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PSO-Net: Development of an automated psoriasis assessment system using attention-based interpretable deep neural networks

30 January 2025
Sharif A. Kamran
Molly V. Lucas
Brendon Lutnick
Chaitanya Parmar
Basudha Pal
Asha Patel Shah
David Apfel
Steven Fakharzadeh
Lloyd Miller
Stephen S. F. Yip
K. Standish
G. O. Cula
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Abstract

Psoriasis is a chronic skin condition that requires long-term treatment and monitoring. Although, the Psoriasis Area and Severity Index (PASI) is utilized as a standard measurement to assess psoriasis severity in clinical trials, it has many drawbacks such as (1) patient burden for in-person clinic visits for assessment of psoriasis, (2) time required for investigator scoring and (3) variability of inter- and intra-rater scoring. To address these drawbacks, we propose a novel and interpretable deep learning architecture called PSO-Net, which maps digital images from different anatomical regions to derive attention-based scores. Regional scores are further combined to estimate an absolute PASI score. Moreover, we devise a novel regression activation map for interpretability through ranking attention scores. Using this approach, we achieved inter-class correlation scores of 82.2% [95% CI: 77- 87%] and 87.8% [95% CI: 84-91%] with two different clinician raters, respectively.

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