Startup makes it easy for doctors to classify skin conditions | MIT News

When Susan Conover wanted to have a strange-looking mole examined at age 22, she was told it would take three months to see a dermatologist. When the mole was finally removed and biopsied, doctors determined it was cancer. At the time, no one could be sure that the cancer hadn’t spread to other parts of her body — the difference between stage 2 and stage 3 or 4 melanoma.

Fortunately, the mole was eventually confined to one spot. But the experience brought Conover into the world of skin diseases and dermatology. After exploring these topics and potential technology solutions in MIT’s System Design and Management graduate program, Conover founded Piction Health.

Piction Health started out as a mobile app that used artificial intelligence to recognize melanoma from images. Over time, however, Conover realized that other skin conditions make up the vast majority of cases that doctors and dermatologists see. Today, Conover and her co-founder Pranav Kuber are focused on helping doctors identify and manage the most common skin conditions — including rashes like eczema, acne and shingles — and plan to partner with a company to help diagnose of skin cancer over time.

“All of these other conditions are often referred to dermatology, and dermatologists get frustrated because they prefer to spend time dealing with cases of skin cancer or other conditions that need their help,” says Conover. “We realized we needed to turn away from skin cancer to help skin cancer patients get to the dermatologist faster.”

After GPs take a picture of a patient’s skin condition, the Piction app shows images of similar skin presentations. Piction also helps physicians differentiate between the conditions they most suspect to make better patient care decisions.

Conover says Piction can reduce the time it takes doctors to evaluate a case by about 30 percent. It can also help doctors refer a patient to a dermatologist more quickly for special cases they don’t trust. More broadly, Conover focuses on helping health organizations reduce costs associated with unnecessary return visits, ineffective prescriptions and unnecessary referrals.

To date, more than 50 physicians have used Piction’s product, and the company has established partnerships with several organizations, including a well-known defense organization for two employees who were recently diagnosed with late-stage melanoma after being unable to see a dermatologist right away. †

“A lot of people don’t realize it’s really hard to see a dermatologist — it can take three to six months — and with the pandemic, trying to see a dermatologist has never been this bad,” says Conover.

Shocked to Action

At the time of Conover’s melanoma diagnosis, she had recently earned a bachelor’s degree in mechanical engineering from the University of Texas at Austin. But she didn’t dive deep into dermatology until she needed a thesis topic for her master’s degree at MIT.

“It was just a really scary experience,” Conover says of her melanoma. “I consider myself very lucky because I learned at MIT that every year there are a huge number of people with skin problems, two-thirds of those people go to primary care to get help, and about half of those cases are misdiagnosed because these health care providers don’t have as much training in dermatology.”

Conover first began exploring the idea of ​​starting a business to diagnose melanoma during the Nuts and Bolts of Founding New Ventures course offered during MIT’s Independent Activities Period in 2015. She also went through the IDEAS Social Innovation Challenge and the MIT $100K Entrepreneurship Competition while building its system. After graduation, she spent a year at MIT as a Catalyst Fellow in the MIT linQ program, where she worked in the lab of Martha Gray, the JW Kieckhefer Professor of Health Sciences and Technology and a member of MIT’s Institute for Medical Engineering and Science (IMES).

Through MIT’s Venture Mentoring Service, Conover also progressed through the I-Corps program, where she continued to engage with stakeholders. Through those conversations, she learned that rashes like psoriasis, eczema, and rosacea are responsible for the vast majority of skin problems seen by primary care physicians.

Meanwhile, while public health campaigns have focused on the importance of sun protection, public knowledge is lacking about conditions such as shingles, which affect up to 1 percent of Americans each year.

While it would be more difficult to train a machine learning model to spot a wide variety of conditions than it would to train a model to spot melanoma, Conover’s small team decided this was the best way forward. used to be.

“We decided it was better to just make the full product, even if it sounded scary and huge: a product that identifies all the different rashes on multiple body parts and skin tones and age groups,” says Conover.

The jump required Piction to establish data partnerships with hundreds of dermatologists in countries around the world during the pandemic. Conover says Piction now has the world’s largest dataset on skin rashes, with more than 1 million photos taken by dermatologists in 18 countries.

“We focused on taking photos of different skin tones because many skin tones are underrepresented even in medical literature and education,” says Conover. “Providers don’t always learn how all different skin tones can cause disease, so our representative database is a substantial statement about our commitment to health equality.”

Conover says Piction’s image database helps doctors assess primary care conditions more accurately. After a health care provider determines the most likely condition, Piction presents physicians with information about treatment options for each condition.

“This primary care environment is the ideal place for our innovation as they care for patients with skin conditions every day,” said Conover.

Helping doctors on a large scale

Conover is constantly reminded of the need for her system by family and friends, who have sent her pictures of their skin condition for advice. Recently, a friend of Conover’s developed shingles, a disease that can quickly worsen and cause blindness if it spreads to certain places on the body. A doctor misdiagnosed the shingles on her forehead as a spider bite and prescribed the wrong medication. The shingles got worse, causing ear and scalp pain before the friend went to the emergency room and received proper treatment.

“It was one of those moments where we thought, if only doctors had the right tools,” says Conover. “The PCP jumped to what it thought was the problem, but didn’t build the full list of possible conditions and narrowed it down from there.”

Piction will launch several additional pilots this year. Later, Conover wants to add capabilities to identify and evaluate wounds and infectious diseases that are more common in other parts of the world, such as leprosy. By partnering with nonprofit organizations, the company hopes to make its solution available to physicians in resource-poor environments as well.

“This has the potential to become a full-fledged diagnostic tool in the future,” says Conover. “I just don’t want anyone to feel the way I felt when I got my first diagnosis, and I want other people like me to be able to get the care they need at the right time and move on with their lives.”

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