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ZZ: obtained funding; developed protocol; contributed equally to the design and running of the model with CH and JJ; critically revised first draft; and agreed to the final version of the paper. BG: obtained funding; developed protocol; critically revised first draft; and agreed final version of the paper. CH: obtained funding; developed protocol; contributed equally to the design and running of the model with JJ and ZZ; wrote first draft of paper; agreed final version of the paper; and acted as corresponding author","order":5,"name":"Ethics","label":"Author Contributions","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Prof Chris Hyde was a member of the Clinical Advisory Committee of Skin Analytics until August 2025. This committee met for 2\u20133 h, 2\u20134 times a year. He received reimbursement for reading material and attending meetings at a rate of \u00a3150 per hour. He has no other interest in Skin Analytics, and in particular he is not a paid employee nor does he hold shares\/share options in the company. Prof Chris Hyde and Dr Zhivko Zhelev undertook a project funded by Skin Analytics to develop a health economic model for the Deep Ensemble for the Recognition of Melanoma (DERM) used in the post-referral pathway. \u2018Developing a cost-effectiveness model of AI in the diagnosis of skin cancer\u2019 commenced in July 2022 and ran for 1 year. The value was \u00a325,000. The project reported here was part of a wider evaluation funded by the NHS Cancer Programme, with the support of Small Business Research Initiative (SBRI) healthcare and the NHS Accelerated Access Collaborative. It was delivered via a sub-contract between the University of Exeter and Skin Analytics, who administered the contract. The value of this contract was approximately \u00a3350,000 which ended on 31 December 2024. Although Skin Analytics worked with the University of Exeter on the wider evaluation and the report to funders and commented on drafts of an interim and final report, they did not influence the results or the conclusions. They did not contribute to this manuscript but were offered an opportunity to correct factual inaccuracies in the final draft of the paper prior to submission. Although this work was commissioned and funded by the NHS Cancer Programme, with the support of SBRI Healthcare and the NHS Accelerated Access Collaborative, the views expressed in the publication are those of the author(s) and not necessarily those of the NHS Cancer Programme or its stakeholders. Other members of the report team apart from Prof Chris Hyde and Dr Zhivko Zhelev have no potential conflicts of interest.","order":6,"name":"Ethics","label":"Funding and Conflicts of Interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval was deemed unnecessary as the evaluation, including the health economic model, was considered an in-service evaluation\/audit according to NHS Health Research Authority guidance (accessed 14 July 2023). General ethical principles, particularly provision of information to patients, were, however, adhered to.","order":7,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}