, 2025-05-01 14:34:00
An artificial intelligence (AI) system for assessing suspicious skin lesions has been conditionally recommended by the National Institute for Health and Care Excellence (NICE) for NHS use in England.
The tool, called Deep Ensemble for Recognition of Malignancy (DERM), can be used while further evidence is gathered.
NICE said that the aim is to reduce delays for patients referred to the urgent suspected skin cancer pathway. Around one in three patients referred are not seen within the NHS 18-week target.
How DERM Works
DERM is designed to support teledermatology services following referral from primary care.
Healthcare staff use a smartphone with a dermoscopic lens attachment to capture images of suspicious lesions. These are uploaded to DERM’s secure online platform.
The system uses a non-learning AI algorithm to analyse the images. It compares each image to a fixed database of known skin conditions, including:
DERM provides a suspected diagnosis and triages the case. Patients with benign lesions may be redirected to non-urgent pathways and receive written safety-netting advice. Suspicious lesions are reviewed virtually by a dermatologist.
NICE said that comparative evidence suggests that DERM might be as accurate as face-to-face or teledermatology assessments, while easing pressure on dermatology services.
Potential to Cut Waiting Times
Around 17,500 melanoma and 160,000 non-melanoma cancers are diagnosed each year in the UK.
NHS dermatology services receive over 1 million referrals annually from primary care. Around 60% of these are urgent referrals for suspected skin cancer. However, only 6% of these are confirmed as cancer, with the remainder being either non-urgent or non-cancer cases.
A shortage of consultant dermatologists has exacerbated delays. Some NHS trusts report having no dermatology consultants at all.
As of July 2024, NHS England reported a referral-to-treatment backlog of 441,000 elective dermatology appointments. Only 63% met the 18-week treatment target.
“DERM has shown promising results in its ability to accurately distinguish between cancerous and non-cancerous skin lesions,” said Anastasia Chalkidou, director of NICE’s Centre for Health Technology Evaluation. Evidence suggested that the system could halve the number of referrals to dermatologists within the urgent skin cancer pathway, while maintaining patient safety, she added.
Further Evidence Gathering
DERM will be used for the next 3 years while the NHS collects further evidence on its impact.
NICE said it remains unclear whether the tool can also free up capacity for patients with non-cancer, non-urgent inflammatory skin conditions that still require face-to-face assessment.
Also, current evidence is based largely on patients with white skin. Its performance in people with black or brown skin is less certain.
To address this, patients from these groups will receive an additional review by a healthcare professional during the trial period.
NICE will reconsider the evidence once the evaluation is complete and issue updated guidance.
Dr Rob Hicks is a retired NHS doctor. A well-known TV and radio broadcaster, he has written several books and has regularly contributed to national newspapers, magazines, and online. He is based in the UK.
