In Reply We read with interest the response of Kovarik et al to our consensus statement.1 The scope of our effort in developing the Checklist for Evaluation of Image-Based Artificial Intelligence Reports in Dermatology consensus guidelines was restricted to technical aspects of the development and reporting of image-based artificial intelligence (AI) in dermatology. We agree that questions associated with patient consent are crucial, but our assessment is that further research and broader participation are required to develop formal consent guidelines. Such efforts should consider existing regulatory and legal requirements, which vary geographically, as well as ethical issues. We would point out that the General Data Protection Regulation of Europe, which is among the more stringent legal frameworks that establish guidelines for collecting and processing personal information, allows sharing of deidentified data for AI use.2,3 We believe that formal research on patient preferences and potential harms is needed to inform the answers to the questions of Kovarik et al. We, among others, are actively engaged in conducting such research, and we strongly endorse the development of guidelines around patient consent for images used in AI.