Startup helps doctors classify skin conditions at a glance | MIT News

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

Fortunately, the mole ended up being confined to one location. But the experience launched Conover into the world of skin disease and dermatology. After exploring these topics and possible technological solutions through MIT’s Systems 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 made up the vast majority of cases doctors and dermatologists see. Today, Conover and his 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 skin cancers down the line.

“All these other conditions are the ones that often get referred to dermatology, and dermatologists get frustrated because they’d rather spend time on cases of skin cancer or other conditions that need their help,” explains Conover. “We realized we needed to move away from skin cancer in order to help skin cancer patients see the dermatologist sooner.”

After primary care physicians take a picture of a patient’s skin condition, Piction’s app displays images of similar skin presentations. Piction also helps doctors differentiate between the conditions they suspect most so they can make better care decisions for the patient.

Conover says Piction can reduce the time it takes doctors to assess a case by about 30%. It can also help doctors refer a patient to a dermatologist more quickly for specific cases they are unsure of handling. More generally, Conover aims to help healthcare organizations reduce the costs associated with unnecessary visits, ineffective prescriptions and unnecessary referrals.

So far, more than 50 doctors have used Piction’s product, and the company has partnered with several organizations, including a well-known advocacy organization that recently had two employees diagnosed with stage-stage melanoma. advanced after they couldn’t 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, there’s never been a worse time to try to see a dermatologist,” says Conover.

shocked in 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 delve deep into dermatology until she needed a thesis topic for her master’s 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 there are huge numbers of people with skin problems every year, two-thirds of those people go to primary care for help, and about half of these cases are misdiagnosed because these providers don’t have as much training in dermatology.

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

Through MIT’s Venture Mentoring Service, Conover also completed the I-Corps program, where she continued to speak with stakeholders. During these conversations, she learned that skin rashes such as psoriasis, eczema, and rosacea account for the vast majority of skin issues seen by primary care physicians.

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

Although training a machine learning model to recognize a myriad of diverse conditions is more difficult than training a model to recognize melanoma, Conover’s small team decided it was the best way forward. .

“We decided it was best to move on to making the complete product, even though it seemed scary and huge: a product that identifies all the different rashes on multiple body parts, 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 largest rash dataset in the world, containing more than a million photos taken by dermatologists in 18 countries.

“We focused on getting 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 present with conditions, so our representative database is a substantial statement about our commitment to health equity.”

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

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

Helping doctors on a large scale

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

“It was one of those times when we thought, ‘If only doctors had the right tools,'” Conover says. “PCP jumped on what they thought was the problem, but didn’t build the full list of potential conditions and narrowed down from there.”

Piction will release several additional pilots this year. Ultimately, Conover wants to add capabilities to identify and assess wounds and infectious diseases that are more common in other parts of the world, such as leprosy. By partnering with nonprofit groups, the company also hopes to bring its solution to doctors in low-resource settings.

“It has the potential to become a comprehensive diagnostic tool in the future,” says Conover. “I just don’t want anyone to feel what I felt when I was first diagnosed, and I want other people like me to be able to get the care they need at the right time and get on with their lives. .”

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