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The mean Kappa of 1000 iteration tests was 0.49 ( confidence interval ( CI ) = [ 0.23 , 0.74 ] ) when comparing three dermatologists and our model, which is comparable to the agreement in similarity assessment among the dermatologists themselves (the mean Kappa of 1000 iteration tests for three dermatologists was 0.48, CI = [ 0.19 , 0.77 ] .) By contrast, the mean Kappa was 0.22 ( CI = [ - 0.00 , 0.43 ] ) when comparing the similarity assessments of three dermatologists and random guesses. Conclusions Our study showed that our image