{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:38:10Z","timestamp":1792456690333,"version":"4.5.0"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Contact Dermatitis"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patch testing, the gold standard for allergic contact dermatitis (ACD) diagnosis, suffers from inter\u2010observer variability. We developed a Vision Transformer\u2010based automated patch test interpretation system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective two\u2010centre study included 424 patients (734 images) using the Korean Standard Series (25 allergens). Four model variants\u20143\u2010class and 6\u2010class classification, each with one\u2010stage and two\u2010stage (binary segmentation\u2009+\u2009classification) processing\u2014were compared. Inter\u2010rater agreement was assessed using Cohen's \u03ba. Performance metrics included accuracy, balanced accuracy, macro F1\u2010score, PPV, and NPV, with 95% CIs by bootstrap resampling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Inter\u2010rater agreement showed substantial variability (\u03ba: 0.393\u20130.557). DeiT demonstrated generally favourable performance compared to CNN architectures in binary classification, achieving higher accuracy than Xception (96.1% vs. 92.3%) and substantially higher recall than ResNet\u201050 (88.0% vs. 66.9%). For 3\u2010class classification, one\u2010stage and two\u2010stage approaches performed comparably (accuracy 92.9% vs. 92.8%, balanced accuracy 88.0% vs. 86.8%, all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). For 6\u2010class classification, two\u2010stage processing was superior (accuracy 91.6% vs. 86.0%, balanced accuracy 70.1% vs. 67.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Institution\u2010stratified analysis confirmed robustness across different test marking conventions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The 3\u2010class approach offers robust performance with implementation flexibility, whilst 6\u2010class classification requires two\u2010stage processing. Consistent performance across a dataset with heterogeneous imaging conditions supports real\u2010world applicability in ACD management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cod.70209","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T08:00:03Z","timestamp":1782720003000},"page":"358-369","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["<scp>AI<\/scp>\n                    \u2010Assisted Automated Two\u2010Stage Patch Test Interpretation System Using Vision Transformer"],"prefix":"10.1111","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6188-6306","authenticated-orcid":false,"given":"Jin Ju","family":"Lee","sequence":"first","affiliation":[{"name":"Departments of Dermatology Ewha Womans University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4984-7504","authenticated-orcid":false,"given":"Yon Soo","family":"Jeong","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6315-3889","authenticated-orcid":false,"given":"You Won","family":"Choi","sequence":"additional","affiliation":[{"name":"Departments of Dermatology Ewha Womans University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9878-6691","authenticated-orcid":false,"given":"Joo Young","family":"Roh","sequence":"additional","affiliation":[{"name":"Departments of Dermatology Ewha Womans University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3460-2539","authenticated-orcid":false,"given":"Hae Young","family":"Choi","sequence":"additional","affiliation":[{"name":"Departments of Dermatology Ewha Womans University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0116-3325","authenticated-orcid":false,"given":"So Hyun","family":"Ahn","sequence":"additional","affiliation":[{"name":"Institute of Convergence Medicine Ewha Womans University  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4519-9474","authenticated-orcid":false,"given":"Ji Yeon","family":"Byun","sequence":"additional","affiliation":[{"name":"Departments of Dermatology Ewha Womans University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.13119"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572\u2010021\u201000271\u20104"},{"key":"e_1_2_12_4_1","first-page":"493","volume-title":"Standardization of Patch Tests and the Doctors Who Read Them","author":"Johnston G.","year":"2009"},{"key":"e_1_2_12_5_1","volume-title":"Patch Testing and Prick Testing: A Practical Guide Official Publication of the ICDRG","author":"Lachapelle 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