Establishing Research Priorities for Artificial Intelligence Approaches in Dermatology Using an e-Delphi Exercise

Abstract

BACKGROUND: Artificial intelligence (AI) has significant potential to improve dermatological care, but most studies have concentrated on image-based skin cancer diagnostics. Broader applications remain limited, and it is uncertain whether existing research reflects clinicians' real-world priorities. Identifying these priorities is essential to ensure that AI development addresses genuine clinical needs and supports safe, equitable integration into practice. OBJECTIVES: To identify and prioritise clinician-derived research questions for the application of AI in dermatology through an international, consensus-based electronic Delphi (e-Delphi) study. METHODS: A three-round e-Delphi exercise was conducted between May 2022 and July 2025, overseen by a 15-member steering group from the British Association of Dermatologists and the American Academy of Dermatology. Clinicians involved in dermatological care or research were invited to participate. In round 1, participants submitted up to five research questions across ten predefined domains. The steering group refined and collated these into unique or themed items for prioritisation. In rounds 2 and 3, participants rated randomised subsets of 30 questions using a 0-5 Likert scale, re-rating the same items in round 3 after reviewing group mean scores. RESULTS: A total of 101 participants contributed to round 1, 150 to round 2, and 78 to round 3. Participants submitted 429 research questions, which were refined into 110 unique and themed items for prioritisation. The highest-rated questions focused on skin cancer diagnostics and monitoring, particularly dermoscopic interpretation and lesion surveillance in high-risk groups. When cancer-related questions were excluded, priorities shifted toward triage, workflow efficiency, diagnostic support for primary care, communication between teams, and improving diagnostic equity across skin tones. Dermatology consultants placed greater emphasis on service efficiency and medico-legal issues, while general practitioners and nurses prioritised implementation and access. CONCLUSIONS: This international consensus study identifies clinician-led priorities for AI research in dermatology. The findings provide a roadmap for researchers, funders, and policymakers to align future AI development with clinical needs, supporting equitable, efficient, and relevant innovation in dermatology.

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