{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T23:29:42Z","timestamp":1791415782666,"version":"4.3.3"},"reference-count":26,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"DSW"},{"name":"SkinVision"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rising incidence of skin cancer is increasing pressure on healthcare systems. Artificial intelligence (AI)-based mobile health applications (mHealth apps) are being offered to the general population to be used on their own initiative. However, the exact willingness to pay (WTP) for the apps and the factors influencing individual valuations remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate individuals\u2019 relative WTP for AI-based mHealth apps for skin cancer risk detection, and to explore the reasons underlying WTP using a mixed-methods approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This survey-based study, embedded in a randomized controlled trial, invited 11 621 participants in the Netherlands between 29 August 2022 and 23 February 2023. Participants were offered a questionnaire about their experiences with an mHealth app, asked about their WTP in three hypothetical scenarios (AI alone, AI with teledermatologist involvement and physical dermatologist consultation) and could provide open-text explanations. Associations between participant characteristics and WTP were assessed using regression analyses, and qualitative analysis was applied to open-text responses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1953 participants (17%, n = 1953\/11 621) completed the questionnaire. Participants had a mean (SD) age of 58.4 (13.1) years, and 58% (n = 1125\/1953) were women. Most participants self-reported as having a light skin type (95%, n = 1864\/1953). A high educational level was reported by 50% of participants (n = 971\/1953), and a large proportion reported prior app use (79%, n = 1550\/1953). Median [interquartile range (IQR)] WTP was significantly higher for AI combined with a teledermatologist compared with AI alone [\u20ac20 (0\u201345) vs. \u20ac5 (0\u201320), P &amp;lt; 0.001], but lower than for a physical dermatologist consultation [\u20ac50 (22\u201375), P &amp;lt; 0.001]. Increasing age was the only participant characteristic positively associated with WTP across all scenarios. Qualitative analyses revealed that similar valuations could range from pragmatic to fundamental and reflect different rationales.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Individuals place the highest monetary value on dermatologist involvement compared with AI-based apps alone. However, this study suggests that WTP does not always reflect perceived importance. Future studies could explore which features of these apps users value most and how to improve engagement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjd\/ljag327","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T11:47:44Z","timestamp":1786016864000},"source":"Crossref","is-referenced-by-count":1,"title":["Willingness to pay among individuals from the Dutch general population for artificial intelligence-based applications for skin cancer detection: a survey-based\u00a0mixed-methods study"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7997-8532","authenticated-orcid":false,"given":"Anna M","family":"Smak Gregoor","sequence":"first","affiliation":[{"name":"Department of Dermatology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rik","family":"Wehrens","sequence":"additional","affiliation":[{"name":"School of Health Policy and Management, Erasmus University , Rotterdam ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah","family":"van der Vall","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Benning","sequence":"additional","affiliation":[{"name":"School of Health Policy and Management, Erasmus University , Rotterdam ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9940-2875","authenticated-orcid":false,"given":"Tamar","family":"Nijsten","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8578-901X","authenticated-orcid":false,"given":"Marlies","family":"Wakkee","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"2026100607412187400_ljag327-B1","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1001\/jamaoncol.2021.6987","article-title":"Cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years for 29 cancer groups from 2010 to 2019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"8","author":"Global Burden of Disease Cancer C","year":"2022","journal-title":"JAMA Oncol"},{"key":"2026100607412187400_ljag327-B2","doi-asserted-by":"crossref","unstructured":"Wongvibulsin S, Yan MJ, Pahalyants V \u00a0et al \u00a0Current state of dermatology mobile applications with artificial intelligence features. JAMA Dermatol \u00a02024; 160:646\u201350.","DOI":"10.1001\/jamadermatol.2024.0468"},{"key":"2026100607412187400_ljag327-B3","doi-asserted-by":"crossref","first-page":"m127","DOI":"10.1136\/bmj.m127","article-title":"Algorithm based smartphone apps to assess risk of skin cancer in adults: systematic review of diagnostic accuracy studies","volume":"368","author":"Freeman","year":"2020","journal-title":"BMJ"},{"key":"2026100607412187400_ljag327-B4","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1111\/bjd.20903","article-title":"Accuracy of commercially available smartphone applications for the detection of melanoma","volume":"186","author":"Sun","year":"2022","journal-title":"Br J Dermatol"},{"key":"2026100607412187400_ljag327-B5","doi-asserted-by":"crossref","DOI":"10.2196\/49982","article-title":"Problems and barriers related to the use of mHealth apps from the perspective of patients: focus group and interview study","volume":"26","author":"Giebel","year":"2024","journal-title":"J Med Internet Res"},{"key":"2026100607412187400_ljag327-B6","article-title":"Stakeholder perspectives towards diagnostic artificial intelligence: a co-produced qualitative evidence synthesis","volume":"71","author":"Kuo RY","year":"2024","journal-title":"EClinicalMedicine"},{"key":"2026100607412187400_ljag327-B7","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1111\/bjd.20441","article-title":"Views on mobile health apps for skin cancer screening in the general population: an in-depth qualitative exploration of perceived barriers and facilitators","volume":"185","author":"Sangers","year":"2021","journal-title":"Br J Dermatol"},{"key":"2026100607412187400_ljag327-B8","doi-asserted-by":"publisher","DOI":"10.1101\/2025.11.18.25340297","article-title":"The impact of a SmartPhone applicatiOn for skin cancer risk assessmenT on the healthcare system (SPOT-study): a randomized controlled trial","author":"Smak Gregoor","year":"2025","journal-title":"medRxiv"},{"key":"2026100607412187400_ljag327-B9","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1111\/bjd.14630","article-title":"Consumer acceptance of patient-performed mobile teledermoscopy for the early detection of melanoma","volume":"175","author":"Horsham","year":"2016","journal-title":"Br J Dermatol"},{"key":"2026100607412187400_ljag327-B10","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1159\/000506154","article-title":"Is teledermoscopy ready to replace face-to-face examinations for the early detection of skin cancer? consumer views, technology acceptance, and satisfaction with care","volume":"236","author":"Horsham","year":"2020","journal-title":"Dermatology"},{"key":"2026100607412187400_ljag327-B11","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1159\/000517257","article-title":"Consumer preference and willingness to pay for direct-to-consumer mobile teledermoscopy services in Australia","volume":"238","author":"Snoswell","year":"2022","journal-title":"Dermatology"},{"key":"2026100607412187400_ljag327-B12","doi-asserted-by":"crossref","DOI":"10.2196\/11500","article-title":"The mHealth App Usability Questionnaire (MAUQ): development and validation study","volume":"7","author":"Zhou","year":"2019","journal-title":"JMIR Mhealth Uhealth"},{"key":"2026100607412187400_ljag327-B13","author":"NZA"},{"key":"2026100607412187400_ljag327-B14","doi-asserted-by":"crossref","DOI":"10.2196\/33372","article-title":"The willingness to pay for telemedicine among patients with chronic diseases: systematic review","volume":"24","author":"Chua","year":"2022","journal-title":"J Med Internet Res"},{"key":"2026100607412187400_ljag327-B15","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1007\/s10198-022-01437-x","article-title":"Determinants of willingness to pay for health services: a systematic review of contingent valuation studies","volume":"23","author":"Steigenberger","year":"2022","journal-title":"Eur J Health Econ"},{"key":"2026100607412187400_ljag327-B16","doi-asserted-by":"crossref","DOI":"10.2196\/25959","article-title":"Consumers\u2019 willingness to pay for eHealth and its influencing factors: systematic review and meta-analysis","volume":"24","author":"Xie","year":"2022","journal-title":"J Med Internet Res"},{"key":"2026100607412187400_ljag327-B17","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/j.2517-6161.1995.tb02031.x","article-title":"Controlling the false discovery rate - a practical and powerful approach to multiple testing","volume":"57","author":"Benjamini","year":"1995","journal-title":"J R Stat Soc B"},{"key":"2026100607412187400_ljag327-B18","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-319-24277-4","volume-title":"ggplot2: Elegant Graphics for Data Analysis","author":"Wickham","year":"2016"},{"key":"2026100607412187400_ljag327-B19","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1097\/ACM.0000000000000388","article-title":"Standards for reporting qualitative research: a synthesis of recommendations","volume":"89","author":"O\u2019Brien","year":"2014","journal-title":"Acad Med"},{"key":"2026100607412187400_ljag327-B20","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1177\/1357633X15586701","article-title":"Consumer preferences for teledermoscopy screening to detect melanoma early","volume":"22","author":"Spinks","year":"2016","journal-title":"J\u00a0Telemed Telecare"},{"key":"2026100607412187400_ljag327-B21","doi-asserted-by":"crossref","DOI":"10.2196\/46402","article-title":"Acceptance of medical artificial intelligence in skin cancer screening: choice-based conjoint survey","volume":"8","author":"Jagemann","year":"2024","journal-title":"JMIR Form Res"},{"key":"2026100607412187400_ljag327-B22","doi-asserted-by":"crossref","DOI":"10.2196\/40834","article-title":"Willingness to use and pay for digital health care services according to 4 scenarios: results from a national survey","volume":"11","author":"Lee","year":"2023","journal-title":"JMIR Mhealth Uhealth"},{"key":"2026100607412187400_ljag327-B23","article-title":"Embedding artificial intelligence in healthcare: an ethnographic exploration of an AI-based mHealth app through the lens of legitimacy","volume":"10","author":"Howe","year":"2024","journal-title":"Digit Health"},{"key":"2026100607412187400_ljag327-B24","doi-asserted-by":"crossref","DOI":"10.2196\/24221","article-title":"Use and control of artificial intelligence in patients across the medical workflow: single-center questionnaire study of patient perspectives","volume":"23","author":"Lennartz","year":"2021","journal-title":"J Med Internet Res"},{"key":"2026100607412187400_ljag327-B25","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1001\/jamadermatol.2019.5014","article-title":"Patient perspectives on the use of artificial intelligence for skin cancer screening: a qualitative study","volume":"156","author":"Nelson","year":"2020","journal-title":"JAMA Dermatol"},{"key":"2026100607412187400_ljag327-B26","doi-asserted-by":"crossref","first-page":"397","DOI":"10.2307\/3147205","article-title":"Differences between continuous and discrete contingent value estimates","volume":"72","author":"Ready","year":"1996","journal-title":"Land Economics"}],"container-title":["British Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjd\/advance-article-pdf\/doi\/10.1093\/bjd\/ljag327\/70514775\/ljag327.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjd\/advance-article-pdf\/doi\/10.1093\/bjd\/ljag327\/70514775\/ljag327.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:41:30Z","timestamp":1791286890000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjd\/advance-article\/doi\/10.1093\/bjd\/ljag327\/8753769"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,7]]},"references-count":26,"URL":"https:\/\/doi.org\/10.1093\/bjd\/ljag327","relation":{},"ISSN":["0007-0963","1365-2133"],"issn-type":[{"value":"0007-0963","type":"print"},{"value":"1365-2133","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,7]]},"article-number":"ljag327"}}