Benchmarking Off-the-Shelf Multimodal AI Models Against Dermatologists on Patient-Captured Skin Images

Artificial intelligence (AI) has advanced at a rapid pace in recent years. Initially, breakthroughs in large language models caught widespread attention. However, recent generations of frontier AI models have adopted multimodal capabilities as a first class citizen, with vision capabilities being central to that. In this paper, we evaluate three recently released models on the task of diagnosing dermatological conditions from patient-submitted images. The models chosen are at the low to mid tier in terms of pricing and thus represent a floor on current AI capabilities, not a ceiling. We evaluate AI performance relative to a panel of three certified dermatologists, who grade each image, and we present four interesting findings. Firstly, depending on the metric, the tested AI models are either on par or slightly trail humans in terms of inter-clinician agreement. Secondly, we find that asking AI models for a confidence rating produces poorly calibrated answers, meaning use of confidence thresholds should not be relied upon in a clinical setting. Thirdly, the effect of providing additional patient metadata is strongly model-specific, with one of the three models degrading on every metric considered. Finally, model cost is not predictive of performance. The best-performing model we tested costs on average 0.0045 per case.