The full information on the skin cancer dataset can be found in (18), and we summarized the dataset in (7, 27). Therefore, we here provide a brief summary. This dataset comprises 4320 diagnoses by 40 dermatologists of 108 skin lesions and were collected during a web-based consensus meeting (the Consensus Net Meeting on Dermoscopy). Skin lesions were obtained from the Department of Dermatology, University Federico II (Naples, Italy); the Department of Dermatology, University of L’Aquila (Italy); the Department of Dermatology, University of Graz (Austria); the Sydney Melanoma Unit, Royal Prince Alfred Hospital (Camperdown, Australia); and the Skin and Cancer Associates (Plantation, Florida). The lesions were selected on the basis of the photographic quality of the clinical and dermoscopic images available. The aim of the study was to diagnose whether or not a skin lesion was a melanoma, the most dangerous type of skin cancer. Histopathological specimens of all skin lesions were available and judged by a histopathology panel (melanoma, n = 27; no melanoma, n = 81; 25% prevalence). All participating dermatologists had at least 5 years of experience in dermoscopy practice, teaching, and research. They first underwent a training procedure in which they familiarized themselves with the study’s definitions and procedures in web-based tutorials with 20 sample skin lesions. They subsequently evaluated 108 skin lesions in a two-step online procedure. First, they used an algorithm to differentiate melanocytic from nonmelanocytic lesions. Whenever a lesion was evaluated as melanocytic, dermatologists were asked to classify it as either a melanoma or a benign melanocytic lesion using four different algorithms. Here, we focus on the diagnostic algorithm with the highest diagnostic accuracy, which is also the one most widely used for melanoma detection: pattern analysis. It uses a set of global (textured patterns covering most of the lesion) and local features (representing characteristics that appear in part of the lesion) to differentiate between melanomas and benign melanocytic lesions. We treated the decision to classify a lesion as melanoma as a positive test result.

The review board of the Second University of Naples waived approval because the study did not affect routine procedures. All participating dermatologists signed a consent form before participating in the study.

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