Public Perceptions, Factors, and Incentives Influencing Patient Willingness to Share Clinical Images for Artificial Intelligence-Based Healthcare Tools

Abstract

Introduction The use of artificial intelligence (AI) as a diagnostic and decision-support tool is increasing in dermatology. The accuracy of image-based AI tools is incumbent on images in training sets, which requires patient consent for sharing. This study aims to understand individuals’ willingness to share their images for AI and variables that influence willingness. Methods In an online survey administered via Amazon Mechanical Turk, sketches of the hand, face, and genitalia assigned to two use cases employing AI (research vs. personal medical care) were shown. Participants rated willingness to share the image on a 7-point Likert scale. Results Of the 1010 participants, individuals were most willing to share images of their hands (81.2%), face (70.3%), and lastly genitals (male: 56.8%, female: 46.7%). Individuals were more willing to share for personal care versus research (OR 0.77 [95% CI 0.69–0.86]). Willingness to share was higher among males, participants with higher education, tech-savvy participants, and frequent social media users. Most participants were willing to share images if offered monetary compensation, with face images requiring the highest payment (mean $18.25, SD 20.05). Only 38.7% of individuals refused image sharing regardless of any monetary compensation, with the majority of this group unwilling to share images of the genitals. Conclusions This study demonstrates overall public support for sharing images to AI-based tools in dermatology, with influencing factors including image type, context, education level, technology comfort, social media use, and monetary compensation. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-023-01031-w.

Consent and Identifiability for Patient Images in Research, Education, and Image-Based Artificial Intelligence

“…Sharing images for clinical research, education, and development of image-based AI has associated ethical and legal concerns. Prior studies suggest patients might share their images, especially for clinical purposes, but consent preferences have not been published. Informed consent is not required for using deidentified data for clinical research and education, abiding by US and European laws, and practices protecting privacy remain unstandardized .…”

“…Prior studies suggest patients might share their images, especially for clinical purposes, but consent preferences have not been published. Informed consent is not required for using deidentified data for clinical research and education, abiding by US and European laws, and practices protecting privacy remain unstandardized . The CLEAR (Checklist for Evaluation of Image-Based AI Reports in Dermatology) guidelines provide a framework for addressing the challenges of image use for AI in dermatology, but guidelines on consent based on patient preferences are needed …”

“…Increasing use of imaging for research, education, and development of image-based artificial intelligence (AI) is parallel to increasing concerns about confidentiality and autonomy. Regulatory requirements for collecting and processing personal information vary geographically, but even the most stringent legal guidelines do not require informed consent for sharing of deidentified data . Despite widespread use of imaging in dermatology and portability of digital image formats that enable both rapid intentional and inadvertent image sharing, information about attitudes and preferences on consent and identifiability are limited.…”

The Past, the Present and the Future of Teledermatology: A Narrative Review

“… 51 In addition, the formation of image sets requires the patients’ consent, an aspect investigated by Ly et al, who observed that most patients were not against this, although for body parts such as the face and genitals they were less predisposed than for areas such as the hands. 52 Recent years have also seen the spread of AI-powered chatbots, of which ChatGPT is the most renowned. 53 It is based on deep-learning technology and one of the major risks being observed is the tendency of users to ask questions of a medical nature, including dermatology.…”