ArticleNature communications2025
Discordance, accuracy and reproducibility study of pathologists' diagnosis of melanoma and melanocytic tumors.
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Article in Nature communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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16citing papers in PubMed, 2 pooled it
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prospective Evidence on Artificial Intelligence-Assisted Melanoma Diagnostics: A Systematic Review and Meta-Analysis.JAMA dermatology · 2026Pooled it
- Transforming histologic assessment: artificial intelligence in cancer diagnosis and personalized treatment.British journal of cancer · 2025Pooled it
- AI Dermatology's Unfulfilled Promise: Why Early Melanoma Detection Remains Unverified.International journal of dermatology · 2026Article
- Dermoscopy and the Early Melanoma Concept.International journal of dermatology · 2026Review
- Discordance Between Morphology and Molecular Findings in Dermatopathology: A Perspective on Diagnostic Integration.Journal of cutaneous pathology · 2026Article
- Article
- Diagnostic concordance of dermatopathology and PCR in differentiating eczema from psoriasis.Journal of the European Academy of Dermatology and Venereology : JEADV · 2026Article
- Towards Accurate Breslow Measurements: Mitigating Issues in Histopathological Imaging.Entropy (Basel, Switzerland) · 2026Article
- Overdiagnosis of Melanoma In Situ.Journal of clinical medicine · 2026Review
- Defensive medicine in dermatological practice - Dermatopathology as a mirror of structural challenges.Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG · 2026Review
- A model combining deep learning and ensemble learning for melanoma recognition via dermoscopy.Frontiers in oncology · 2026Article
- Circulating tumor cells as biomarkers in melanoma: techniques, challenges, and clinical applications.Frontiers in cell and developmental biology · 2026Review
- From Slide to Insight: The Emerging Alliance of Digital Pathology and AI in Melanoma Diagnostics.Cancers · 2025Review
- Screening and novel diagnostic technologies for melanoma: an update.Melanoma management · 2025Review
- Numerical Analysis of a SiN Digital Fourier Transform Spectrometer for a Non-Invasive Skin Cancer Biosensor.Sensors (Basel, Switzerland) · 2025Article
- Targeting ferroptosis, pyroptosis and necroptosis for cancer immunotherapy in melanoma: mechanistic insights and clinical perspectives.Frontiers in immunology · 2025Review
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Authors and funding
47 authors.
Sarah HaggenmüllerDigital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Christoph WiesDigital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany.ORCID http://orcid.org/0000-0001-7136-298X
Julia AbelsDigital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Jana T WintersteinDigital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany.ORCID http://orcid.org/0000-0003-3346-9537
Lukas HeinleinDigital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany.ORCID http://orcid.org/0009-0009-5720-7700
Carina Nogueira GarciaDigital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Jochen S UtikalDepartment of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany.ORCID http://orcid.org/0000-0001-5316-0241
Sebastian A WohlfeilDepartment of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany.ORCID http://orcid.org/0000-0003-4677-6149
Friedegund MeierSkin Cancer Center at the University Cancer Center and National Center for Tumor Diseases Dresden, Department of Dermatology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.ORCID http://orcid.org/0000-0003-4340-9706
Sarah HobelsbergerSkin Cancer Center at the University Cancer Center and National Center for Tumor Diseases Dresden, Department of Dermatology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Frank F GellrichSkin Cancer Center at the University Cancer Center and National Center for Tumor Diseases Dresden, Department of Dermatology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.ORCID http://orcid.org/0000-0002-2164-4644
Mildred SergonInstitute of Pathology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Axel HauschildDepartment of Dermatology, University Hospital (UKSH), Kiel, Germany.
Lars E FrenchDepartment of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany.ORCID http://orcid.org/0000-0002-4629-1486
Lucie HeinzerlingDepartment of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany.
Justin G SchlagerDepartment of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany.
Kamran GhoreschiDepartment of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID http://orcid.org/0000-0002-5526-7517
Max SchlaakDepartment of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.ORCID http://orcid.org/0000-0002-1663-8098
Franz J HilkeDepartment of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Gabriela PochDepartment of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Sören KorsingDepartment of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Cosimo SarfertDepartment of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Carola BerkingDepartment of Dermatology, University Hospital Erlangen, Comprehensive Cancer Center Erlangen - European Metropolitan Region Nürnberg, CCC Alliance WERA, Erlangen, Germany.ORCID http://orcid.org/0000-0003-0229-8931
Markus V HepptDepartment of Dermatology, University Hospital Erlangen, Comprehensive Cancer Center Erlangen - European Metropolitan Region Nürnberg, CCC Alliance WERA, Erlangen, Germany.ORCID http://orcid.org/0000-0003-4603-1825
Michael ErdmannDepartment of Dermatology, University Hospital Erlangen, Comprehensive Cancer Center Erlangen - European Metropolitan Region Nürnberg, CCC Alliance WERA, Erlangen, Germany.ORCID http://orcid.org/0000-0001-7136-6489
Sebastian HaferkampDepartment of Dermatology, University Hospital Regensburg, Regensburg, Germany.
Konstantin DrexlerDepartment of Dermatology, University Hospital Regensburg, Regensburg, Germany.
Dirk SchadendorfDepartment of Dermatology, Venereology and Allergology, University Hospital Essen, Essen, Germany.ORCID http://orcid.org/0000-0003-3524-7858
Wiebke SondermannDepartment of Dermatology, Venereology and Allergology, University Hospital Essen, Essen, Germany.ORCID http://orcid.org/0000-0002-3684-3523
Matthias GoebelerDepartment of Dermatology, Venereology and Allergology, University Hospital Würzburg and National Center for Tumor Diseases (NCT) WERA Würzburg, Würzburg, Germany.ORCID http://orcid.org/0000-0001-7095-9848
Bastian SchillingGoethe University Frankfurt, University Hospital, Department of Dermatology, Frankfurt, Germany.ORCID http://orcid.org/0000-0001-8859-4103
Jakob Nikolas KatherElse Kroener Fresenius Center for Digital Health, Technical University Dresden, Dresden, Germany.ORCID http://orcid.org/0000-0002-3730-5348
Stefan FröhlingDepartment of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany.ORCID http://orcid.org/0000-0001-7907-4595
Mar Llamas-VelascoDepartment of Dermatology, University Hospital La Princesa, Madrid, Spain.
Luis C RequenaDermatology Department, Fundación Jiménez Díaz, Autonomous University of Madrid, Madrid, Spain; Anatomic Pathology Service, Fundación Jiménez Díaz, Madrid, Spain.
Gerardo FerraraAnatomic Pathology and Cytopathology Unit, Istituto Nazionale Tumori I.R.C.C.S. Fondazione 'G. Pascale', Naples, Italy.ORCID http://orcid.org/0000-0003-0727-4015
Maite Fernandez-FiguerasUniversity General Hospital of Catalonia, Grupo Quironsalud, International University of Catalonia, Sant Cugat del Vallés, Barcelona, Spain.ORCID http://orcid.org/0000-0002-2366-7110
Sylvie FraitagPathology department, Necker-Enfants Malades Hospital, Université Paris-Cité, Assistance Publique des Hopitaux de Paris, Paris, France.
Cornelia S L MüllerCenter for Histology, Cytology and Molecular Diagnostics, Trier, Germany.
Hans StarzDermpath München, Munich, Germany.
Heinz KutznerDermatopathology Friedrichshafen, Friedrichshafen, Germany.
Raymond BarnhillDepartments of Pathology and Translational Research, Institut Curie, Paris, France.
Richard CarrDepartment of Pathology, Warwick Hospital, Warwick, UK.
Kenneth S ResnikInstitute for Dermatopathology, Newtown Square, PA, USA.
Stephan Alexander BraunDepartment of Dermatology, University of Münster, Münster, Germany; Department of Dermatology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.ORCID http://orcid.org/0000-0002-5600-0195
Tim Holland-LetzDepartment of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Titus J BrinkerDigital Biomarkers for Oncology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany. titus.brinker@dkfz.de.ORCID http://orcid.org/0000-0002-3620-5919
Funding
Bundesministerium für Gesundheit (Federal Ministry of Health, Germany) Skin Classification Project 2
Abstract
Accurate melanoma diagnosis is crucial for patient outcomes and reliability of AI diagnostic tools. We assess interrater variability among eight expert pathologists reviewing histopathological images and clinical metadata of 792 melanoma-suspicious lesions prospectively collected at eight German hospitals. Moreover, we provide access to the largest panel-validated dataset featuring dermoscopic and histopathological images with metadata. Complete agreement is achieved in 53.5% of cases (424/792), and a majority vote ( ≥ five pathologists) in 90.9% (720/792). Considerable discordance is observed for non-invasive melanomas (complete agreement in only 10/73 cases). The expert panel disagrees with the local pathologists' and dermatologists' diagnoses in 14.9% and 33.5% of cases, respectively. This variability highlights the diagnostic challenges of early-stage melanomas and the need to reconsider how ground truth is established in routine care and AI research. Including at least two pathologists or virtual panels may contribute to more consistent diagnostic results.
Indexed as
MelanomaPathologistsSkin NeoplasmsDermoscopyFemaleGermanyHumansMaleMiddle AgedObserver VariationProspective StudiesReproducibility of Results
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