Machine Learning in Medicine.
N Engl J Med. 2019 Apr 4;380(14):1347-1358. doi: 10.1056/NEJMra1814259.
Rajkomar A1, Dean J1, Kohane I1.
A 49-year-old patient notices a painless rash on his shoulder but does not seek care. Months later, his wife asks him to see a doctor, who diagnoses a seborrheic keratosis. Later, when the patient undergoes a screening colonoscopy, a nurse notices a dark macule on his shoulder and advises him to have it evaluated. One month later, the patient sees a dermatologist, who obtains a biopsy specimen of the lesion. The findings reveal a noncancerous pigmented lesion. Still concerned, the dermatologist requests a second reading of the biopsy specimen, and invasive melanoma is diagnosed. An oncologist initiates treatment with systemic chemotherapy. A physician friend asks the patient why he is not receiving immunotherapy.