Author Interviews, BMJ, Dermatology, Technology / 13.02.2020 Interview with: Professor Jon Deeks PhD, CStat Institute of Applied Health Research Professor of Biostatistics College of Medical and Dental Sciences University of Birmingham, UK What is the background for this study? Response: Skin cancer is one of the most common cancers in the world, and the incidence is increasing. In 2003, the World Health Organization estimated that between two and three million skin cancers occur globally each year, 80% of which are basal cell carcinoma, 16% cutaneous squamous cell carcinoma, and 4% melanoma. The potential for melanoma to metastasise to other parts of the body means that it is responsible for up to 75% of skin cancer deaths. Five year survival can be as high as 91-95% for melanoma if it is identified early, which makes early detection and treatment key to improving survival. Early detection of melanoma is reliant on people with new or changing moles seeking early advice from medical professionals. Skin cancer smartphone applications (“apps”) provide a technological approach to assist people with suspicious lesions to decide whether they should seek further medical attention. Of increasing interest are smartphone apps that use inbuilt algorithms (or “artificial intelligence”) that catalogue and classify images of lesions into high or low risk for skin cancer (usually melanoma). Apps with inbuilt algorithms that make a medical claim are now classified as medical devices that require regulatory approval. These apps could be harmful if recommendations are erroneous, particularly if false reassurance leads to delays in people obtaining medical assessment.  CE (Conformit Europenne) marking has been applied to allow distribution of two algorithm based apps in Europe (SkinScan and SkinVision), one of which is also available in Australia and New Zealand. However, no apps currently have United States Food and Drug Administration (FDA) approval to allow their distribution in the US and Canada. We have completed a systematic review of studies that examine the accuracy of all apps that use inbuilt algorithms to identify skin cancer in users of smartphones.  We report on the scope, findings, and validity of the evidence. (more…)