A reinforcement learning model for AI-based decision support in skin cancer

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Barata C., Rotemberg V., Codella N. C. F., Tschandl P., Rinner C., AKAY B. N., ...Daha Fazla

Nature Medicine, cilt.29, sa.8, ss.1941-1946, 2023 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 29 Sayı: 8
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1038/s41591-023-02475-5
  • Dergi Adı: Nature Medicine
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, Biotechnology Research Abstracts, CAB Abstracts, Chemical Abstracts Core, MEDLINE, Public Affairs Index, Veterinary Science Database, DIALNET
  • Sayfa Sayıları: ss.1941-1946
  • Ankara Üniversitesi Adresli: Evet

Özet

We investigated whether human preferences hold the potential to improve diagnostic artificial intelligence (AI)-based decision support using skin cancer diagnosis as a use case. We utilized nonuniform rewards and penalties based on expert-generated tables, balancing the benefits and harms of various diagnostic errors, which were applied using reinforcement learning. Compared with supervised learning, the reinforcement learning model improved the sensitivity for melanoma from 61.4% to 79.5% (95% confidence interval (CI): 73.5–85.6%) and for basal cell carcinoma from 79.4% to 87.1% (95% CI: 80.3–93.9%). AI overconfidence was also reduced while simultaneously maintaining accuracy. Reinforcement learning increased the rate of correct diagnoses made by dermatologists by 12.0% (95% CI: 8.8–15.1%) and improved the rate of optimal management decisions from 57.4% to 65.3% (95% CI: 61.7–68.9%). We further demonstrated that the reward-adjusted reinforcement learning model and a threshold-based model outperformed naïve supervised learning in various clinical scenarios. Our findings suggest the potential for incorporating human preferences into image-based diagnostic algorithms.