Janice Kim, Ali Aljassabi, Tarek Zieneldien, Sophia Ma, Jane M Grant-Kels
Dermatologist-inventors have ethical responsibilities extending beyond demonstrating that an innovation is helpful, accurate, and safe. Diagnostic technologies can be a positive influence on access to care, healthcare equity, and patient trust, particularly when these technologies are intended for rural and resource-limited communities. Ethical development of novel dermatologic diagnostic technologies requires consideration of beneficence, justice, transparency, accessibility, and responsible commercialization. Physician-inventors should evaluate whether a technology addresses a meaningful clinical need, performs adequately across diverse patient populations, and can be integrated into real-world clinical settings. Accessibility should also be considered during the design process rather than after development. Eliminating unnecessary cold-chain requirements may improve the feasibility of distributing diagnostic technologies to rural and low-resource settings where refrigeration and temperature-controlled transportation might be limited. These design strategies should be supported by appropriate analytical and clinical validation to ensure that accessibility does not compromise diagnostic performance. Such validations could lead to perpetuating inequities in underserved communities, where low cost technologies are most likely to have the biggest impact.