{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:12:55Z","timestamp":1793725975200,"version":"4.6.1"},"reference-count":77,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Nat Med"],"published-print":{"date-parts":[[2026,8]]},"DOI":"10.1038\/s41591-026-04553-w","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T09:02:18Z","timestamp":1785834138000},"page":"3000-3009","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Divergent impacts of explainable AI for dermatological diagnosis on clinicians versus lay people"],"prefix":"10.1038","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5930-3899","authenticated-orcid":false,"given":"Xuhai \u2018Orson\u2019","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2290-9333","authenticated-orcid":false,"given":"Haoyu","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoran","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Will Ke","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reina","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7890-7209","authenticated-orcid":false,"given":"Luis R.","family":"Soenksen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2662-472X","authenticated-orcid":false,"given":"Omar","family":"Badri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheharbano","family":"Jafry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Burger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lotanna","family":"Nwandu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2227-0215","authenticated-orcid":false,"given":"Apoorva","family":"Mehta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8026-4206","authenticated-orcid":false,"given":"Erik P.","family":"Duhaime","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asif","family":"Qasim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hause","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6341-2736","authenticated-orcid":false,"given":"Janis Karleen","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Hershon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulius","family":"Mui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro A.","family":"Gru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"No\u00e9mie","family":"Elhadad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Mamykina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Groh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0391-7810","authenticated-orcid":false,"given":"Philipp","family":"Tschandl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7988-9356","authenticated-orcid":false,"given":"Roxana","family":"Daneshjou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6349-7251","authenticated-orcid":false,"given":"Marzyeh","family":"Ghassemi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"4553_CR1","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1111\/bjd.13121","volume":"171","author":"J Malvehy","year":"2014","unstructured":"Malvehy, J. et al. Clinical performance of the Nevisense system in cutaneous melanoma detection: an international, multicentre, prospective and blinded clinical trial on efficacy and safety. Br. J. Dermatol. 171, 1099\u20131107 (2014).","journal-title":"Br. J. Dermatol."},{"key":"4553_CR2","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1038\/s41746-024-01161-1","volume":"7","author":"KP Venkatesh","year":"2024","unstructured":"Venkatesh, K. P., Kadakia, K. T. & Gilbert, S. Learnings from the first AI-enabled skin cancer device for primary care authorized by FDA. NPJ Digit. Med. 7, 156 (2024).","journal-title":"NPJ Digit. Med."},{"key":"4553_CR3","doi-asserted-by":"publisher","first-page":"1295","DOI":"10.1001\/archderm.137.10.1295","volume":"137","author":"J Resneck Jr.","year":"2001","unstructured":"Resneck, J. Jr. Too few or too many dermatologists? Difficulties in assessing optimal workforce size. Arch. Dermatol. 137, 1295\u20131301 (2001).","journal-title":"Arch. Dermatol."},{"key":"4553_CR4","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1001\/jamadermatol.2016.0938","volume":"152","author":"L Uscher-Pines","year":"2016","unstructured":"Uscher-Pines, L., Malsberger, R., Burgette, L., Mulcahy, A. & Mehrotra, A. Effect of teledermatology on access to dermatology care among medicaid enrollees. JAMA Dermatol. 152, 905\u2013912 (2016).","journal-title":"JAMA Dermatol."},{"key":"4553_CR5","doi-asserted-by":"publisher","unstructured":"Krogue, J. D. et al. Searching for dermatology information online using images vs text: a randomized study. Preprint at medRxiv https:\/\/doi.org\/10.1101\/2024.10.25.24316155 (2024).","DOI":"10.1101\/2024.10.25.24316155"},{"key":"4553_CR6","doi-asserted-by":"publisher","first-page":"102470","DOI":"10.1016\/j.media.2022.102470","volume":"79","author":"BHM van der Velden","year":"2022","unstructured":"van der Velden, B. H. M., Kuijf, H. J., Gilhuijs, K. G. A. & Viergever, M. A. Explainable artificial intelligence (XAI) in deep learning-based medical image analysis. Med. Image Anal. 79, 102470 (2022).","journal-title":"Med. Image Anal."},{"key":"4553_CR7","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1038\/nature21056","volume":"542","author":"A Esteva","year":"2017","unstructured":"Esteva, A. et al. Dermatologist-level classification of skin cancer with deep neural networks. Nature 542, 115\u2013118 (2017).","journal-title":"Nature"},{"key":"4553_CR8","doi-asserted-by":"publisher","unstructured":"Selvaraju, R. R. et al. Grad-CAM: visual explanations from deep networks via gradient-based localization. In Proc. IEEE International Conference on Computer Vision 618\u2013626 https:\/\/doi.org\/10.1109\/ICCV.2017.74 (IEEE, 2017).","DOI":"10.1109\/ICCV.2017.74"},{"key":"4553_CR9","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1109\/2.410145","volume":"28","author":"VN Gudivada","year":"1995","unstructured":"Gudivada, V. N. & Raghavan, V. V. Content based image retrieval systems. Computer 28, 18\u201322 (1995).","journal-title":"Computer"},{"key":"4553_CR10","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.1038\/s41591-020-0942-0","volume":"26","author":"P Tschandl","year":"2020","unstructured":"Tschandl, P. et al. Human\u2013computer collaboration for skin cancer recognition. Nat. Med. 26, 1229\u20131234 (2020).","journal-title":"Nat. Med."},{"key":"4553_CR11","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.ejca.2022.02.025","volume":"167","author":"K Hauser","year":"2022","unstructured":"Hauser, K. et al. Explainable artificial intelligence in skin cancer recognition: a systematic review. Eur. J. Cancer 167, 54\u201369 (2022).","journal-title":"Eur. J. Cancer"},{"key":"4553_CR12","doi-asserted-by":"publisher","first-page":"e59505","DOI":"10.2196\/59505","volume":"26","author":"R AlSaad","year":"2024","unstructured":"AlSaad, R. et al. Multimodal large language models in health care: applications, challenges, and future outlook. J. Med. Internet Res. 26, e59505 (2024).","journal-title":"J. Med. Internet Res."},{"key":"4553_CR13","doi-asserted-by":"publisher","unstructured":"Panagoulias, D. P., Virvou, M. & Tsihrintzis, G. A. Evaluating LLM\u2014generated multimodal diagnosis from medical images and symptom analysis. Preprint at https:\/\/doi.org\/10.48550\/arXiv.2402.01730 (2024).","DOI":"10.48550\/arXiv.2402.01730"},{"key":"4553_CR14","doi-asserted-by":"publisher","first-page":"5909","DOI":"10.3390\/jcm13195909","volume":"13","author":"P Goktas","year":"2024","unstructured":"Goktas, P. & Grzybowski, A. Assessing the impact of ChatGPT in dermatology: a comprehensive rapid review. J. Clin. Med. 13, 5909 (2024).","journal-title":"J. Clin. Med."},{"key":"4553_CR15","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1177\/12034754251336238","volume":"29","author":"A Pillai","year":"2025","unstructured":"Pillai, A. et al. Evaluating the diagnostic and treatment capabilities of GPT-4 Vision in dermatology: a pilot study. J. Cutan. Med. Surg. 29, 570\u2013576 (2025).","journal-title":"J. Cutan. Med. Surg."},{"key":"4553_CR16","doi-asserted-by":"publisher","unstructured":"Robinette, P., Li, W., Allen, R., Howard, A. M. & Wagner, A. R. Overtrust of robots in emergency evacuation scenarios. In 2016 11th ACM\/IEEE International Conference on Human-Robot Interaction (HRI) 101\u2013108 https:\/\/doi.org\/10.1109\/HRI.2016.7451740 (IEEE, 2016).","DOI":"10.1109\/HRI.2016.7451740"},{"key":"4553_CR17","doi-asserted-by":"publisher","first-page":"e745","DOI":"10.1016\/S2589-7500(21)00208-9","volume":"3","author":"M Ghassemi","year":"2021","unstructured":"Ghassemi, M., Oakden-Rayner, L. & Beam, A. L. The false hope of current approaches to explainable artificial intelligence in health care. Lancet Digit. Health 3, e745\u2013e750 (2021).","journal-title":"Lancet Digit. Health"},{"key":"4553_CR18","doi-asserted-by":"publisher","unstructured":"Fragiadakis, G., Diou, C., Kousiouris, G. & Nikolaidou, M. Evaluating human-AI collaboration: a review and methodological framework. Preprint at https:\/\/doi.org\/10.48550\/arXiv.2407.19098 (2024).","DOI":"10.48550\/arXiv.2407.19098"},{"key":"4553_CR19","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1038\/s41586-025-08866-7","volume":"642","author":"T Tu","year":"2025","unstructured":"Tu, T. et al. Towards conversational diagnostic artificial intelligence. Nature 642, 442\u2013450 (2025).","journal-title":"Nature"},{"key":"4553_CR20","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1093\/jamia\/ocaa268","volume":"28","author":"TP Quinn","year":"2021","unstructured":"Quinn, T. P., Senadeera, M., Jacobs, S., Coghlan, S. & Le, V. Trust and medical AI: the challenges we face and the expertise needed to overcome them. J. Am. Med. Inform. Assoc. 28, 890\u2013894 (2021).","journal-title":"J. Am. Med. Inform. Assoc."},{"key":"4553_CR21","doi-asserted-by":"publisher","first-page":"e53207","DOI":"10.2196\/53207","volume":"3","author":"R Rosenbacke","year":"2024","unstructured":"Rosenbacke, R., Melhus, \u00c5, McKee, M. & Stuckler, D. How explainable artificial intelligence can increase or decrease clinicians\u2019 trust in AI applications in health care: systematic review. JMIR AI 3, e53207 (2024).","journal-title":"JMIR AI"},{"key":"4553_CR22","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1038\/s41591-023-02728-3","volume":"30","author":"M Groh","year":"2024","unstructured":"Groh, M. et al. Deep learning-aided decision support for diagnosis of skin disease across skin tones. Nat. Med. 30, 573\u2013583 (2024).","journal-title":"Nat. Med."},{"key":"4553_CR23","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-023-04698-z","volume":"23","author":"SA Alowais","year":"2023","unstructured":"Alowais, S. A. et al. Revolutionizing healthcare: the role of artificial intelligence in clinical practice. BMC Med. Educ. 23, 689 (2023).","journal-title":"BMC Med. Educ."},{"key":"4553_CR24","doi-asserted-by":"publisher","first-page":"1753","DOI":"10.1016\/j.jid.2020.01.019","volume":"140","author":"SS Han","year":"2020","unstructured":"Han, S. S. et al. Augmented intelligence dermatology: deep neural networks empower medical professionals in diagnosing skin cancer and predicting treatment options for 134 skin disorders. J. Invest. Dermatol. 140, 1753\u20131761 (2020).","journal-title":"J. Invest. Dermatol."},{"key":"4553_CR25","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1038\/s42256-022-00593-2","volume":"5","author":"A Sharma","year":"2023","unstructured":"Sharma, A., Lin, I. W., Miner, A. S., Atkins, D. C. & Althoff, T. Human\u2013AI collaboration enables more empathic conversations in text-based peer-to-peer mental health support. Nat. Mach. Intell. 5, 46\u201357 (2023).","journal-title":"Nat. Mach. Intell."},{"key":"4553_CR26","doi-asserted-by":"publisher","first-page":"854","DOI":"10.1177\/1745691620974773","volume":"16","author":"H Lin","year":"2021","unstructured":"Lin, H., Werner, K. M. & Inzlicht, M. Promises and perils of experimentation: the mutual-internal-validity problem. Perspect. Psychol. Sci. 16, 854\u2013863 (2021).","journal-title":"Perspect. Psychol. Sci."},{"key":"4553_CR27","doi-asserted-by":"publisher","unstructured":"Mayanja, J., Asanda, E. H., Mwesigwa, J., Tumwebaze, P. & Marvin, G. Explainable artificial intelligence and deep transfer learning for skin disease diagnosis. In Fourth International Conference on Image Processing and Capsule Networks (eds Shakya, S., Tavares, J. M. R. S., Fern\u00e1ndez-Caballero, A. & Papakostas, G.) 711\u2013724 https:\/\/doi.org\/10.1007\/978-981-99-7093-3_47 (Springer, 2023).","DOI":"10.1007\/978-981-99-7093-3_47"},{"key":"4553_CR28","doi-asserted-by":"publisher","first-page":"12623","DOI":"10.1109\/TCYB.2021.3069920","volume":"52","author":"S Wang","year":"2022","unstructured":"Wang, S., Yin, Y., Wang, D., Wang, Y. & Jin, Y. Interpretability-based multimodal convolutional neural networks for skin lesion diagnosis. IEEE Trans. Cybern. 52, 12623\u201312637 (2022).","journal-title":"IEEE Trans. Cybern."},{"key":"4553_CR29","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/s11604-023-01474-3","volume":"42","author":"D Ueda","year":"2024","unstructured":"Ueda, D. et al. Fairness of artificial intelligence in healthcare: review and recommendations. Jpn. J. Radiol. 42, 3\u201315 (2024).","journal-title":"Jpn. J. Radiol."},{"key":"4553_CR30","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1038\/s41746-021-00385-9","volume":"4","author":"S Gaube","year":"2021","unstructured":"Gaube, S. et al. Do as AI say: susceptibility in deployment of clinical decision-aids. NPJ Digit. Med. 4, 31 (2021).","journal-title":"NPJ Digit. Med."},{"key":"4553_CR31","doi-asserted-by":"publisher","unstructured":"Fogliato, R. et al. Who goes first? Influences of human-AI workflow on decision making in clinical imaging. In Proc. 2022 ACM Conference on Fairness, Accountability, and Transparency 1362\u20131374 https:\/\/doi.org\/10.1145\/3531146.3533193 (Association for Computing Machinery, 2022).","DOI":"10.1145\/3531146.3533193"},{"key":"4553_CR32","doi-asserted-by":"publisher","first-page":"10419","DOI":"10.5465\/AMBPP.2022.29","volume":"2022","author":"L Jiang","year":"2022","unstructured":"Jiang, L., Qin, X., Dong, X., Chen, C. & Liao, W. How and when AI-human order influences procedural justice in a multistage decision-making process. Acad. Manag. Proc. 2022, 10419 (2022).","journal-title":"Acad. Manag. Proc."},{"key":"4553_CR33","doi-asserted-by":"publisher","first-page":"eabq6147","DOI":"10.1126\/sciadv.abq6147","volume":"8","author":"R Daneshjou","year":"2022","unstructured":"Daneshjou, R. et al. Disparities in dermatology AI performance on a diverse, curated clinical image set. Sci. Adv. 8, eabq6147 (2022).","journal-title":"Sci. Adv."},{"key":"4553_CR34","doi-asserted-by":"publisher","unstructured":"Li, J., Yang, Y., Liao, Q. V., Zhang, J. & Lee, Y.-C. As confidence aligns: understanding the effect of AI confidence on human self-confidence in human-AI decision making. In Proc. 2025 CHI Conference on Human Factors in Computing Systems (eds Evers, V. et al.) 1\u201316 https:\/\/doi.org\/10.1145\/3706598.3713336 (Association for Computing Machinery, 2025).","DOI":"10.1145\/3706598.3713336"},{"key":"4553_CR35","doi-asserted-by":"publisher","first-page":"1505284","DOI":"10.3389\/fdata.2024.1505284","volume":"7","author":"A Said","year":"2025","unstructured":"Said, A. On explaining recommendations with Large Language Models: a review. Front. Big Data 7, 1505284 (2025).","journal-title":"Front. Big Data"},{"key":"4553_CR36","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1257\/089533005775196732","volume":"19","author":"S Frederick","year":"2005","unstructured":"Frederick, S. Cognitive reflection and decision making. J. Econ. Perspect. 19, 25\u201342 (2005).","journal-title":"J. Econ. Perspect."},{"key":"4553_CR37","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-023-43095-4","volume":"15","author":"T Chanda","year":"2024","unstructured":"Chanda, T. et al. Dermatologist-like explainable AI enhances trust and confidence in diagnosing melanoma. Nat. Commun. 15, 524 (2024).","journal-title":"Nat. Commun."},{"key":"4553_CR38","doi-asserted-by":"publisher","unstructured":"Carrasco-Farre, C. Large Language Models are as persuasive as humans, but how? About the cognitive effort and moral-emotional language of LLM arguments. Preprint at https:\/\/doi.org\/10.48550\/arXiv.2404.09329 (2024).","DOI":"10.48550\/arXiv.2404.09329"},{"key":"4553_CR39","doi-asserted-by":"publisher","unstructured":"Bansal, G. et al. Does the whole exceed its parts? The effect of ai explanations on complementary team performance. In Proc. 2021 CHI Conference on Human Factors in Computing Systems (eds Kitamura, Y. et al.) 1\u201316 https:\/\/doi.org\/10.1145\/3411764.3445717 (Association for Computing Machinery, 2021).","DOI":"10.1145\/3411764.3445717"},{"key":"4553_CR40","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1093\/jamia\/ocw105","volume":"24","author":"D Lyell","year":"2017","unstructured":"Lyell, D. & Coiera, E. Automation bias and verification complexity: a systematic review. J. Am. Med. Inform. Assoc. 24, 423\u2013431 (2017).","journal-title":"J. Am. Med. Inform. Assoc."},{"key":"4553_CR41","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1136\/amiajnl-2011-000089","volume":"19","author":"K Goddard","year":"2012","unstructured":"Goddard, K., Roudsari, A. & Wyatt, J. C. Automation bias: a systematic review of frequency, effect mediators, and mitigators. J. Am. Med. Inform. Assoc. 19, 121\u2013127 (2012).","journal-title":"J. Am. Med. Inform. Assoc."},{"key":"4553_CR42","doi-asserted-by":"publisher","unstructured":"Larasati, R. Trust and explanation in artificial intelligence systems: a healthcare application in disease detection and preliminary diagnosis. https:\/\/doi.org\/10.21954\/ou.ro.00015aca (The Open University, 2023).","DOI":"10.21954\/ou.ro.00015aca"},{"key":"4553_CR43","doi-asserted-by":"publisher","unstructured":"Kim, S. S. Y., Vaughan, J. W., Liao, Q. V., Lombrozo, T. & Russakovsky, O. Fostering appropriate reliance on large language models: the role of explanations, sources, and inconsistencies. In Proc. 2025 CHI Conference on Human Factors in Computing Systems (eds Evers, V. et al.) 1\u201319 https:\/\/doi.org\/10.1145\/3706598.3714020 (Association for Computing Machinery, 2025).","DOI":"10.1145\/3706598.3714020"},{"key":"4553_CR44","doi-asserted-by":"publisher","first-page":"e13445","DOI":"10.2196\/13445","volume":"7","author":"S Aboueid","year":"2019","unstructured":"Aboueid, S., Liu, R. H., Desta, B. N., Chaurasia, A. & Ebrahim, S. The use of artificially intelligent self-diagnosing digital platforms by the general public: scoping review. JMIR Med. Inform. 7, e13445 (2019).","journal-title":"JMIR Med. Inform."},{"key":"4553_CR45","doi-asserted-by":"publisher","first-page":"2263","DOI":"10.1016\/S0140-6736(18)32819-8","volume":"392","author":"H Fraser","year":"2018","unstructured":"Fraser, H., Coiera, E. & Wong, D. Safety of patient-facing digital symptom checkers. Lancet 392, 2263\u20132264 (2018).","journal-title":"Lancet"},{"key":"4553_CR46","unstructured":"Kim, Y., Xu, X., McDuff, D., Breazeal, C. & Park, H. W. Health-LLM: large language models for health prediction via wearable sensor data. In Proc. Fifth Conference on Health, Inference, and Learning 522\u2013539 https:\/\/proceedings.mlr.press\/v248\/kim24b.html (PMLR, 2024)."},{"key":"4553_CR47","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-82501-9","volume":"14","author":"J Senoner","year":"2024","unstructured":"Senoner, J., Schallmoser, S., Kratzwald, B., Feuerriegel, S. & Netland, T. Explainable AI improves task performance in human\u2013AI collaboration. Sci. Rep. 14, 31150 (2024).","journal-title":"Sci. Rep."},{"key":"4553_CR48","doi-asserted-by":"publisher","unstructured":"Strong, J., Men, Q. & Noble, J. A. Trustworthy and practical AI for healthcare: a guided deferral system with large language models. In Proc. AAAI Conference on Artificial Intelligence Vol. 39, 28413\u201328421 https:\/\/doi.org\/10.1609\/aaai.v39i27.35063 (AAAI, 2025).","DOI":"10.1609\/aaai.v39i27.35063"},{"key":"4553_CR49","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1080\/12460125.2021.1958505","volume":"32","author":"S Bayer","year":"2022","unstructured":"Bayer, S., Gimpel, H. & Markgraf, M. The role of domain expertise in trusting and following explainable AI decision support systems. J. Decis. Syst. 32, 110\u2013138 (2022).","journal-title":"J. Decis. Syst."},{"key":"4553_CR50","doi-asserted-by":"publisher","unstructured":"Nourani, M., King, J. & Ragan, E. The role of domain expertise in user trust and the impact of first impressions with intelligent systems. In Proc. AAAI Conference on Human Computation and Crowdsourcing (eds Aroyo, L. & Simperl, E.) 112\u2013121 https:\/\/doi.org\/10.1609\/hcomp.v8i1.7469 (PKP Publishing Services, 2020).","DOI":"10.1609\/hcomp.v8i1.7469"},{"key":"4553_CR51","doi-asserted-by":"publisher","first-page":"e55766","DOI":"10.2196\/55766","volume":"26","author":"A Ayorinde","year":"2024","unstructured":"Ayorinde, A. et al. Health care professionals\u2019 experience of using AI: systematic review with narrative synthesis. J. Med. Internet Res. 26, e55766 (2024).","journal-title":"J. Med. Internet Res."},{"key":"4553_CR52","doi-asserted-by":"publisher","unstructured":"Bussone, A., Stumpf, S. & O\u2019Sullivan, D. The role of explanations on trust and reliance in clinical decision support systems. In 2015 International Conference on Healthcare Informatics 160\u2013169 https:\/\/doi.org\/10.1109\/ICHI.2015.26 (IEEE, 2015).","DOI":"10.1109\/ICHI.2015.26"},{"key":"4553_CR53","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1038\/s41746-025-01943-1","volume":"8","author":"S Sharma","year":"2025","unstructured":"Sharma, S., Alaa, A. M. & Daneshjou, R. A longitudinal analysis of declining medical safety messaging in generative AI models. NPJ Digit. Med. 8, 592 (2025).","journal-title":"NPJ Digit. Med."},{"key":"4553_CR54","doi-asserted-by":"publisher","unstructured":"Gomez, C., Cho, S. M., Ke, S., Huang, C.-M. & Unberath, M. Human-AI collaboration is not very collaborative yet: a taxonomy of interaction patterns in AI-assisted decision making from a systematic review. Front. Comput. Sci. https:\/\/doi.org\/10.3389\/fcomp.2024.1521066 (2025).","DOI":"10.3389\/fcomp.2024.1521066"},{"key":"4553_CR55","doi-asserted-by":"publisher","first-page":"102506","DOI":"10.1016\/j.artmed.2023.102506","volume":"138","author":"F Cabitza","year":"2023","unstructured":"Cabitza, F. et al. Rams, hounds and white boxes: investigating human\u2013AI collaboration protocols in medical diagnosis. Artif. Intell. Med. 138, 102506 (2023).","journal-title":"Artif. Intell. Med."},{"key":"4553_CR56","doi-asserted-by":"publisher","first-page":"1154","DOI":"10.1038\/s41591-024-02887-x","volume":"30","author":"C Kim","year":"2024","unstructured":"Kim, C. et al. Transparent medical image AI via an image\u2013text foundation model grounded in medical literature. Nat. Med. 30, 1154\u20131165 (2024).","journal-title":"Nat. Med."},{"key":"4553_CR57","doi-asserted-by":"publisher","first-page":"2691","DOI":"10.1038\/s41591-025-03747-y","volume":"31","author":"S Yan","year":"2025","unstructured":"Yan, S. et al. A multimodal vision foundation model for clinical dermatology. Nat. Med. 31, 2691\u20132702 (2025).","journal-title":"Nat. Med."},{"key":"4553_CR58","doi-asserted-by":"publisher","unstructured":"Kolkur, S., Kalbande, D., Shimpi, P., Bapat, C. & Jatakia, J. Human skin detection using RGB, HSV and YCbCr color models. In Proc. International Conference on Communication and Signal Processing 2016 (ICCASP 2016) https:\/\/doi.org\/10.2991\/iccasp-16.2017.51 (Atlantis Press, 2016).","DOI":"10.2991\/iccasp-16.2017.51"},{"key":"4553_CR59","doi-asserted-by":"publisher","first-page":"e217249","DOI":"10.1001\/jamanetworkopen.2021.7249","volume":"4","author":"A Jain","year":"2021","unstructured":"Jain, A. et al. Development and assessment of an artificial intelligence\u2013based tool for skin condition diagnosis by primary care physicians and nurse practitioners in teledermatology practices. JAMA Netw. Open 4, e217249 (2021).","journal-title":"JAMA Netw. Open"},{"key":"4553_CR60","doi-asserted-by":"publisher","first-page":"1233","DOI":"10.1056\/NEJMsr2214184","volume":"388","author":"P Lee","year":"2023","unstructured":"Lee, P., Bubeck, S. & Petro, J. Benefits, limits, and risks of GPT-4 as an AI chatbot for medicine. N. Engl. J. Med. 388, 1233\u20131239 (2023).","journal-title":"N. Engl. J. Med."},{"key":"4553_CR61","doi-asserted-by":"publisher","unstructured":"Groh, M. et al. Evaluating deep neural networks trained on clinical images in dermatology with the Fitzpatrick 17k dataset. In 2021 IEEE\/CVF Conference on Computer Vision and Pattern Recognition Workshops (CVPRW) 1820\u20131828 https:\/\/doi.org\/10.1109\/CVPRW53098.2021.00201 (IEEE, 2021).","DOI":"10.1109\/CVPRW53098.2021.00201"},{"key":"4553_CR62","doi-asserted-by":"publisher","unstructured":"Jian, J.-Y., Bisantz, A. M. & Drury, C. G. Foundations for an empirically determined scale of trust in automated systems. Int. J. Cogn. Ergon. https:\/\/doi.org\/10.1207\/S15327566IJCE0401_04 (2000).","DOI":"10.1207\/S15327566IJCE0401_04"},{"key":"4553_CR63","doi-asserted-by":"publisher","unstructured":"Hoffman, R. R., Mueller, S. T., Klein, G. & Litman, J. Measures for explainable AI: explanation goodness, user satisfaction, mental models, curiosity, trust, and human-AI performance. Front. Comput. Sci. https:\/\/doi.org\/10.3389\/fcomp.2023.1096257 (2023).","DOI":"10.3389\/fcomp.2023.1096257"},{"key":"4553_CR64","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1017\/S1930297500005921","volume":"8","author":"U Haran","year":"2013","unstructured":"Haran, U., Ritov, I. & Mellers, B. A. The role of actively open-minded thinking in information acquisition, accuracy, and calibration. Judgm. Decis. Mak. 8, 188\u2013201 (2013).","journal-title":"Judgm. Decis. Mak."},{"key":"4553_CR65","unstructured":"Dosovitskiy, A. et al. An image is worth 16x16 words: transformers for image recognition at scale. In 9th International Conference on Learning Representations https:\/\/openreview.net\/forum?id=YicbFdNTTy (ICLR, 2021)."},{"key":"4553_CR66","unstructured":"Long, M., Cao, Z., Wang, J. & Jordan, M. I. Conditional adversarial domain adaptation. In Advances in Neural Information Processing Systems 1640\u20131650 (NeurIPS, 2018)."},{"key":"4553_CR67","doi-asserted-by":"publisher","unstructured":"Huang, G., Liu, Z., van der Maaten, L. & Weinberger, K. Q. Densely connected convolutional networks. In Proc. IEEE Conference on Computer Vision and Pattern Recognition 2261\u20132269 https:\/\/doi.org\/10.1109\/CVPR.2017.243 (IEEE, 2017).","DOI":"10.1109\/CVPR.2017.243"},{"key":"4553_CR68","doi-asserted-by":"publisher","unstructured":"Kinyanjui, N. M. et al. Fairness of classifiers across skin tones in dermatology. In Medical Image Computing and Computer Assisted Intervention \u2013 MICCAI 2020 (eds Martel, A. L. et al.) 320\u2013329 https:\/\/doi.org\/10.1007\/978-3-030-59725-2_31 (Springer, 2020).","DOI":"10.1007\/978-3-030-59725-2_31"},{"key":"4553_CR69","doi-asserted-by":"publisher","first-page":"2838","DOI":"10.1038\/s41591-024-03113-4","volume":"30","author":"Y Yang","year":"2024","unstructured":"Yang, Y., Zhang, H., Gichoya, J. W., Katabi, D. & Ghassemi, M. The limits of fair medical imaging AI in real-world generalization. Nat. Med. 30, 2838\u20132848 (2024).","journal-title":"Nat. Med."},{"key":"4553_CR70","doi-asserted-by":"publisher","first-page":"988","DOI":"10.1109\/72.788640","volume":"10","author":"VN Vapnik","year":"1999","unstructured":"Vapnik, V. N. An overview of statistical learning theory. IEEE Trans. Neural Netw. 10, 988\u2013999 (1999).","journal-title":"IEEE Trans. Neural Netw."},{"key":"4553_CR71","doi-asserted-by":"publisher","unstructured":"Ganin, Y. et al. Domain-adversarial training of neural networks. In Domain Adaptation in Computer Vision Applications (ed Csurka, G.) 189\u2013209 https:\/\/doi.org\/10.1007\/978-3-319-58347-1_10 (Springer, 2017).","DOI":"10.1007\/978-3-319-58347-1_10"},{"key":"4553_CR72","doi-asserted-by":"publisher","unstructured":"Li, Y. et al. Deep domain generalization via conditional invariant adversarial networks. In Computer Vision \u2013 ECCV 2018: 15th European Conference (eds Ferrari, V., Hebert, M., Sminchisescu, C. & Weiss, Y.) 647\u2013663 https:\/\/doi.org\/10.1007\/978-3-030-01267-0_38 (Springer, 2018).","DOI":"10.1007\/978-3-030-01267-0_38"},{"key":"4553_CR73","unstructured":"Sagawa, S., Koh, P. W., Hashimoto, T. B. & Liang, P. Distributionally robust neural networks for group shifts: on the importance of regularization for worst-case generalization. In 8th International Conference on Learning Representations https:\/\/openreview.net\/forum?id=ryxGuJrFvS (ICLR, 2020)."},{"key":"4553_CR74","doi-asserted-by":"publisher","first-page":"838","DOI":"10.1137\/0330046","volume":"30","author":"BT Polyak","year":"1992","unstructured":"Polyak, B. T. & Juditsky, A. B. Acceleration of stochastic approximation by averaging. SIAM J. Control Optim. 30, 838\u2013855 (1992).","journal-title":"SIAM J. Control Optim."},{"key":"4553_CR75","doi-asserted-by":"publisher","unstructured":"Deng, J. et al. ImageNet: a large-scale hierarchical image database. In 2009 IEEE Conference on Computer Vision and Pattern Recognition 248\u2013255 https:\/\/doi.org\/10.1109\/CVPR.2009.5206848 (IEEE, 2009).","DOI":"10.1109\/CVPR.2009.5206848"},{"key":"4553_CR76","unstructured":"Ridnik, T., Ben-Baruch, E., Noy, A. & Zelnik-Manor, L. ImageNet-21K pretraining for the masses. In Proc. Neural Information Processing Systems Track on Datasets and Benchmarks 1 (eds Vanschoren, J. & Yeung, S.) https:\/\/datasets-benchmarks-proceedings.neurips.cc\/paper\/2021\/hash\/98f13708210194c475687be6106a3b84-Abstract-round1.html (NeurIPS Datasets and Benchmarks, 2021)."},{"key":"4553_CR77","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1016\/j.jaad.2015.01.025","volume":"72","author":"H Tsao","year":"2015","unstructured":"Tsao, H. et al. Early detection of melanoma: reviewing the ABCDEs. J. Am. Acad. Dermatol. 72, 717\u2013723 (2015).","journal-title":"J. Am. Acad. Dermatol."}],"container-title":["Nature Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04553-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04553-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04553-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T14:01:32Z","timestamp":1786629692000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04553-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":77,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["4553"],"URL":"https:\/\/doi.org\/10.1038\/s41591-026-04553-w","relation":{},"ISSN":["1078-8956","1546-170X"],"issn-type":[{"value":"1078-8956","type":"print"},{"value":"1546-170X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"6 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"X.O.X. holds a part-time visiting faculty researcher position at Google. The work presented in this paper was conducted independently of, and is unrelated to, his responsibilities at Google. The remaining authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}}]}}