{"id":"https://openalex.org/W4411866992","doi":"https://doi.org/10.1109/access.2025.3584904","title":"External Validation of AI Models for Skin Diseases: A Systematic Review","display_name":"External Validation of AI Models for Skin Diseases: A Systematic Review","publication_year":2025,"publication_date":"2025-01-01","ids":{"openalex":"https://openalex.org/W4411866992","doi":"https://doi.org/10.1109/access.2025.3584904"},"language":"en","primary_location":{"id":"doi:10.1109/access.2025.3584904","is_oa":true,"landing_page_url":"https://doi.org/10.1109/access.2025.3584904","pdf_url":null,"source":{"id":"https://openalex.org/S2485537415","display_name":"IEEE Access","issn_l":"2169-3536","issn":["2169-3536"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310319808","host_organization_name":"Institute of Electrical and Electronics Engineers","host_organization_lineage":["https://openalex.org/P4310319808"],"host_organization_lineage_names":["Institute of Electrical and Electronics Engineers"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"IEEE Access","raw_type":"journal-article"},"type":"review","indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1109/access.2025.3584904","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5031117813","display_name":"Thayan\u00e1 Ribeiro Silva Fernandes","orcid":"https://orcid.org/0000-0002-6590-4620"},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Thayan\u00e1 Ribeiro Silva Fernandes","raw_affiliation_strings":["Programa de Pós-Graduação em Biotecnologia (PPGBiotec), Universidade Federal do Delta do Parnaíba, Parnaíba, Brazil"],"raw_orcid":"https://orcid.org/0000-0002-6590-4620","affiliations":[{"raw_affiliation_string":"Programa de Pós-Graduação em Biotecnologia (PPGBiotec), Universidade Federal do Delta do Parnaíba, Parnaíba, Brazil","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5070350823","display_name":"Ariel Soares Teles","orcid":"https://orcid.org/0000-0002-0840-3870"},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Ariel Soares Teles","raw_affiliation_strings":["Programa de Pós-Graduação em Biotecnologia (PPGBiotec), Universidade Federal do Delta do Parnaíba, Parnaíba, Brazil"],"raw_orcid":"https://orcid.org/0000-0002-0840-3870","affiliations":[{"raw_affiliation_string":"Programa de Pós-Graduação em Biotecnologia (PPGBiotec), Universidade Federal do Delta do Parnaíba, Parnaíba, Brazil","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5011777347","display_name":"Jacks Renan Neves Fernandes","orcid":"https://orcid.org/0000-0001-7868-0673"},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Jacks Renan Neves Fernandes","raw_affiliation_strings":["Programa de Pós-Graduação em Biotecnologia (PPGBiotec), Universidade Federal do Delta do Parnaíba, Parnaíba, Brazil"],"raw_orcid":"https://orcid.org/0000-0001-7868-0673","affiliations":[{"raw_affiliation_string":"Programa de Pós-Graduação em Biotecnologia (PPGBiotec), Universidade Federal do Delta do Parnaíba, Parnaíba, Brazil","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5048602472","display_name":"Lucas Daniel Batista Lima","orcid":"https://orcid.org/0000-0002-4278-6975"},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Lucas Daniel Batista Lima","raw_affiliation_strings":["Programa de Pós-Graduação em Biotecnologia (PPGBiotec), Universidade Federal do Delta do Parnaíba, Parnaíba, Brazil"],"raw_orcid":"https://orcid.org/0000-0002-4278-6975","affiliations":[{"raw_affiliation_string":"Programa de Pós-Graduação em Biotecnologia (PPGBiotec), Universidade Federal do Delta do Parnaíba, Parnaíba, Brazil","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5028560170","display_name":"Daniel Lima Sousa","orcid":"https://orcid.org/0000-0001-5031-1147"},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Daniel Lima Sousa","raw_affiliation_strings":["Programa de Pós-Graduação em Biotecnologia (PPGBiotec), Universidade Federal do Delta do Parnaíba, Parnaíba, Brazil"],"raw_orcid":"https://orcid.org/0000-0001-5031-1147","affiliations":[{"raw_affiliation_string":"Programa de Pós-Graduação em Biotecnologia (PPGBiotec), Universidade Federal do Delta do Parnaíba, Parnaíba, Brazil","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5038841941","display_name":"Raimundo de Castro Soares","orcid":"https://orcid.org/0000-0002-0904-0370"},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Raimundo de Castro Soares","raw_affiliation_strings":["Programa de Pós-Graduação em Biotecnologia (PPGBiotec), Universidade Federal do Delta do Parnaíba, Parnaíba, Brazil"],"raw_orcid":"https://orcid.org/0000-0002-0904-0370","affiliations":[{"raw_affiliation_string":"Programa de Pós-Graduação em Biotecnologia (PPGBiotec), Universidade Federal do Delta do Parnaíba, Parnaíba, Brazil","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5020396642","display_name":"Silmar Teixeira","orcid":"https://orcid.org/0000-0002-9240-1228"},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Silmar Silva Teixeira","raw_affiliation_strings":["Programa de Pós-Graduação em Biotecnologia (PPGBiotec), Universidade Federal do Delta do Parnaíba, Parnaíba, Brazil"],"raw_orcid":"https://orcid.org/0000-0002-9240-1228","affiliations":[{"raw_affiliation_string":"Programa de Pós-Graduação em Biotecnologia (PPGBiotec), Universidade Federal do Delta do Parnaíba, Parnaíba, Brazil","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":7,"corresponding_author_ids":["https://openalex.org/A5031117813"],"corresponding_institution_ids":[],"apc_list":{"value":1850,"currency":"USD","value_usd":1850},"apc_paid":{"value":1850,"currency":"USD","value_usd":1850},"fwci":3.0285,"has_fulltext":false,"cited_by_count":4,"citation_normalized_percentile":{"value":0.92104041,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":91,"max":99},"biblio":{"volume":"13","issue":null,"first_page":"114411","last_page":"114427"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10392","display_name":"Cutaneous Melanoma Detection and Management","score":0.6819000244140625,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10392","display_name":"Cutaneous Melanoma Detection and Management","score":0.6819000244140625,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/computer-science","display_name":"Computer science","score":0.6446861624717712}],"concepts":[{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.6446861624717712}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1109/access.2025.3584904","is_oa":true,"landing_page_url":"https://doi.org/10.1109/access.2025.3584904","pdf_url":null,"source":{"id":"https://openalex.org/S2485537415","display_name":"IEEE Access","issn_l":"2169-3536","issn":["2169-3536"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310319808","host_organization_name":"Institute of Electrical and Electronics Engineers","host_organization_lineage":["https://openalex.org/P4310319808"],"host_organization_lineage_names":["Institute of Electrical and Electronics Engineers"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"IEEE Access","raw_type":"journal-article"},{"id":"pmh:oai:doaj.org/article:3336bdaf46324c0e8b72c58b89d3496d","is_oa":true,"landing_page_url":"https://doaj.org/article/3336bdaf46324c0e8b72c58b89d3496d","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"IEEE Access, Vol 13, Pp 114411-114427 (2025)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1109/access.2025.3584904","is_oa":true,"landing_page_url":"https://doi.org/10.1109/access.2025.3584904","pdf_url":null,"source":{"id":"https://openalex.org/S2485537415","display_name":"IEEE Access","issn_l":"2169-3536","issn":["2169-3536"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310319808","host_organization_name":"Institute of Electrical and Electronics Engineers","host_organization_lineage":["https://openalex.org/P4310319808"],"host_organization_lineage_names":["Institute of Electrical and Electronics Engineers"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"IEEE Access","raw_type":"journal-article"},"sustainable_development_goals":[],"awards":[{"id":"https://openalex.org/G1236391445","display_name":null,"funder_award_id":"441817/2023-8","funder_id":"https://openalex.org/F4320322025","funder_display_name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico"},{"id":"https://openalex.org/G2958383845","display_name":null,"funder_award_id":"308736/2022-2","funder_id":"https://openalex.org/F4320322025","funder_display_name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico"},{"id":"https://openalex.org/G6151594749","display_name":null,"funder_award_id":"308059/2022-0","funder_id":"https://openalex.org/F4320322025","funder_display_name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico"}],"funders":[{"id":"https://openalex.org/F4320321091","display_name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","ror":"https://ror.org/00x0ma614"},{"id":"https://openalex.org/F4320322025","display_name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","ror":"https://ror.org/03swz6y49"}],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":104,"referenced_works":["https://openalex.org/W1975675278","https://openalex.org/W2037789405","https://openalex.org/W2077663753","https://openalex.org/W2078271269","https://openalex.org/W2089463633","https://openalex.org/W2100697007","https://openalex.org/W2124493593","https://openalex.org/W2158976271","https://openalex.org/W2410116847","https://openalex.org/W2417191710","https://openalex.org/W2785200097","https://openalex.org/W2786147899","https://openalex.org/W2905810301","https://openalex.org/W2907554860","https://openalex.org/W2924749256","https://openalex.org/W2941496369","https://openalex.org/W2969525510","https://openalex.org/W2972198316","https://openalex.org/W2972754417","https://openalex.org/W3020962693","https://openalex.org/W3025011581","https://openalex.org/W3034678801","https://openalex.org/W3037840142","https://openalex.org/W3045827876","https://openalex.org/W3083956316","https://openalex.org/W3090260921","https://openalex.org/W3092516577","https://openalex.org/W3096847877","https://openalex.org/W3106102469","https://openalex.org/W3106540337","https://openalex.org/W3108821140","https://openalex.org/W3109609494","https://openalex.org/W3118615836","https://openalex.org/W3136325607","https://openalex.org/W3136552952","https://openalex.org/W3137245688","https://openalex.org/W3159814022","https://openalex.org/W3160301207","https://openalex.org/W3178669050","https://openalex.org/W3183421885","https://openalex.org/W3184331448","https://openalex.org/W3184962210","https://openalex.org/W3195545591","https://openalex.org/W3202828184","https://openalex.org/W3209532832","https://openalex.org/W4206005215","https://openalex.org/W4206777594","https://openalex.org/W4210571288","https://openalex.org/W4210684977","https://openalex.org/W4210881729","https://openalex.org/W4220786947","https://openalex.org/W4229036772","https://openalex.org/W4240067134","https://openalex.org/W4283210562","https://openalex.org/W4293555013","https://openalex.org/W4304782722","https://openalex.org/W4306898278","https://openalex.org/W4308189433","https://openalex.org/W4312141008","https://openalex.org/W4315753726","https://openalex.org/W4318708271","https://openalex.org/W4320035860","https://openalex.org/W4320857501","https://openalex.org/W4321237779","https://openalex.org/W4321996897","https://openalex.org/W4378349596","https://openalex.org/W4382982296","https://openalex.org/W4384922598","https://openalex.org/W4386001451","https://openalex.org/W4386357170","https://openalex.org/W4386712902","https://openalex.org/W4387104519","https://openalex.org/W4387336447","https://openalex.org/W4387356912","https://openalex.org/W4387511188","https://openalex.org/W4387579197","https://openalex.org/W4387763575","https://openalex.org/W4388460620","https://openalex.org/W4388900926","https://openalex.org/W4389429918","https://openalex.org/W4389513437","https://openalex.org/W4390014060","https://openalex.org/W4390347855","https://openalex.org/W4390608362","https://openalex.org/W4390674087","https://openalex.org/W4391685416","https://openalex.org/W4391692564","https://openalex.org/W4394857110","https://openalex.org/W4396723911","https://openalex.org/W4396750358","https://openalex.org/W4400657291","https://openalex.org/W4401431270","https://openalex.org/W4401702011","https://openalex.org/W4401888862","https://openalex.org/W4403510073","https://openalex.org/W4404229978","https://openalex.org/W4404586244","https://openalex.org/W4406542579","https://openalex.org/W4407054226","https://openalex.org/W4407134851","https://openalex.org/W4407734856","https://openalex.org/W4408235965","https://openalex.org/W4408806526","https://openalex.org/W6628505203"],"related_works":["https://openalex.org/W4391375266","https://openalex.org/W2899084033","https://openalex.org/W2748952813","https://openalex.org/W2390279801","https://openalex.org/W4391913857","https://openalex.org/W2358668433","https://openalex.org/W4396701345","https://openalex.org/W2376932109","https://openalex.org/W2001405890","https://openalex.org/W4396696052"],"abstract_inverted_index":{"The":[0,168],"increasing":[1],"integration":[2,261],"of":[3,18,64,102,139,177,185,222,227,239,262],"Artificial":[4],"Intelligence":[5],"(AI)":[6],"into":[7,41,264],"dermatology":[8,82],"holds":[9],"significant":[10],"potential":[11],"to":[12,51,91,173,257],"enhance":[13],"the":[14,61,99,120,219,248,259],"diagnosis":[15],"and":[16,54,93,115,142,152,165,197,232,236,242,253],"prognosis":[17],"skin":[19,33,106,223],"diseases,":[20,107,162],"which":[21],"represent":[22],"a":[23,71,123,149,174,182],"considerable":[24],"public":[25],"health":[26],"burden.":[27],"While":[28],"numerous":[29],"AI":[30,79,103,263],"models":[31,80,104,196,206],"for":[32,78,105,250],"conditions":[34],"have":[35],"been":[36,84],"developed,":[37],"their":[38,57,110],"successful":[39],"translation":[40],"real-world":[42],"clinical":[43,111],"practice":[44],"critically":[45],"depends":[46],"on":[47,98,156,191],"rigorous":[48,252],"external":[49,65,100,187,211],"validation":[50,101,157,188,199,255],"ensure":[52],"generalizability":[53],"reliability":[55],"beyond":[56],"development":[58],"environment.":[59],"Despite":[60],"growing":[62],"recognition":[63],"validation\u2019s":[66],"importance":[67],"in":[68,81,210],"medical":[69],"AI,":[70],"comprehensive":[72],"synthesis":[73],"specifically":[74],"addressing":[75],"this":[76],"process":[77],"has":[83],"lacking.":[85],"This":[86],"systematic":[87,124,169],"literature":[88],"review":[89],"aimed":[90],"identify":[92],"synthesize":[94],"studies":[95,189],"focused":[96,155,190],"exclusively":[97],"thereby":[108],"assessing":[109],"applicability,":[112],"methodological":[113],"robustness,":[114],"identifying":[116],"key":[117],"challenges.":[118],"Following":[119],"PRISMA":[121],"framework,":[122],"search":[125],"was":[126,146],"conducted":[127],"across":[128],"five":[129],"major":[130],"digital":[131],"libraries":[132],"(ACM":[133],"Digital":[134],"Library,":[135],"IEEE":[136],"Xplore,":[137],"Web":[138],"Science,":[140],"PubMed,":[141],"Scopus).":[143],"Study":[144],"quality":[145],"assessed":[147],"using":[148],"customized":[150],"checklist,":[151],"data":[153,240],"extraction":[154],"practices,":[158],"model":[159],"characteristics,":[160],"targeted":[161],"performance":[163,209],"assessment,":[164],"identified":[166],"limitations.":[167],"study":[170],"selection":[171],"led":[172],"detailed":[175],"analysis":[176],"41":[178],"studies.":[179],"We":[180],"observed":[181],"clear":[183],"predominance":[184],"retrospective":[186],"diagnostic":[192],"models,":[193],"while":[194],"prognostic":[195],"prospective":[198],"designs":[200],"were":[201],"notably":[202],"scarce.":[203],"Although":[204],"some":[205],"demonstrated":[207],"promising":[208],"validation,":[212],"several":[213],"critical":[214],"limitations":[215],"persist.":[216],"These":[217,245],"include":[218],"narrow":[220],"representation":[221],"disease":[224],"categories,":[225],"lack":[226],"subgroup":[228],"fairness":[229],"analyses,":[230],"small":[231],"imbalanced":[233],"sample":[234],"sizes,":[235],"insufficient":[237],"standardization":[238],"collection":[241],"evaluation":[243],"metrics.":[244],"findings":[246],"underscore":[247],"need":[249],"more":[251],"transparent":[254],"frameworks":[256],"support":[258],"reliable":[260],"dermatological":[265],"practice.":[266]},"counts_by_year":[{"year":2026,"cited_by_count":3},{"year":2025,"cited_by_count":1}],"updated_date":"2026-06-04T09:04:59.091469","created_date":"2025-10-10T00:00:00"}