AI Simplification of Dermatopathology Reports for Patients: Basic Versus Prompt-Engineered Approaches.

Authors

William J Nahm, Arlene M Ruiz de Luzuriaga, Goranit Sakunchotpanit, Dan Nguyen, Krithika Nayudu, Ryan Chen, Arjun Mahajan, Vinod E Nambudiri

Published in

Journal of cutaneous pathology. Aug 13, 2026. Epub Aug 13, 2026.

Abstract

Patients struggle to comprehend dermatopathology reports. As artificial intelligence (AI) tools become more accessible, patients may use them to interpret reports; however, optimal approaches remain unexplored.
Evaluate whether prompt-engineered AI simplification of dermatopathology reports improves factualness, completeness, and reduces potential harm compared to basic AI usage.
Survey-based study (January-April 2025) of 52 US dermatology and dermatopathology professionals (70.3% response rate). Six fictitious dermatopathology reports were simplified using: (1) Basic ChatGPT-4.0 with simple prompt and (2) Custom "DermDecoder" GPT with structured 489-word prompt. Participants rated reports on 3-point Likert scales for factualness, completeness, and potential harm, with free-text responses analyzed thematically.
Mean ratings ranged from 1.27 to 1.63 (factualness/completeness) and 1.31-1.83 (harmfulness), indicating "Agree" to "Mostly Agree" or "Completely Harmless" to "Mostly Harmless." DermDecoder performed significantly worse for completeness in psoriasis (t = -2.79, p = 0.007) and harmfulness in molluscum contagiosum (p = 0.049) and melanoma in situ (p = 0.048). Free-text analysis revealed Basic Prompt preserved details but lacked clinical context, while DermDecoder provided generic education disconnected from pathological findings.
Fictitious reports, small sample, evolving AI capabilities, and absence of patient perspectives.
Prompt engineering offered no advantage over basic AI usage in balancing professional accuracy with patient accessibility, necessitating human-in-the-loop oversight for AI-generated explanations.

PMID:
42593409
Bibliographic data and abstract were imported from PubMed on 13 Aug 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.