TY  - JOUR
AU  - Chanda, Tirtha
AU  - Haggenmueller, Sarah
AU  - Bucher, Tabea
AU  - Holland-Letz, Tim
AU  - Kittler, Harald
AU  - Tschandl, Philipp
AU  - Heppt, Markus V
AU  - Berking, Carola
AU  - Utikal, Jochen
AU  - Schilling, Bastian
AU  - Buerger, Claudia
AU  - Navarrete-Dechent, Cristian
AU  - Goebeler, Matthias
AU  - Kather, Jakob Nikolas
AU  - Schneider, Carolin V
AU  - Durani, Benjamin
AU  - Durani, Hendrike
AU  - Jansen, Martin
AU  - Wacker, Juliane
AU  - Wacker, Joerg
AU  - Brinker, Titus
TI  - Dermatologist-like explainable AI enhances melanoma diagnosis accuracy: eye-tracking study.
JO  - Nature Communications
VL  - 16
IS  - 1
SN  - 2041-1723
CY  - [London]
PB  - Springer Nature
M1  - DKFZ-2025-01121
SP  - 4739
PY  - 2025
N1  - #EA:C140#LA:C140#
AB  - Artificial intelligence (AI) systems substantially improve dermatologists' diagnostic accuracy for melanoma, with explainable AI (XAI) systems further enhancing their confidence and trust in AI-driven decisions. Despite these advancements, there remains a critical need for objective evaluation of how dermatologists engage with both AI and XAI tools. In this study, 76 dermatologists participate in a reader study, diagnosing 16 dermoscopic images of melanomas and nevi using an XAI system that provides detailed, domain-specific explanations, while eye-tracking technology assesses their interactions. Diagnostic performance is compared with that of a standard AI system lacking explanatory features. Here we show that XAI significantly improves dermatologists' diagnostic balanced accuracy by 2.8 percentage points compared to standard AI. Moreover, diagnostic disagreements with AI/XAI systems and complex lesions are associated with elevated cognitive load, as evidenced by increased ocular fixations. These insights have significant implications for the design of AI/XAI tools for visual tasks in dermatology and the broader development of XAI in medical diagnostics.
KW  - Melanoma: diagnosis
KW  - Melanoma: diagnostic imaging
KW  - Humans
KW  - Artificial Intelligence
KW  - Eye-Tracking Technology
KW  - Dermatologists
KW  - Skin Neoplasms: diagnosis
KW  - Skin Neoplasms: diagnostic imaging
KW  - Female
KW  - Dermoscopy: methods
KW  - Male
KW  - Nevus: diagnosis
KW  - Nevus: diagnostic imaging
KW  - Adult
KW  - Middle Aged
LB  - PUB:(DE-HGF)16
C6  - pmid:40399272
C2  - pmc:PMC12095463
DO  - DOI:10.1038/s41467-025-59532-5
UR  - https://inrepo02.dkfz.de/record/301729
ER  -