspicious skin lesions. DERM (Deep Ensemble for Recognition of Malignancy), developed by Skin Analytics, analyses images to assess and triage skin lesions, potentially redirecting benign cases to non-urgent pathways.
Healthcare staff use a smartphone with a dermoscopic lens attachment (a high-quality magnifying lens used to examine skin lesions) to take high-quality images of suspicious skin lesions. After a patient has been referred from primary care into a teledermatology service the skin lesion can be remotely assessed, diagnosed, or monitored without requiring a physical in-person visit. These images are then uploaded to DERM's online platform.
DERM uses an algorithm to analyse the images, examining visual characteristics and comparing them to its bank of images of known skin conditions. When suspicious lesions are found the patient can be directed to a human dermatology specialist for further investigation while people with other skin conditions are reassured and offered advice.
With increasing referrals to dermatology services for suspected skin cancers, early evidence suggests automated use of DERM could approximately halve the number of referrals to dermatologists within the urgent skin cancer pathway compared to using teledermatology alone.
In the UK, dermatology services receive one million referrals each year from primary care. About 60% are urgent referrals for suspected skin cancer. Of these, only 6% are confirmed to be skin cancer and the remaining 94% are either non-urgent or non-cancer cases.
DERM represents an important innovation that aligns with the Government's health priorities to move "from analogue to digital" by rolling out new digital technologies to benefit patients, reduce waiting lists and modernise the NHS.
How DERM works:
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For lesions identified as pre-cancerous or cancerous, an NHS dermatologist reviews the case virtually and determines the appropriate management plan.
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For patients with black or brown skin, an additional healthcare professional review will take place during the evidence generation period. This is because the incidence of skin cancer is lower in these patient groups, and the use of DERM for skin cancer detection is less certain.
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Patients whose lesions are identified as benign by DERM are discharged from the urgent pathway and receive their results with written advice from a healthcare professional.
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The technology is intended for people aged 18 or over. DERM can be used with or without healthcare professional review of lesions identified as non-cancer.
"This recommendation represents an important step forward in our approach to evaluating AI technologies in healthcare, driving innovation into the hands of health and care professionals to enable best practice," commented Dr Anastasia Chalkidou, HealthTech programme director at NICE.
"DERM has shown promising results in its ability to accurately distinguish between cancerous and non-cancerous skin lesions, with evidence suggesting it could halve the number of referrals to dermatologists within the urgent skin cancer pathway while maintaining patient safety.
"DERM is an example of how we can harness artificial intelligence to benefit both patients and healthcare professionals. Our evaluation shows this technology maintains diagnostic accuracy while reducing the burden on specialist dermatology services. By implementing this system within existing pathways, we can ensure patients get the right care more quickly."
"By embracing the power of AI, this exciting technology could help us slash waiting times, meaning that people with suspected skin cancer get the help they need, or peace of mind, faster," added Ashley Dalton, Minister for Public Health and Prevention.
"Technologies like this one are a great example of how we’re shifting from analogue to digital, and this government is determined to ensure that NHS patients are among the first to access the cutting-edge of healthcare.
"Our National Cancer Plan will transform the way we approach this disease, improving care and bringing this country’s cancer survival rates back up to the standards of the best in the world."
The technology will be used by the NHS for the next three years while further evidence is generated. Once the evidence generation period is complete, a NICE committee will reconsider the evidence and publish new guidance.
