AI09 Skin in the game: are artificial intelligence skin checker apps held to a high enough standard?

Abstract Artificial Intelligence (AI) has experienced a surge of mainstream interest and development in recent years. Specifically to the field of dermatology, we have witnessed the rise of AI systems capable of diagnosing skin pathology, in particular lesions, through convolutional neural networks. Such tools, when employed clinically, are subject to rigorous oversight from all stakeholders. Given the necessity for ensuring patient safety, this is understandable. However, alongside these legitimate services has come the rise of apps available through platforms such as the Google Play store advertising their AI-driven skin assessments to the general public. This is an ill-defined, unregulated area that carries significant concern, in particular the capacity to cause harm, be it through inaccurate diagnosis or no onward referral pathways. There is also a question of probity, and whether providers are honest in their advertisements of their app’s analysis. We investigated these apps available through the Google Play store with specific reference to the criteria of whether a fee was charged for services, whether a dermatologist was attached to the service and, given their advertisement of offering an analysis of skin conditions, did they accept responsibility for any diagnosis provided? A keyword search was performed on the Google Play store looking for apps that contained the phrases ‘AI skin’, ‘AI skin checker’ and ‘AI skin scanner’. In total 11 apps offered a skin disease assessment through an AI system. Of these, four (36%) were free, three (27%) required payment and four (36%) had both a free and paid-for service. Only one app (9%) had an associated dermatologist available for onward referral, with none being available for the free-to-use versions. Finally, although all 11 apps advertised their clinically proven AI, they contained disclaimers stating these were not diagnostic services. From this limited review, we have found that all available AI skin-checking apps on the Google Play store do not accept responsibility for analyses offered, and the majority do not provide further referral options. It is foreseeable that the number of such apps will grow in the future and, as with other areas of AI, it is imperative that standards are set at the earliest of opportunities to protect patients from harm. We contend that there should be an option for onward referral, and any app advertising skin pathology assessment cannot be allowed to describe itself as nondiagnostic, abdicating liability for the analysis provided to users.