Explainable Image Quality Assessments in Teledermatological Photography
This addresses the need for automated, explainable image quality assessment to improve efficiency in teledermatological consultations, though it is incremental as it applies existing deep learning methods to a specific domain.
The paper tackles the problem of poor image quality in teledermatology, where up to 50% of patient-submitted images have issues, by introducing ImageQX, a convolutional neural network that achieves expert-level performance with a macro F1-score of 0.73 for quality assessment and F1-scores up to 0.70 for explaining quality issues.
Image quality is a crucial factor in the effectiveness and efficiency of teledermatological consultations. However, up to 50% of images sent by patients have quality issues, thus increasing the time to diagnosis and treatment. An automated, easily deployable, explainable method for assessing image quality is necessary to improve the current teledermatological consultation flow. We introduce ImageQX, a convolutional neural network for image quality assessment with a learning mechanism for identifying the most common poor image quality explanations: bad framing, bad lighting, blur, low resolution, and distance issues. ImageQX was trained on 26,635 photographs and validated on 9,874 photographs, each annotated with image quality labels and poor image quality explanations by up to 12 board-certified dermatologists. The photographic images were taken between 2017 and 2019 using a mobile skin disease tracking application accessible worldwide. Our method achieves expert-level performance for both image quality assessment and poor image quality explanation. For image quality assessment, ImageQX obtains a macro F1-score of 0.73 +- 0.01, which places it within standard deviation of the pairwise inter-rater F1-score of 0.77 +- 0.07. For poor image quality explanations, our method obtains F1-scores of between 0.37 +- 0.01 and 0.70 +- 0.01, similar to the inter-rater pairwise F1-score of between 0.24 +- 0.15 and 0.83 +- 0.06. Moreover, with a size of only 15 MB, ImageQX is easily deployable on mobile devices. With an image quality detection performance similar to that of dermatologists, incorporating ImageQX into the teledermatology flow can enable a better, faster flow for remote consultations.