Browsing by Author "Peirano, Dominga"

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    A systematic review and meta-analysis of artificial intelligence versus clinicians for skin cancer diagnosis
    (2024) Salinas, María Paz; Sepúlveda, Javiera; Hidalgo, Leonel; Peirano, Dominga; Morel, Macarena; Uribe, Pablo; Rotemberg, Verónica; Briones, Juan; Mery, Domingo; Navarrete-Dechent, Cristian
    Scientific research of artificial intelligence (AI) in dermatology has increased exponentially. The objective of this study was to perform a systematic review and meta-analysis to evaluate the performance of AI algorithms for skin cancer classification in comparison to clinicians with different levels of expertise. Based on PRISMA guidelines, 3 electronic databases (PubMed, Embase, and Cochrane Library) were screened for relevant articles up to August 2022. The quality of the studies was assessed using QUADAS-2. A meta-analysis of sensitivity and specificity was performed for the accuracy of AI and clinicians. Fifty-three studies were included in the systematic review, and 19 met the inclusion criteria for the meta-analysis. Considering all studies and all subgroups of clinicians, we found a sensitivity (Sn) and specificity (Sp) of 87.0% and 77.1% for AI algorithms, respectively, and a Sn of 79.78% and Sp of 73.6% for all clinicians (overall); differences were statistically significant for both Sn and Sp. The difference between AI performance (Sn 92.5%, Sp 66.5%) vs. generalists (Sn 64.6%, Sp 72.8%), was greater, when compared with expert clinicians. Performance between AI algorithms (Sn 86.3%, Sp 78.4%) vs expert dermatologists (Sn 84.2%, Sp 74.4%) was clinically comparable. Limitations of AI algorithms in clinical practice should be considered, and future studies should focus on real-world settings, and towards AI-assistance.
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    Author Correction: A systematic review and meta-analysis of artificial intelligence versus clinicians for skin cancer diagnosis
    (2024) Salinas Espinoza, María Paz; Sepúlveda, Javiera; Hidalgo, Leonel; Peirano, Dominga; Morel, Macarena; Uribe, Pablo; Rotemberg, Verónica; Briones, Juan; Mery, Domingo; Navarrete Dechent, Cristian Patricio
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    Management of periocular keratinocyte carcinomas with Mohs micrographic surgery and predictors of complex reconstruction: a retrospective study
    (2023) Peirano, Dominga; Vargas Mancilla, Sebastián Enrique; Hidalgo Acuña, Leonel Esteban; Donoso Mendieta, Francisca; Abusleme, Eugenia; Sanhueza Zamora, Felipe Alberto; Cárdenas de la Torre, Consuelo Paz; Droppelmann, Katherine; Castro Ayala, Juan Camilo; Uribe González, Pablo Francisco; Zoroquiain Velez, José Pablo; Navarrete Dechent, Cristián Patricio
    Background: Skin cancer is the most frequent cancer worldwide and the most frequent periocular tumor. Keratinocyte Carcinomas (KC) located in periorificial areas, such as periocular tumors, are considered high-risk tumors. Mohs Micrographic Surgery (MMS) is considered the first line for the treatment of high-risk KC, providing a lower recurrence rate than conventional wide excision. Objective: To describe the clinical-pathological features of periocular KC treated with MMS in a tertiary university center in Chile. Methods: A single-center, retrospective study of patients with KC located on the periocular area, that underwent MMS between 2017---2022. MMS details were recorded. Results: One hundred thirteen patients with periocular carcinomas were included. The mean age was 59 ± 13 years; 52% were women. The most frequent location was the medial canthus (53%), followed by the lower eyelid (30.1%). The most frequent BCC histology was the nodular variant (59.3%). Regarding MMS, the average number of stages was 1.5 ± 0.7, and 54% of the cases required only 1 stage to achieve clear margins. To date, no recurrence has been reported. Tumors larger than 8.5 mm in largest diameter or 43.5 mm2were more likely to require complex reconstruction. Study limitations: Retrospective design and a relatively low number of patients in the SCC group. Possible selection bias, as larger or more complex cases, may have been referred to oculoplastic surgeons directly.