10.5826/dpc.1301a35
Introduction: Artificial intelligence (AI) and its application are one of the most discussed modern technologies nowadays. With the rapid use of AI in medicine, and specifically in dermatology, only a few studies have studied the attitude of physicians toward AI.
Objective: To recognize the attitudes towards AI among dermatologists in the Kingdom of Saudi Arabia.
Methods: A cross-sectional survey was done among dermatologists in Saudi Arabia.  Questionnaires were distributed through several online channels.
Results: Overall, 103 dermatologists filled out the survey. The majority saw very strong or strong potential for AI in automated detection of skin diseases based on dermatological clinical images (50.9%), dermoscopic images (66.6%), and within dermatopathology (66.6%). In regard to results of attitudes towards AI, 56.6% and 52. 8% agreed that AI will revolutionize medicine and dermatology, respectively. However, many of the respondents disagreed that AI will replace physicians (41.5%) and human dermatologists (39.6%) in the future.. Age did not impact the overall attitude of dermatologists. 
Conclusion: Dermatologists in Saudi Arabia showed an optimistic attitude towards AI in dermatology and medicine. However, dermatologists believe that AI will not replace humans in the future.
text/xml
2160-9381
2524
en
Louai Salah
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Attitudes
Attitudes Towards Artificial intelligence Among Dermatologists Working in Saudi Arabia		
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Original Article
2023-01-31
2022-04-08
2023-01-31
2023-02-27
e2023035
Dermatol Pract Concept
Introduction: Artificial intelligence (AI) and its application are one of the most discussed modern technologies nowadays. With the rapid use of AI in medicine, and specifically in dermatology, only a few studies have studied the attitude of physicians toward AI.
Objective: To recognize the attitudes towards AI among dermatologists in the Kingdom of Saudi Arabia.
Methods: A cross-sectional survey was done among dermatologists in Saudi Arabia.  Questionnaires were distributed through several online channels.
Results: Overall, 103 dermatologists filled out the survey. The majority saw very strong or strong potential for AI in automated detection of skin diseases based on dermatological clinical images (50.9%), dermoscopic images (66.6%), and within dermatopathology (66.6%). In regard to results of attitudes towards AI, 56.6% and 52. 8% agreed that AI will revolutionize medicine and dermatology, respectively. However, many of the respondents disagreed that AI will replace physicians (41.5%) and human dermatologists (39.6%) in the future.. Age did not impact the overall attitude of dermatologists. 
Conclusion: Dermatologists in Saudi Arabia showed an optimistic attitude towards AI in dermatology and medicine. However, dermatologists believe that AI will not replace humans in the future.
Louai Salah
2023/01/31
10.5826/dpc.1301a35
e2023035
Dermatology Department, East Jeddah General Hospital, Ministry of Health, Jeddah, Saudi Arabia
2160-9381
Attitudes
en
e2023035
Oh S, Kim JH, Choi SW, et al. Physician Confidence in Artificial Intelligence: An Online Mobile Survey. JMIR. 2019 Mar 25;21(3):e12422. doi: 10.2196/12422. PubMed PMID: 30907742; PubMed Central PMCID: PMCPMC6452288. eng.
Attitudes Towards Artificial intelligence Among Dermatologists Working in Saudi Arabia		
https://dpcj.org/index.php/dpc/article/download/2524/1972
      Attitudes Towards Artificial Intelligence Among
          Dermatologists Working in Saudi Arabia
       Fatima Al-Ali1, Sam Polesie2,3, John Paoli2,3, Mohammed Aljasser4, 5, Louai A Salah6


1 Department of Internal Medicine, King Hamad University Hospital, Muharraq, Bahrain
2 Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg,
  Gothenburg, Sweden
3 Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden
4 College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
5 Division of Dermatology, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
6 Dermatology Department, East Jeddah General Hospital, Ministry of Health, Jeddah, Saudi Arabia



Key words: dermatologists, artificial intelligence, attitudes
Citation: Al-Ali F, Polesie S, Paoli J, Aljasser M, Salah LA. Attitudes Towards Artificial intelligence Among Dermatologists Working in Saudi
Arabia. Dermatol Pract Concept. 2023;13(1):e2023035. DOI: https://doi.org/10.5826/dpc.1301a35
Accepted: June 17, 2022; Published: January 2023
Copyright: ©2023 Al-Ali et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing Interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding Author: Louai A Salah, Dermatology Department, East Jeddah Hospital, 2277 King Abdullah Rd, Al Sulaymaniyah, Jeddah
22253, Makkah, Saudi Arabia. Tel: 012 232 7555 E-mail loai.salah@gmail.com




  ABSTRACT              Introduction: Artificial intelligence (AI) and its applications are among the most discussed modern
                        technologies today. Despite the rapidly expanding use of AI in medicine, and specifically in dermatol-
                        ogy, only a few studies have studied the attitude of physicians toward AI.
                        Objective: To recognize the attitudes towards AI among dermatologists in the Kingdom of Saudi
                        Arabia.
                        Methods: A cross-sectional survey was done among dermatologists in Saudi Arabia. Questionnaires
                        were distributed through several online channels.
                        Results: Overall, 103 dermatologists filled out the survey. The majority saw very strong or strong
                        potential for AI in the automated detection of skin diseases based on dermatological clinical images
                        (50.9%), dermoscopic images (66.6%) and within dermatopathology (66.6%). In regard to results of
                        attitudes towards AI, 56.6% and 52. 8% agreed that AI will revolutionize medicine and dermatology,
                        respectively. However, many of the respondents disagreed that AI will replace physicians (41.5%) and
                        human dermatologists (39.6%) in the future. Age did not impact the overall attitude of dermatologists.
                        Conclusion: Dermatologists in Saudi Arabia showed an optimistic attitude towards AI in dermatology
                        and medicine. However, dermatologists believe that AI will not replace humans in the future.




Original Article | Dermatol Pract Concept. 2023;13(1):e2023035                                                                             1
Introduction                                                      Results
With the current advancement of technology, algorithms            Among the 103 dermatologists who responded to the survey,
have taken on a huge role in the field of medicine and dis-       87 (84.5%) were practicing dermatology in Saudi Arabia
placed much of the work of physicians. Artificial intelligence    and 9 (9.4%) were not, at the time of the study (Table 1).
(AI) and its application in various fields are considered one     The majority of the respondents were male (n=33, 67.3%),
of the most talked about modern technologies today. Experts       mostly between the ages of 31 to 40 years old (n=17, 34.7%)
                                                             st
in medicine have described AI as the stethoscope of the 21        and had 6-10 years (n=14, 28.6%) experience in dermatol-
century [1].                                                      ogy. In regards to their main practice setting, most of the
    AI is a revolution that can help optimize any job. A
r­ ecent review showed a promising impact on the sensitivity
and accuracy in the screening of skin lesions and skin cancer       Table 1. Socio-demographic characteristics of
detection [2]. Multiple recent studies demonstrated the ben-             respondents in the study (n = 103).
efits of AI. Worldwide, there is an increasing number of im-                                 Variables
pressive attempts at the rapid leveraging of this technology                                               n     Percentage(%)
in dermatology [3].                                                Practicing in Saudi Arabia
    With the rapidly expanding use of AI in medicine and            Yes                                  87            84.5
specifically in dermatology, there are only a few studies that
                                                                    No                                     9            8.7
discussed the attitude of physicians towards AI. In order to
                                                                    Skipped                                7            6.7
understand the attitudes, an online survey was prepared.
                                                                   Distribution of answers to the questions below:
                                                                    Answered                             49            47.6
Objective                                                           Skipped                              54            52.4
                                                                   Gender
The goal of the current study is to understand the attitudes
towards AI among dermatologists in the Kingdom of Saudi             Female                               16            32.6
Arabia. To our knowledge, this topic has never been investi-        Male                                 33            67.4
gated through research in Saudi Arabia.                            Age
                                                                    21-30 years                            2            4.1
                                                                    31-40 years                          17            34.7
Materials and Methods
                                                                    41-50 years                            7           14.3
A cross-sectional survey was prepared. Survey forms were            51-60 years                            8           16.3
disseminated electronically through the Saudi Society of            61-70 years                          15            30.6
Dermatology and Dermatologic Surgery mailing group and             Main practice setting
a Saudi dermatologists’ WhatsApp group during the months
                                                                    University hospital                  12            24.5
of September 2020, March and July 2021. Included in the
                                                                    Military hospital                      5           10.2
study were dermatologists (consultants and specialists)
                                                                    Public teaching hospital               8           16.3
working or having worked in Saudi Arabia at the time of the
                                                                    Public non-teaching hospital           8           16.3
survey and who had online access.
    The survey was adapted from the form used in an orig-           Private clinic                       10            20.4

inal study by two of the authors [4]. It contained 30 ques-         Private hospital                       4            8.2
tions including socio-demographic data (gender, age, main           Other                                  2            4.1
practice setting, and years of working in Saudi Arabia), their     Years of working in dermatology
background knowledge and sources of AI and, lastly, their           0-5 years                              5           10.2
feelings and attitudes towards AI in dermatology.                   6-10 years                           14            28.6
    Analysis and data management were done using IBM                11-15 years                            6           12.2
SPSS software version 23 (IBM Corp., Armonk, N.Y., US).             16-20 years                            4            8.2
Results were presented as counts and percentages for cate-
                                                                    21-25 years                            8           16.3
gorical variables while numerical variables were presented by
                                                                    26-30 years                            2            4.1
mean and standard deviations. Also, the General Linear Re-
                                                                    31-35 years                            5           10.2
gression Model (GLRM) was used to determine the relation
                                                                    36-40 years                            4            8.2
of sex and group with attitudes using scores for the answers.
P-values <0.05 were considered statistically significant.           40 above years                         1              2



2                                                                     Original Article | Dermatol Pract Concept. 2023;13(1):e2023035
respondents practiced in University hospitals (n=12, 24.5%)             (n=28, 49.1%) and on dermatopathology images (n=23,
followed by private clinics (n=10, 20.4 %), public teaching             40.4%) (Table 4).
hospitals (n=8, 16.3%) and public non-teaching hospitals                      More than half of the respondents considered themselves
(n=8, 16.3%).                                                           as well-educated regarding the use of modern technology
    Answers regarding background knowledge in AI revealed               (n=28, 52.8%). The majority of respondents had read med-
that 46 (63.9%) knew about AI as a topic in dermatology.                ical publications regarding AI within dermatology (n=25,
However, 11.1% (n=8) had excellent knowledge when it                    51%) while most had not used AI as a diagnostic aid in real
comes to AI in dermatology and the majority (n=20, 27.8%)               life (n=34, 69.4%) (Table 5).
had only heard about it but not more (Table 2). Meanwhile,                    Results of attitudes towards AI revealed that age did not
when asked about their source of AI information, 68.8%,                 affect the attitudes of dermatologists toward AI overall. In
65.6%, 42.2% and 32.8% heard about AI from social me-                   general, 56.6% (n=30) and 52.8% (n=28) agreed that AI
dia, media, friends, and lectures, respectively (Table 3).              will generally revolutionize medicine and dermatology, re-
    In regard to potential applications of AI in dermatology,           spectively. Twenty-six (49.1%) agreed that dermatology and
respondents believed that AI has a strong potential in the au-          medicine become more exciting to them with the increased
tomated detection of skin diseases based on clinical derma-             use of AI. More than half agreed that AI will improve der-
tological images (n=20, 35.1%), on dermatoscopic images                 matology (n=30, 56.6%) and medicine in general (n=27,
                                                                        50.9%) and almost half (n=24, 45.3%) agreed that AI must
                                                                        be part of medical training. However, most respondents
   Table 2. Distribution of answers regarding                           expressed disagreement regarding AI replacing physicians
 background knowledge of artificial intelligence.
                                          Count Percent (%)                    Table 3. Distribution of answers regarding
 AI is a topic that has become of interest to the
                                                                             sources of knowledge on artificial intelligence.
 Dermatology community.                                                         Sources              Count            Percent (%)
 Were you already aware of this topic in Dermatology?
                                                                         Media
  Yes                                       46         63.9              Yes                            42                 65.6
  No                                        26         36.1              No                             22                 34.4
 Which degree of knowledge would you say you have                        Social Media
 when it comes to AI within Dermatology?                                 Yes                            44                 68.7
  Excellent Knowledge                         8        11.1              No                             20                 31.2
  Good Knowledge                            14         19.4              Lectures

  Basic Knowledge                           19         26.4              Yes                            21                 32.8
                                                                         No                             43                 67.2
  I have heard about it, but                20         27.8
  not more                                                               Friends
                                                                         Yes                            27                 42.2
  I have never heard about it               11         15.3
                                                                         No                             37                 57.8
*72 (69.9.%) participants answered this part
                                                                        *64 (62.1%) participants answered this part


   Table 4. Distribution of answers regarding the potential of artificial intelligence in dermatology*.
                                          Very strong             Strong         Moderate          Low            No         I don’t
         Question Choices                  potential             potential       potential       potential     potential      know
 Automated detection of skin               9(15.8%)           20(35.1%)          16(28.1%)      10(17.5%)       1(1.7%)     1(1.7%)
 diseases based on dermatological
 clinical images?
 Automated detection of skin               10(17.5%)          28(49.1%)          13(22.8%)        5(8.8%)        0(0%)      1(1.7%)
 diseases based on dermatoscopic
 images?
 Automated detection of skin               15(26.3%)          23(40.3%)          11(19.3%)       6(10.5%)        0(0.%)     2(3.5%)
 diseases based on
 dermatopathology images?

*57 (55.3%) participants answered this part



Original Article | Dermatol Pract Concept. 2023;13(1):e2023035                                                                         3
        Table 5. Distribution of answers regarding attitudes towards artificial intelligence among
                                     dermatologists in Saudi Arabia.
                                                           Section 1*
                                                                                Neither
                                                  Strongly                     agree nor                      Strongly      I don’t
              Question Choices                     agree          Agree         disagree       Disagree       Disagree       know
 AI will revolutionize Medicine in general.       16(30.2%)      30(56.6%)      4(7.5%)        2(3.8%)        0(0.0%)       1(1.9%)
 AI will revolutionize Dermatology                16(30.2%)      28(52.8%)      4(7.5%)        3(5.7%)        0(0.0%)       0(0.0%)
 AI will revolutionize Dermatology more           6(11.3%)       15(28.3%)     16(30.2%)      10(18.9%)       2(3.8%)       4(7.5%)
 than other medical specialties in general.
 In the foreseeable future, all physicians will    2(3.8%)        4(7.5%)       5(9.4%)       22(41.5%)      17(32.1%)      3(5.7%)
 be replaced by AI.
 The human dermatologist will be replaced          2(3.8%)        3(5.7%)       5(9.4%)       21(39.6%)       18(34%)       4(7.5%)
 by AI in the foreseeable future.
 A development with an increased use of AI         3(5.7%)       6(11.3%)        9(17%)       23(43.4%)      12(22.6%)      0(0.0%)
 in Dermatology frightens me.
 A development with an increased use of AI        14(26.4%)      26(49.1%)     12(22.6%)       1(1.9%)        0(0.0%)       0(0.0%)
 in Dermatology makes Dermatology more
 exciting to me.
 A development with an increased use of AI        13(24.5%)      26(49.1%)     11(20.7%)       1(1.9%)        2(3.8%)       0(0.0%)
 makes Medicine in general more exciting
 to me.
 AI will improve Dermatology.                     15(28.3%)      30(56.6%)      5(9.4%)        1(1.9%)        2(3.8%)       0(0.0%)
 AI will improve Medicine in general.             16(30.2%)      27(50.9%)     7(13.2%)        1(1.9%)        1(1.9%)       1(1.9%)
 AI should be part of medical training.           21(39.6%)      24(45.3%)      5(9.4%)        2(3.8%)        0(0.0%)       1(1.9%)
                                                           Section 2**
                                                                                Neither
                                                  Strongly                     agree nor                      Strongly      I don’t
                                                   agree          Agree         disagree       Disagree       Disagree       know
 I consider myself well informed about            13(26.5%)      28(52.8%)      3(6.1%)       5(10.2%)        0(0.0%)       0(0.0%)
 the use of modern technology, especially
 computers.
                                                     Yes            No
 Would you consider yourself to be someone 47(95.9%)              2(4.1%)
 who enjoys technology?
 Have you read any medical publications           25(51.1%)      24(49%)
 regarding AI within Dermatology?
 Have you used AI as a diagnostic                 15(30.6%)      34(69.4%)
 aid in real life within Dermatology?

*53 (51.5%) participants answered this part
** 49 (47.6) participants answered this part



(n=22, 41.5%) and human dermatologists (n=21, 39.6%) in            had not used AI in diagnosis in real settings but generally
the future. In addition, 43.4% (n=23) were not frightened          agreed that AI will revolutionize dermatology and medicine.
about the increased use of AI. The majority of respondents            While 63,9% of the respondents were aware of AI as a
were neutral regarding the proposal that “AI will revolu-          topic in dermatology, the majority of them had only heard
tionize dermatology more than other medical specialties”           about it (n=20, 27.8%) and only 11.1% had excellent knowl-
(n=16, 30.2%).                                                     edge. Although the awareness of AI among dermatologists
                                                                   was lower compared to the report of Polesie et al. [4], respon-

Discussion                                                         dents viewed AI as having strong potential in the detection of
                                                                   skin diseases. Dermatologists saw a stronger potential of AI in
In this cross-sectional study, dermatologists in Saudi Arabia      detection using dermatoscopic images and within dermatopa-
showed a positive attitude towards AI. Most of the respondents     thology than with dermatological clinical images [4].


4                                                                        Original Article | Dermatol Pract Concept. 2023;13(1):e2023035
    In our study, although respondents were optimistic about       showed that most dermatologists were aware of the poten-
the increased use of AI in the development of dermatology          tial of AI in the automated detection of skin diseases using
and medicine in general, the majority (n=21, 39.6%) dis-           dermatoscopic, histopathological and clinical dermatologi-
agreed that AI will replace doctors. Only 3.8% strongly            cal images. Moreover, they agreed that AI will revolutionize
agreed while 5.7% agreed with this hypothesis. This is con-        dermatology and the development of AI within our specialty
sistent with other studies about AI. Polesie et al. reported       seemed exciting to them. However, most participants believed
similar results in which only 5.5% of the participants agreed      that AI will not replace physicians in the future.
that human doctors will be displaced by AI [4]. Krittanawong
also concluded that although AI may become more effective
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the attitudes of dermatologists about AI. Furthermore, results




Original Article | Dermatol Pract Concept. 2023;13(1):e2023035                                                                          5
