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Efendioglu EM, Cigiloglu A. An artificial intelligence perspective on geriatric syndromes: assessing the information accuracy and readability of ChatGPT. Eur Geriatr Med 2025:10.1007/s41999-025-01202-2. [PMID: 40257746 DOI: 10.1007/s41999-025-01202-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2025] [Accepted: 03/24/2025] [Indexed: 04/22/2025]
Abstract
PURPOSE ChatGPT, a comprehensive language processing model, provides the opportunity for supportive and professional interactions with patients. However, its use to address patients' frequently asked questions (FAQs) and the readability of the text generated by ChatGPT remain unexplored, particularly in geriatrics. We identified the FAQs about common geriatric syndromes and assessed the accuracy and readability of the responses provided by ChatGPT. METHODS Two geriatricians with extensive knowledge and experience in geriatric syndromes independently reviewed the 28 responses provided by ChatGPT. The accuracy of the responses generated by ChatGPT was categorized on a rating scale from 0 (harmful) to 4 (excellent) based on current guidelines and approaches. The readability of the text generated by ChatGPT was assessed by administering two tests: the Flesch-Kincaid Reading Ease (FKRE) and the Flesch-Kincaid Grade Level (FKGL). RESULTS ChatGPT-generated responses with an overall mean accuracy score of 88% (3.52/4). Responses generated for sarcopenia diagnosis and depression treatment in older adults had the lowest accuracy scores (2.0 and 2.5, respectively). The mean FKRE score of the texts was 25.2, while the mean FKGL score was 14.5. CONCLUSION The accuracy scores of the responses generated by ChatGPT were high in most common geriatric syndromes except for sarcopenia diagnosis and depression treatment. Moreover, the text generated by ChatGPT was very difficult to read and best understood by college graduates. ChatGPT may reduce the uncertainty many patients face. Nevertheless, it remains advisable to consult with subject matter experts when undertaking consequential decision-making.
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Affiliation(s)
- Eyyup Murat Efendioglu
- Department of Internal Medicine, Division of Geriatric Medicine, Gaziantep City Hospital, Gaziantep, Turkey.
| | - Ahmet Cigiloglu
- Department of Internal Medicine, Division of Geriatric Medicine, Kahramanmaraş Necip Fazıl City Hospital, 46050, Dulkadiroglu, Kahmaranmaraş, Turkey
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2
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Salybekov AA, Yerkos A, Sedlmayr M, Wolfien M. Ethics and Algorithms to Navigate AI's Emerging Role in Organ Transplantation. J Clin Med 2025; 14:2775. [PMID: 40283605 PMCID: PMC12027807 DOI: 10.3390/jcm14082775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2025] [Revised: 04/14/2025] [Accepted: 04/15/2025] [Indexed: 04/29/2025] Open
Abstract
Background/Objectives: Solid organ transplantation remains a critical life-saving treatment for end-stage organ failure, yet it faces persistent challenges, such as organ scarcity, graft rejection, and postoperative complications. Artificial intelligence (AI) has the potential to address these challenges by revolutionizing transplantation practices. Methods: This review article explores the diverse applications of AI in solid organ transplantation, focusing on its impact on diagnostics, treatment, and the evolving market landscape. We discuss how machine learning, deep learning, and generative AI are harnessing vast datasets to predict transplant outcomes, personalized immunosuppressive regimens, and optimize patient selection. Additionally, we examine the ethical implications of AI in transplantation and highlight promising AI-driven innovations nearing FDA evaluation. Results: AI improves organ allocation processes, refines predictions for transplant outcomes, and enables tailored immunosuppressive regimens. These advancements contribute to better patient selection and enhance overall transplant success rates. Conclusions: By bridging the gap in organ availability and improving long-term transplant success, AI holds promise to significantly advance the field of solid organ transplantation.
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Affiliation(s)
- Amankeldi A. Salybekov
- Regenerative Medicine Division, Cell and Gene Therapy Department, Qazaq Institute of Innovative Medicine, Astana 020000, Kazakhstan
| | - Ainur Yerkos
- Department of Computer Science, Al-Farabi Kazakh National University, Almaty 050040, Kazakhstan;
| | - Martin Sedlmayr
- Institute for Medical Informatics and Biometry, Faculty of Medicine Carl Gustav Carus, TUD Dresden University of Technology, 01069 Dresden, Germany;
| | - Markus Wolfien
- Institute for Medical Informatics and Biometry, Faculty of Medicine Carl Gustav Carus, TUD Dresden University of Technology, 01069 Dresden, Germany;
- Center for Scalable Data Analytics and Artificial Intelligence (ScaDS.AI), 01069 Dresden, Germany
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3
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Kraaijkamp JJM, Persoon A, Chavannes NH, Achterberg WP, Choukou MA, Dockery F, Kim H, Pérez LM, Pompeu JE, Topinkova E, Vassallo MA, Maier AB, Becker C, Amagasa Y, Holstege MS, van Haastregt J, van Dam van Isselt EF. eHealth in geriatric rehabilitation: an international consensus study. Eur Geriatr Med 2025:10.1007/s41999-025-01170-7. [PMID: 40113729 DOI: 10.1007/s41999-025-01170-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Accepted: 02/12/2025] [Indexed: 03/22/2025]
Abstract
PURPOSE Current evidence on the use of eHealth in geriatric rehabilitation is limited. This aim of this study was to achieve international consensus on three key eHealth-related topics in geriatric rehabilitation: the use, domains, and scientific evaluation of eHealth. Additionally, we developed a model that provides insight into the use of eHealth in geriatric rehabilitation. METHODS An international, two-round Delphi study was conducted. Two models served as a framework for the initial statement draft, with a total of 28 statements based on our systematic review results, an international survey, and expert opinion. Eligible healthcare professionals working in geriatric rehabilitation facilities were recruited across 10 countries. RESULTS Eighty healthcare professionals participated in round one and 47 in round two. In the first round, consensus was obtained for 20 of the 28 statements (71%). Prior to round two, four statements were revised, two statements were combined, and one statement was removed. In round two, consensus was obtained on six statements, bringing the total to 26: three related to the use of eHealth, five to the domains of eHealth, and 18 related to the scientific evaluation of eHealth. CONCLUSION International consensus has been reached on the use, domains, and scientific evaluation of eHealth in geriatric rehabilitation. This first step in generating reliable knowledge and understandable information will help promote a consistent approach to the development, implementation, and scientific evaluation of eHealth in geriatric rehabilitation.
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Affiliation(s)
- Jules J M Kraaijkamp
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
- University Network for the Care Sector Zuid-Holland, Leiden University Medical Center, Leiden, The Netherlands.
| | - Anke Persoon
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- National eHealth Living Lab, Leiden, The Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- University Network for the Care Sector Zuid-Holland, Leiden University Medical Center, Leiden, The Netherlands
| | - Mohamed-Amine Choukou
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Centre on Aging, University of Manitoba, Winnipeg, Canada
| | - Frances Dockery
- Beaumont Hospital & Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Hyub Kim
- Department of Occupational Therapy, Far East University, Eumseong, Republic of Korea
| | - Laura M Pérez
- Research on Aging, Frailty and Care Transitions in Barcelona (REFiT-BCN), Parc Sanitari Pere Virgili and Vall d'Hebron Institute (VHIR), Barcelona, Spain
| | - José E Pompeu
- Department of Physiotherapy, Speech Therapy and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Eva Topinkova
- Department of Geriatrics and Internal Medicine, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
- Faculty of Health and Social Sciences, University of South Bohemia, České Budějovice, Czech Republic
| | - Mark A Vassallo
- Geriatric Medicine Society of Malta, Karin Grech Hospital, Pieta, Malta
| | - Andrea B Maier
- Healthy Longevity Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- NUS Academy for Healthy Longevity, National University of Singapore, Singapore, Singapore
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Clemens Becker
- Department of Clinical Gerontology, Robert-Bosch-Krankenhaus, Stuttgart, Germany
- Unit of Digital Geriatric Medicine, Geriatric Centre, University Clinic, Heidelberg, Germany
| | | | - Marije S Holstege
- Department of Research, Treatment and Advice Center, Omring, Hoorn, The Netherlands
- Inholland University of Applied Sciences, Research Group Geriatric Rehabilitation, Centre of Expertise Prevention in Health and Social Care, Faculty of Health, Sports and Social Work, Amsterdam, The Netherlands
| | - Jolanda van Haastregt
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Living Lab in Ageing and Long Term Care, Maastricht University, Maastricht, The Netherlands
| | - Eléonore F van Dam van Isselt
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- University Network for the Care Sector Zuid-Holland, Leiden University Medical Center, Leiden, The Netherlands
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4
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Buchman DZ. AI and the ethics of techno-solutionism in pain management. Pain 2025; 166:469-470. [PMID: 39283348 PMCID: PMC11808704 DOI: 10.1097/j.pain.0000000000003389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Accepted: 07/27/2024] [Indexed: 02/12/2025]
Affiliation(s)
- Daniel Z Buchman
- Centre for Addiction and Mental Health
- Krembil Research Institute, University Health Network
- Dalla Lana School of Public Health, University of Toronto
- University of Toronto Joint Centre for Bioethics
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Marko JGO, Neagu CD, Anand PB. Examining inclusivity: the use of AI and diverse populations in health and social care: a systematic review. BMC Med Inform Decis Mak 2025; 25:57. [PMID: 39910518 PMCID: PMC11796235 DOI: 10.1186/s12911-025-02884-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 01/20/2025] [Indexed: 02/07/2025] Open
Abstract
BACKGROUND Artificial intelligence (AI)-based systems are being rapidly integrated into the fields of health and social care. Although such systems can substantially improve the provision of care, diverse and marginalized populations are often incorrectly or insufficiently represented within these systems. This review aims to assess the influence of AI on health and social care among these populations, particularly with regard to issues related to inclusivity and regulatory concerns. METHODS We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Six leading databases were searched, and 129 articles were selected for this review in line with predefined eligibility criteria. RESULTS This research revealed disparities in AI outcomes, accessibility, and representation among diverse groups due to biased data sources and a lack of representation in training datasets, which can potentially exacerbate inequalities in care delivery for marginalized communities. CONCLUSION AI development practices, legal frameworks, and policies must be reformulated to ensure that AI is applied in an equitable manner. A holistic approach must be used to address disparities, enforce effective regulations, safeguard privacy, promote inclusion and equity, and emphasize rigorous validation.
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Affiliation(s)
- John Gabriel O Marko
- University of Bradford Facility of Engineering and Digital Technology, Bradford, UK.
| | - Ciprian Daniel Neagu
- University of Bradford Facility of Engineering and Digital Technology, Bradford, UK
| | - P B Anand
- University of Bradford Faculty of Management Law and Social Sciences, Bradford, UK
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Zanelli S, Agnoletti D, Alastruey J, Allen J, Bianchini E, Bikia V, Boutouyrie P, Bruno RM, Climie R, Djeldjli D, Gkaliagkousi E, Giudici A, Gopcevic K, Grillo A, Guala A, Hametner B, Joseph J, Karimpour P, Kodithuwakku V, Kyriacou PA, Lazaridis A, Lønnebakken MT, Martina MR, Mayer CC, Nabeel PM, Navickas P, Nemcsik J, Orter S, Park C, Pereira T, Pucci G, Rey ABA, Salvi P, Seabra ACG, Seeland U, van Sloten T, Spronck B, Stansby G, Steens I, Stieglitz T, Tan I, Veerasingham D, Wassertheurer S, Weber T, Westerhof BE, Charlton PH. Developing technologies to assess vascular ageing: a roadmap from VascAgeNet. Physiol Meas 2024; 45:121001. [PMID: 38838703 PMCID: PMC11697036 DOI: 10.1088/1361-6579/ad548e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 03/15/2024] [Accepted: 06/05/2024] [Indexed: 06/07/2024]
Abstract
Vascular ageing (vascular ageing) is the deterioration of arterial structure and function which occurs naturally with age, and which can be accelerated with disease. Measurements of vascular ageing are emerging as markers of cardiovascular risk, with potential applications in disease diagnosis and prognosis, and for guiding treatments. However, vascular ageing is not yet routinely assessed in clinical practice. A key step towards this is the development of technologies to assess vascular ageing. In this Roadmap, experts discuss several aspects of this process, including: measurement technologies; the development pipeline; clinical applications; and future research directions. The Roadmap summarises the state of the art, outlines the major challenges to overcome, and identifies potential future research directions to address these challenges.
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Affiliation(s)
- Serena Zanelli
- Laboratoire Analyse, Géométrie et Applications, Université Sorbonne Paris Nord, Paris, France
- Axelife, Paris, France
| | - Davide Agnoletti
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico Sant’Orsola, Bologna, Italy
- Cardiovascular Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Jordi Alastruey
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EU, United Kingdom
| | - John Allen
- Research Centre for Intelligent Healthcare, Coventry University, Coventry CV1 5RW, United Kingdom
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
| | - Elisabetta Bianchini
- Institute of Clinical Physiology, Italian National Research Council (CNR), Pisa, Italy
| | - Vasiliki Bikia
- Stanford University, Stanford, California, United States
- Swiss Federal Institute of Technology of Lausanne, Lausanne, Switzerland
| | - Pierre Boutouyrie
- INSERM U970 Team 7, Paris Cardiovascular Research Centre
- PARCC, University Paris Descartes, AP-HP, Pharmacology Unit, Hôpital Européen Georges Pompidou, 56
Rue Leblanc, Paris 75015, France
| | - Rosa Maria Bruno
- INSERM U970 Team 7, Paris Cardiovascular Research Centre
- PARCC, University Paris Descartes, AP-HP, Pharmacology Unit, Hôpital Européen Georges Pompidou, 56
Rue Leblanc, Paris 75015, France
| | - Rachel Climie
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | | | | | - Alessandro Giudici
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
- GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, Netherlands
| | | | - Andrea Grillo
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Andrea Guala
- Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
| | - Bernhard Hametner
- Center for Health & Bioresources, Medical Signal Analysis, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - Jayaraj Joseph
- Department of Electrical Engineering, Indian Institute of Technology Madras, Chennai 600 036, India
| | - Parmis Karimpour
- Research Centre for Biomedical Engineering, City, University of London, London EC1V 0HB, United Kingdom
| | | | - Panicos A Kyriacou
- Research Centre for Biomedical Engineering, City, University of London, London EC1V 0HB, United Kingdom
| | - Antonios Lazaridis
- Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mai Tone Lønnebakken
- Department of Heart Disease, Haukeland University Hospital and Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Christopher Clemens Mayer
- Center for Health & Bioresources, Medical Signal Analysis, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - P M Nabeel
- Healthcare Technology Innovation Centre, IIT Madras, Chennai 600 113, India
| | - Petras Navickas
- Clinic of Cardiac and Vascular Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - János Nemcsik
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Stefan Orter
- Center for Health & Bioresources, Medical Signal Analysis, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - Chloe Park
- MRC Unit for Lifelong Health and Ageing at UCL, 1–19 Torrington Place, London WC1E 7HB, UK
| | - Telmo Pereira
- Polytechnic University of Coimbra, Coimbra Health School, Rua 5 de Outubro—S. Martinho do Bispo, Apartado 7006, 3046-854 Coimbra, Portugal
| | - Giacomo Pucci
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
- Unit of Internal Medicine, ‘Santa Maria’ Terni Hospital, Terni, Italy
| | - Ana Belen Amado Rey
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering—IMTEK, IMBIT—NeuroProbes, BrainLinks-BrainTools Center, University of Freiburg, Freiburg, Germany
| | - Paolo Salvi
- Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Ana Carolina Gonçalves Seabra
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering—IMTEK, IMBIT—NeuroProbes, BrainLinks-BrainTools Center, University of Freiburg, Freiburg, Germany
| | - Ute Seeland
- Institute of Social Medicine, Epidemiology and Health Economics, Charitè—Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Thomas van Sloten
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Bart Spronck
- Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University,
Sydney, Australia
| | - Gerard Stansby
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
- Northern Vascular Centre, Freeman Hospital, Newcastle upon Tyne NE7 7DN, United Kingdom
| | - Indra Steens
- Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
| | - Thomas Stieglitz
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering—IMTEK, IMBIT—NeuroProbes, BrainLinks-BrainTools Center, University of Freiburg, Freiburg, Germany
- Bernstein Center Freiburg, University of Freiburg, Freiburg, Germany
| | - Isabella Tan
- Macquarie University, Sydney, Australia
- The George Institute for Global Health, Sydney, Australia
| | | | - Siegfried Wassertheurer
- Center for Health & Bioresources, Medical Signal Analysis, AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | - Thomas Weber
- Cardiology Department, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Berend E Westerhof
- Department of Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Neonatology, Radboud University Medical Center, Radboud Institute for Health Sciences, Amalia Children’s Hospital, Nijmegen, The Netherlands
| | - Peter H Charlton
- Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, United Kingdom
- Research Centre for Biomedical Engineering, City, University of London, London EC1V 0HB, United Kingdom
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Garmany A, Terzic A. Artificial intelligence powers regenerative medicine into predictive realm. Regen Med 2024; 19:611-616. [PMID: 39660914 PMCID: PMC11703382 DOI: 10.1080/17460751.2024.2437281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Accepted: 11/29/2024] [Indexed: 12/12/2024] Open
Abstract
The expanding regenerative medicine toolkit is reaching a record number of lives. There is a pressing need to enhance the precision, efficiency, and effectiveness of regenerative approaches and achieve reliable outcomes. While regenerative medicine has relied on an empiric paradigm, availability of big data along with advances in informatics and artificial intelligence offer the opportunity to inform the next generation of regenerative sciences along the discovery, translation, and application pathway. Artificial intelligence can streamline discovery and development of optimized biotherapeutics by aiding in the interpretation of readouts associated with optimal repair outcomes. In advanced biomanufacturing, artificial intelligence holds potential in ensuring quality control and assuring scalability through automated monitoring of process-critical variables mandatory for product consistency. In practice application, artificial intelligence can guide clinical trial design, patient selection, delivery strategies, and outcome assessment. As artificial intelligence transforms the regenerative horizon, caution is necessary to reduce bias, ensure generalizability, and mitigate ethical concerns with the goal of equitable access for patients and populations.
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Affiliation(s)
- Armin Garmany
- Marriott Heart Disease Research Program, Department of Cardiovascular Medicine, Department of Molecular Pharmacology & Experimental Therapeutics, Department of Clinical Genomics, Mayo Clinic, Rochester, MN, USA
- Mayo Clinic Alix School of Medicine, Regenerative Sciences Track, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, USA
| | - Andre Terzic
- Marriott Heart Disease Research Program, Department of Cardiovascular Medicine, Department of Molecular Pharmacology & Experimental Therapeutics, Department of Clinical Genomics, Mayo Clinic, Rochester, MN, USA
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Dean TB, Seecheran R, Badgett RG, Zackula R, Symons J. Perceptions and attitudes toward artificial intelligence among frontline physicians and physicians' assistants in Kansas: a cross-sectional survey. JAMIA Open 2024; 7:ooae100. [PMID: 39386068 PMCID: PMC11458514 DOI: 10.1093/jamiaopen/ooae100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 04/22/2024] [Accepted: 09/12/2024] [Indexed: 10/12/2024] Open
Abstract
Objective This survey aims to understand frontline healthcare professionals' perceptions of artificial intelligence (AI) in healthcare and assess how AI familiarity influences these perceptions. Materials and Methods We conducted a survey from February to March 2023 of physicians and physician assistants registered with the Kansas State Board of Healing Arts. Participants rated their perceptions toward AI-related domains and constructs on a 5-point Likert scale, with higher scores indicating stronger agreement. Two sub-groups were created for analysis to assess the impact of participants' familiarity and experience with AI on the survey results. Results From 532 respondents, key concerns were Perceived Communication Barriers (median = 4.0, IQR = 2.8-4.8), Unregulated Standards (median = 4.0, IQR = 3.6-4.8), and Liability Issues (median = 4.0, IQR = 3.5-4.8). Lower levels of agreement were noted for Trust in AI Mechanisms (median = 3.0, IQR = 2.2-3.4), Perceived Risks of AI (median = 3.2, IQR = 2.6-4.0), and Privacy Concerns (median = 3.3, IQR = 2.3-4.0). Positive correlations existed between Intention to use AI and Perceived Benefits (r = 0.825) and Trust in AI Mechanisms (r = 0.777). Perceived risk negatively correlated with Intention to Use AI (r = -0.718). There was no difference in perceptions between AI experienced and AI naïve subgroups. Discussion The findings suggest that perceptions of benefits, trust, risks, communication barriers, regulation, and liability issues influence healthcare professionals' intention to use AI, regardless of their AI familiarity. Conclusion The study highlights key factors affecting AI adoption in healthcare from the frontline healthcare professionals' perspective. These insights can guide strategies for successful AI implementation in healthcare.
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Affiliation(s)
- Tanner B Dean
- Department of Internal Medicine, Intermountain Health, Salt Lake City, UT 84120, United States
| | - Rajeev Seecheran
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, United States
| | - Robert G Badgett
- Department of Internal Medicine, University of Kansas School of Medicine—Wichita, Wichita, KS 67214, United States
| | - Rosey Zackula
- Center for Clinical Research—Wichita, University of Kansas School of Medicine—Wichita, Wichita, KS 67214, United States
| | - John Symons
- Center for Cyber Social Dynamics, University of Kansas, Lawrence, KS 66045, United States
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Harky A, Patel RSK, Yien M, Khaled A, Nguyen D, Roy S, Zeinah M. Risk management of patients with multiple CVDs: what are the best practices? Expert Rev Cardiovasc Ther 2024; 22:603-614. [PMID: 39548654 DOI: 10.1080/14779072.2024.2427634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 07/16/2024] [Accepted: 11/06/2024] [Indexed: 11/18/2024]
Abstract
INTRODUCTION Managing patients with multiple risk factors for CVDs can present distinct challenges for healthcare providers, therefore addressing them can be paramount to optimize patient care. AREAS COVERED This narrative review explores the burden that CVDs place on healthcare systems as well as how we can best optimize the risk management of these patients. Through a comprehensive review of literature, guidelines and clinical studies, this paper explores various approaches to risk management, lifestyle modifications and pharmacological interventions utilized in the management of CVDs. Furthermore, emerging technologies such as machine learning (ML) are discussed, highlighting potential opportunities for future research. By reviewing existing recommendations and evidence, this paper aims to provide insight into optimizing strategies and improving the outcomes for patients with multiple CVDs. EXPERT OPINION Optimizing risk factors can have a significant impact on patient outcomes, as such each patient should have a clear plan on how to manage these risk factors to minimize adverse healthcare results.
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Affiliation(s)
- Amer Harky
- Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK
| | | | - Maya Yien
- School of Medicine, University of Liverpool, Liverpool, UK
| | - Abdullah Khaled
- Department of Anaesthetics and Intensive Care, Queens Hospital, Romford, UK
| | - Dang Nguyen
- Massachusetts General Hospital, Corrigan Minehan Heart Center, Harvard Medical School, Boston, MA, USA
| | - Sakshi Roy
- School of Medicine, Queens University Belfast, Belfast, Northern Ireland, UK
| | - Mohamed Zeinah
- Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK
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10
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Nichol AA, Halley M, Federico C, Cho MK, Sankar PL. Moral Engagement and Disengagement in Health Care AI Development. AJOB Empir Bioeth 2024; 15:291-300. [PMID: 38588388 PMCID: PMC11458830 DOI: 10.1080/23294515.2024.2336906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
BACKGROUND Machine learning (ML) is utilized increasingly in health care, and can pose harms to patients, clinicians, health systems, and the public. In response, regulators have proposed an approach that would shift more responsibility to ML developers for mitigating potential harms. To be effective, this approach requires ML developers to recognize, accept, and act on responsibility for mitigating harms. However, little is known regarding the perspectives of developers themselves regarding their obligations to mitigate harms. METHODS We conducted 40 semi-structured interviews with developers of ML predictive analytics applications for health care in the United States. RESULTS Participants varied widely in their perspectives on personal responsibility and included examples of both moral engagement and disengagement, albeit in a variety of forms. While most (70%) of participants made a statement indicative of moral engagement, most of these statements reflected an awareness of moral issues, while only a subset of these included additional elements of engagement such as recognizing responsibility, alignment with personal values, addressing conflicts of interests, and opportunities for action. Further, we identified eight distinct categories of moral disengagement reflecting efforts to minimize potential harms or deflect personal responsibility for preventing or mitigating harms. CONCLUSIONS These findings suggest possible facilitators and barriers to the development of ethical ML that could act by encouraging moral engagement or discouraging moral disengagement. Regulatory approaches that depend on the ability of ML developers to recognize, accept, and act on responsibility for mitigating harms might have limited success without education and guidance for ML developers about the extent of their responsibilities and how to implement them.
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Affiliation(s)
- Ariadne A Nichol
- Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, California, USA
| | - Meghan Halley
- Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, California, USA
| | - Carole Federico
- Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, California, USA
| | - Mildred K Cho
- Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, California, USA
| | - Pamela L Sankar
- Department of Medical Ethics & Health Policy, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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11
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Chen S, Yu J, Chamouni S, Wang Y, Li Y. Integrating machine learning and artificial intelligence in life-course epidemiology: pathways to innovative public health solutions. BMC Med 2024; 22:354. [PMID: 39218895 PMCID: PMC11367811 DOI: 10.1186/s12916-024-03566-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024] Open
Abstract
The integration of machine learning (ML) and artificial intelligence (AI) techniques in life-course epidemiology offers remarkable opportunities to advance our understanding of the complex interplay between biological, social, and environmental factors that shape health trajectories across the lifespan. This perspective summarizes the current applications, discusses future potential and challenges, and provides recommendations for harnessing ML and AI technologies to develop innovative public health solutions. ML and AI have been increasingly applied in epidemiological studies, demonstrating their ability to handle large, complex datasets, identify intricate patterns and associations, integrate multiple and multimodal data types, improve predictive accuracy, and enhance causal inference methods. In life-course epidemiology, these techniques can help identify sensitive periods and critical windows for intervention, model complex interactions between risk factors, predict individual and population-level disease risk trajectories, and strengthen causal inference in observational studies. By leveraging the five principles of life-course research proposed by Elder and Shanahan-lifespan development, agency, time and place, timing, and linked lives-we discuss a framework for applying ML and AI to uncover novel insights and inform targeted interventions. However, the successful integration of these technologies faces challenges related to data quality, model interpretability, bias, privacy, and equity. To fully realize the potential of ML and AI in life-course epidemiology, fostering interdisciplinary collaborations, developing standardized guidelines, advocating for their integration in public health decision-making, prioritizing fairness, and investing in training and capacity building are essential. By responsibly harnessing the power of ML and AI, we can take significant steps towards creating healthier and more equitable futures across the life course.
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Affiliation(s)
- Shanquan Chen
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Jiazhou Yu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sarah Chamouni
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Yuqi Wang
- Department of Computer Science, University College London, London, WC1E 6BT, UK
| | - Yunfei Li
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, 171 64, Sweden.
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12
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Ho A, Bavli I, Mahal R, McKeown MJ. Multi-Level Ethical Considerations of Artificial Intelligence Health Monitoring for People Living with Parkinson's Disease. AJOB Empir Bioeth 2024; 15:178-191. [PMID: 37889210 DOI: 10.1080/23294515.2023.2274582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Artificial intelligence (AI) has garnered tremendous attention in health care, and many hope that AI can enhance our health system's ability to care for people with chronic and degenerative conditions, including Parkinson's Disease (PD). This paper reports the themes and lessons derived from a qualitative study with people living with PD, family caregivers, and health care providers regarding the ethical dimensions of using AI to monitor, assess, and predict PD symptoms and progression. Thematic analysis identified ethical concerns at four intersecting levels: personal, interpersonal, professional/institutional, and societal levels. Reflecting on potential benefits of predictive algorithms that can continuously collect and process longitudinal data, participants expressed a desire for more timely, ongoing, and accurate information that could enhance management of day-to-day fluctuations and facilitate clinical and personal care as their disease progresses. Nonetheless, they voiced concerns about intersecting ethical questions around evolving illness identities, familial and professional care relationships, privacy, and data ownership/governance. The multi-layer analysis provides a helpful way to understand the ethics of using AI in monitoring and managing PD and other chronic/degenerative conditions.
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Affiliation(s)
- Anita Ho
- Centre for Applied Ethics, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Itai Bavli
- Centre for Applied Ethics, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Ravneet Mahal
- Pacific Parkinson's Research Centre, University of British Columbia, Vancouver, Canada
| | - Martin J McKeown
- Pacific Parkinson's Research Centre, University of British Columbia, Vancouver, Canada
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13
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Khan M, Banerjee S, Muskawad S, Maity R, Chowdhury SR, Ejaz R, Kuuzie E, Satnarine T. The Impact of Artificial Intelligence on Allergy Diagnosis and Treatment. Curr Allergy Asthma Rep 2024; 24:361-372. [PMID: 38954325 DOI: 10.1007/s11882-024-01152-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE OF REVIEW Artificial intelligence (AI), be it neuronal networks, machine learning or deep learning, has numerous beneficial effects on healthcare systems; however, its potential applications and diagnostic capabilities for immunologic diseases have yet to be explored. Understanding AI systems can help healthcare workers better assimilate artificial intelligence into their practice and unravel its potential in diagnostics, clinical research, and disease management. RECENT FINDINGS We reviewed recent advancements in AI systems and their integration in healthcare systems, along with their potential benefits in the diagnosis and management of diseases. We explored machine learning as employed in allergy diagnosis and its learning patterns from patient datasets, as well as the possible advantages of using AI in the field of research related to allergic reactions and even remote monitoring. Considering the ethical challenges and privacy concerns raised by clinicians and patients with regard to integrating AI in healthcare, we explored the new guidelines adapted by regulatory bodies. Despite these challenges, AI appears to have been successfully incorporated into various healthcare systems and is providing patient-centered solutions while simultaneously assisting healthcare workers. Artificial intelligence offers new hope in the field of immunologic disease diagnosis, monitoring, and management and thus has the potential to revolutionize healthcare systems.
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Affiliation(s)
- Maham Khan
- Fatima Jinnah Medical University, Lahore, Pakistan.
| | | | | | - Rick Maity
- Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | | | - Rida Ejaz
- Shifa College of Medicine, Islamabad, Pakistan
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14
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Norris ML, Obeid N, El-Emam K. Examining the role of artificial intelligence to advance knowledge and address barriers to research in eating disorders. Int J Eat Disord 2024; 57:1357-1368. [PMID: 38597344 DOI: 10.1002/eat.24215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 03/22/2024] [Accepted: 03/22/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVE To provide a brief overview of artificial intelligence (AI) application within the field of eating disorders (EDs) and propose focused solutions for research. METHOD An overview and summary of AI application pertinent to EDs with focus on AI's ability to address issues relating to data sharing and pooling (and associated privacy concerns), data augmentation, as well as bias within datasets is provided. RESULTS In addition to clinical applications, AI can utilize useful tools to help combat commonly encountered challenges in ED research, including issues relating to low prevalence of specific subpopulations of patients, small overall sample sizes, and bias within datasets. DISCUSSION There is tremendous potential to embed and utilize various facets of artificial intelligence (AI) to help improve our understanding of EDs and further evaluate and investigate questions that ultimately seek to improve outcomes. Beyond the technology, issues relating to regulation of AI, establishing ethical guidelines for its application, and the trust of providers and patients are all needed for ultimate adoption and acceptance into ED practice. PUBLIC SIGNIFICANCE Artificial intelligence (AI) offers a promise of significant potential within the realm of eating disorders (EDs) and encompasses a broad set of techniques that offer utility in various facets of ED research and by extension delivery of clinical care. Beyond the technology, issues relating to regulation, establishing ethical guidelines for application, and the trust of providers and patients are needed for the ultimate adoption and acceptance of AI into ED practice.
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Affiliation(s)
- Mark L Norris
- Department of Pediatrics, Children's Hospital of Eastern Ontario (CHEO), University of Ottawa, Ottawa, Ontario, Canada
- CHEO Research Institute, Ottawa, Ontario, Canada
| | - Nicole Obeid
- CHEO Research Institute, Ottawa, Ontario, Canada
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | - Khaled El-Emam
- CHEO Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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15
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van Genderen ME, van de Sande D, Hooft L, Reis AA, Cornet AD, Oosterhoff JHF, van der Ster BJP, Huiskens J, Townsend R, van Bommel J, Gommers D, van den Hoven J. Charting a new course in healthcare: early-stage AI algorithm registration to enhance trust and transparency. NPJ Digit Med 2024; 7:119. [PMID: 38720011 PMCID: PMC11078921 DOI: 10.1038/s41746-024-01104-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 04/15/2024] [Indexed: 05/12/2024] Open
Affiliation(s)
- Michel E van Genderen
- Erasmus MC University Medical Center, Department of Adult Intensive Care, Rotterdam, The Netherlands.
| | - Davy van de Sande
- Erasmus MC University Medical Center, Department of Adult Intensive Care, Rotterdam, The Netherlands
| | - Lotty Hooft
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Andreas Alois Reis
- Department of Research for Health, Division of the Chief Scientist, World Health Organization, Geneva, Switzerland
| | - Alexander D Cornet
- Section editor Intensive Care at Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine), Amsterdam, The Netherlands
- Department of Intensive Care, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Jacobien H F Oosterhoff
- Delft University of Technology, Faculty of Technology, Policy and Management, Delft, The Netherlands
| | - Björn J P van der Ster
- Erasmus MC University Medical Center, Department of Adult Intensive Care, Rotterdam, The Netherlands
| | | | - Reggie Townsend
- Vice President Data Ethics Practice, SAS Worldwide Headquarters, Cary, N.C., USA
- National Artificial Intelligence Advisory Committee, Executive Office of the President of the United States, Washington, D.C., USA
| | - Jasper van Bommel
- Erasmus MC University Medical Center, Department of Adult Intensive Care, Rotterdam, The Netherlands
| | - Diederik Gommers
- Erasmus MC University Medical Center, Department of Adult Intensive Care, Rotterdam, The Netherlands
| | - Jeroen van den Hoven
- Delft University of Technology, Faculty of Technology, Policy and Management, Delft, The Netherlands
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16
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Sridhar GR, Siva Prasad AV, Lakshmi G. Scope and caveats: Artificial intelligence in gastroenterology. Artif Intell Gastroenterol 2024; 5:91607. [DOI: 10.35712/aig.v5.i1.91607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/18/2024] [Accepted: 03/29/2024] [Indexed: 04/29/2024] Open
Abstract
The use of Artificial intelligence (AI) has evolved from its mid-20th century origins to playing a pivotal tool in modern medicine. It leverages digital data and computational hardware for diverse applications, including diagnosis, prognosis, and treatment responses in gastrointestinal and hepatic conditions. AI has had an impact in diagnostic techniques, particularly endoscopy, ultrasound, and histopathology. AI encompasses machine learning, natural language processing, and robotics, with machine learning being central. This involves sophisticated algorithms capable of managing complex datasets, far surpassing traditional statistical methods. These algorithms, both supervised and unsupervised, are integral for interpreting large datasets. In liver diseases, AI's non-invasive diagnostic applications, particularly in non-alcoholic fatty liver disease, and its role in characterizing hepatic lesions is promising. AI aids in distinguishing between normal and cirrhotic livers and improves the accuracy of lesion characterization and prognostication of hepatocellular carcinoma. AI enhances lesion identification during endoscopy, showing potential in the diagnosis and management of early-stage esophageal carcinoma. In peptic ulcer disease, AI technologies influence patient management strategies. AI is useful in colonoscopy, particularly in detecting smaller colonic polyps. However, its applicability in non-academic settings requires further validation. Addressing these issues is vital for harnessing the potential of AI. In conclusion, while AI offers transformative possibilities in gastroenterology, careful integration and balancing of technical possibilities with ethical and practical application, is essential for optimal use.
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Affiliation(s)
| | - Atmakuri V Siva Prasad
- Department of Gastroenterology, Institute of Gastroenterology, Visakhapatnam 530003, India
| | - Gumpeny Lakshmi
- Department of Internal Medicine, Gayatri Vidya Parishad Institute of Healthcare & Medical Technology, Visakhapatnam 530048, India
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17
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John London A, Karlawish J, Largent EA, Phillips Hey S, McCarthy EP. Algorithmic identification of persons with dementia for research recruitment: ethical considerations. Inform Health Soc Care 2024; 49:28-41. [PMID: 38196387 PMCID: PMC11001531 DOI: 10.1080/17538157.2023.2299881] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Underdiagnosis, misdiagnosis, and patterns of social inequality that translate into unequal access to health systems all pose barriers to identifying and recruiting diverse and representative populations into research on Alzheimer's disease and Alzheimer's disease related dementias. In response, some have turned to algorithms to identify patients living with dementia using information that is associated with this condition but that is not as specific as a diagnosis. This paper explains six ethical issues associated with the use of such algorithms including the generation of new, sensitive, identifiable medical information for research purposes without participant consent, issues of justice and equity, risk, and ethical communication. It concludes with a discussion of strategies for addressing these issues and prompting valuable research.
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Affiliation(s)
- Alex John London
- Center for Ethics and Policy, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | - Jason Karlawish
- Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Emily A. Largent
- Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Ellen P. McCarthy
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
- Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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18
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Wang Y, Li N, Chen L, Wu M, Meng S, Dai Z, Zhang Y, Clarke M. Guidelines, Consensus Statements, and Standards for the Use of Artificial Intelligence in Medicine: Systematic Review. J Med Internet Res 2023; 25:e46089. [PMID: 37991819 PMCID: PMC10701655 DOI: 10.2196/46089] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 08/21/2023] [Accepted: 09/26/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND The application of artificial intelligence (AI) in the delivery of health care is a promising area, and guidelines, consensus statements, and standards on AI regarding various topics have been developed. OBJECTIVE We performed this study to assess the quality of guidelines, consensus statements, and standards in the field of AI for medicine and to provide a foundation for recommendations about the future development of AI guidelines. METHODS We searched 7 electronic databases from database establishment to April 6, 2022, and screened articles involving AI guidelines, consensus statements, and standards for eligibility. The AGREE II (Appraisal of Guidelines for Research & Evaluation II) and RIGHT (Reporting Items for Practice Guidelines in Healthcare) tools were used to assess the methodological and reporting quality of the included articles. RESULTS This systematic review included 19 guideline articles, 14 consensus statement articles, and 3 standard articles published between 2019 and 2022. Their content involved disease screening, diagnosis, and treatment; AI intervention trial reporting; AI imaging development and collaboration; AI data application; and AI ethics governance and applications. Our quality assessment revealed that the average overall AGREE II score was 4.0 (range 2.2-5.5; 7-point Likert scale) and the mean overall reporting rate of the RIGHT tool was 49.4% (range 25.7%-77.1%). CONCLUSIONS The results indicated important differences in the quality of different AI guidelines, consensus statements, and standards. We made recommendations for improving their methodological and reporting quality. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews (CRD42022321360); https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=321360.
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Affiliation(s)
- Ying Wang
- Department of Medical Administration, West China Hospital, Sichuan University, Chengdu, China
| | - Nian Li
- Department of Medical Administration, West China Hospital, Sichuan University, Chengdu, China
| | - Lingmin Chen
- Department of Anesthesiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Miaomiao Wu
- Department of General Practice, National Clinical Research Center for Geriatrics, International Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Sha Meng
- Department of Operation Management, West China Hospital, Sichuan University, Chengdu, China
| | - Zelei Dai
- Department of Radiation Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Yonggang Zhang
- Department of Periodical Press, National Clinical Research Center for Geriatrics, Chinese Evidence-based Medicine Center, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Mike Clarke
- Northern Ireland Methodology Hub, Queen's University Belfast, Belfast, United Kingdom
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St. Sauver J, Fu S, Sohn S, Weston S, Fan C, Olson J, Thorsteinsdottir B, LeBrasseur N, Pagali S, Rocca W, Liu H. Identification of delirium from real-world electronic health record clinical notes. J Clin Transl Sci 2023; 7:e187. [PMID: 37745932 PMCID: PMC10514685 DOI: 10.1017/cts.2023.610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 08/02/2023] [Accepted: 08/08/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction We tested the ability of our natural language processing (NLP) algorithm to identify delirium episodes in a large-scale study using real-world clinical notes. Methods We used the Rochester Epidemiology Project to identify persons ≥ 65 years who were hospitalized between 2011 and 2017. We identified all persons with an International Classification of Diseases code for delirium within ±14 days of a hospitalization. We independently applied our NLP algorithm to all clinical notes for this same population. We calculated rates using number of delirium episodes as the numerator and number of hospitalizations as the denominator. Rates were estimated overall, by demographic characteristics, and by year of episode, and differences were tested using Poisson regression. Results In total, 14,255 persons had 37,554 hospitalizations between 2011 and 2017. The code-based delirium rate was 3.02 per 100 hospitalizations (95% CI: 2.85, 3.20). The NLP-based rate was 7.36 per 100 (95% CI: 7.09, 7.64). Rates increased with age (both p < 0.0001). Code-based rates were higher in men compared to women (p = 0.03), but NLP-based rates were similar by sex (p = 0.89). Code-based rates were similar by race and ethnicity, but NLP-based rates were higher in the White population compared to the Black and Asian populations (p = 0.001). Both types of rates increased significantly over time (both p values < 0.001). Conclusions The NLP algorithm identified more delirium episodes compared to the ICD code method. However, NLP may still underestimate delirium cases because of limitations in real-world clinical notes, including incomplete documentation, practice changes over time, and missing clinical notes in some time periods.
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Affiliation(s)
- Jennifer St. Sauver
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Sunyang Fu
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Sunghwan Sohn
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Susan Weston
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Chun Fan
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Janet Olson
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | - Nathan LeBrasseur
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN, USA
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | | | - Walter Rocca
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Women’s Health Research Center, Mayo Clinic, Rochester, MN, USA
| | - Hongfang Liu
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, USA
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Abstract
Promoting equity in AI in health care requires addressing biases at cli nical implementation.
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Affiliation(s)
- Matthew DeCamp
- Center for Bioethics and Humanities, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Charlotta Lindvall
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
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21
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Wang Z, Li Z, Li K, Mu S, Zhou X, Di Y. Performance of artificial intelligence in diabetic retinopathy screening: a systematic review and meta-analysis of prospective studies. Front Endocrinol (Lausanne) 2023; 14:1197783. [PMID: 37383397 PMCID: PMC10296189 DOI: 10.3389/fendo.2023.1197783] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/23/2023] [Indexed: 06/30/2023] Open
Abstract
Aims To systematically evaluate the diagnostic value of an artificial intelligence (AI) algorithm model for various types of diabetic retinopathy (DR) in prospective studies over the previous five years, and to explore the factors affecting its diagnostic effectiveness. Materials and methods A search was conducted in Cochrane Library, Embase, Web of Science, PubMed, and IEEE databases to collect prospective studies on AI models for the diagnosis of DR from January 2017 to December 2022. We used QUADAS-2 to evaluate the risk of bias in the included studies. Meta-analysis was performed using MetaDiSc and STATA 14.0 software to calculate the combined sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of various types of DR. Diagnostic odds ratios, summary receiver operating characteristic (SROC) plots, coupled forest plots, and subgroup analysis were performed according to the DR categories, patient source, region of study, and quality of literature, image, and algorithm. Results Finally, 21 studies were included. Meta-analysis showed that the pooled sensitivity, specificity, pooled positive likelihood ratio, pooled negative likelihood ratio, area under the curve, Cochrane Q index, and pooled diagnostic odds ratio of AI model for the diagnosis of DR were 0.880 (0.875-0.884), 0.912 (0.99-0.913), 13.021 (10.738-15.789), 0.083 (0.061-0.112), 0.9798, 0.9388, and 206.80 (124.82-342.63), respectively. The DR categories, patient source, region of study, sample size, quality of literature, image, and algorithm may affect the diagnostic efficiency of AI for DR. Conclusion AI model has a clear diagnostic value for DR, but it is influenced by many factors that deserve further study. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023389687.
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Kilbourne AM, Geng E, Eshun-Wilson I, Sweeney S, Shelley D, Cohen DJ, Kirchner JE, Fernandez ME, Parchman ML. How does facilitation in healthcare work? Using mechanism mapping to illuminate the black box of a meta-implementation strategy. Implement Sci Commun 2023; 4:53. [PMID: 37194084 PMCID: PMC10190070 DOI: 10.1186/s43058-023-00435-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 05/06/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Healthcare facilitation, an implementation strategy designed to improve the uptake of effective clinical innovations in routine practice, has produced promising yet mixed results in randomized implementation trials and has not been fully researched across different contexts. OBJECTIVE Using mechanism mapping, which applies directed acyclic graphs that decompose an effect of interest into hypothesized causal steps and mechanisms, we propose a more concrete description of how healthcare facilitation works to inform its further study as a meta-implementation strategy. METHODS Using a modified Delphi consensus process, co-authors developed the mechanistic map based on a three-step process. First, they developed an initial logic model by collectively reviewing the literature and identifying the most relevant studies of healthcare facilitation components and mechanisms to date. Second, they applied the logic model to write vignettes describing how facilitation worked (or did not) based on recent empirical trials that were selected via consensus for inclusion and diversity in contextual settings (US, international sites). Finally, the mechanistic map was created based on the collective findings from the vignettes. FINDINGS Theory-based healthcare facilitation components informing the mechanistic map included staff engagement, role clarification, coalition-building through peer experiences and identifying champions, capacity-building through problem solving barriers, and organizational ownership of the implementation process. Across the vignettes, engagement of leaders and practitioners led to increased socialization of the facilitator's role in the organization. This in turn led to clarifying of roles and responsibilities among practitioners and identifying peer experiences led to increased coherence and sense-making of the value of adopting effective innovations. Increased trust develops across leadership and practitioners through expanded capacity in adoption of the effective innovation by identifying opportunities that mitigated barriers to practice change. Finally, these mechanisms led to eventual normalization and ownership of the effective innovation and healthcare facilitation process. IMPACT Mapping methodology provides a novel perspective of mechanisms of healthcare facilitation, notably how sensemaking, trust, and normalization contribute to quality improvement. This method may also enable more efficient and impactful hypothesis-testing and application of complex implementation strategies, with high relevance for lower-resourced settings, to inform effective innovation uptake.
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Affiliation(s)
- Amy M. Kilbourne
- Health Services Research & Development, VA Office of Research and Development, US Department of Veterans Affairs and University of Michigan, 810 Vermont Ave, NW, Washington, D.C., 20420 USA
| | - Elvin Geng
- Washington University at St. Louis, St. Louis, MO USA
| | | | | | - Donna Shelley
- New York University School of Global Public Health, New York, New York USA
| | | | - JoAnn E. Kirchner
- Central Arkansas VA Healthcare System and University of Arkansas for Medical Sciences, North Little Rock, AR USA
| | - Maria E. Fernandez
- University of Texas Health Science Center at Houston, School of Public Health, Houston, TX USA
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Thai K, Tsiandoulas KH, Stephenson EA, Menna-Dack D, Zlotnik Shaul R, Anderson JA, Shinewald AR, Ampofo A, McCradden MD. Perspectives of Youths on the Ethical Use of Artificial Intelligence in Health Care Research and Clinical Care. JAMA Netw Open 2023; 6:e2310659. [PMID: 37126349 PMCID: PMC10152306 DOI: 10.1001/jamanetworkopen.2023.10659] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
Importance Understanding the views and values of patients is of substantial importance to developing the ethical parameters of artificial intelligence (AI) use in medicine. Thus far, there is limited study on the views of children and youths. Their perspectives contribute meaningfully to the integration of AI in medicine. Objective To explore the moral attitudes and views of children and youths regarding research and clinical care involving health AI at the point of care. Design, Setting, and Participants This qualitative study recruited participants younger than 18 years during a 1-year period (October 2021 to March 2022) at a large urban pediatric hospital. A total of 44 individuals who were receiving or had previously received care at a hospital or rehabilitation clinic contacted the research team, but 15 were found to be ineligible. Of the 29 who consented to participate, 1 was lost to follow-up, resulting in 28 participants who completed the interview. Exposures Participants were interviewed using vignettes on 3 main themes: (1) health data research, (2) clinical AI trials, and (3) clinical use of AI. Main Outcomes and Measures Thematic description of values surrounding health data research, interventional AI research, and clinical use of AI. Results The 28 participants included 6 children (ages, 10-12 years) and 22 youths (ages, 13-17 years) (16 female, 10 male, and 3 trans/nonbinary/gender diverse). Mean (SD) age was 15 (2) years. Participants were highly engaged and quite knowledgeable about AI. They expressed a positive view of research intended to help others and had strong feelings about the uses of their health data for AI. Participants expressed appreciation for the vulnerability of potential participants in interventional AI trials and reinforced the importance of respect for their preferences regardless of their decisional capacity. A strong theme for the prospective use of clinical AI was the desire to maintain bedside interaction between the patient and their physician. Conclusions and Relevance In this study, children and youths reported generally positive views of AI, expressing strong interest and advocacy for their involvement in AI research and inclusion of their voices for shared decision-making with AI in clinical care. These findings suggest the need for more engagement of children and youths in health care AI research and integration.
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Affiliation(s)
- Kelly Thai
- Department of Bioethics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Genetics & Genome Biology, Peter Gilgan Centre for Research & Learning, Toronto, Ontario, Canada
| | - Kate H Tsiandoulas
- Department of Bioethics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Elizabeth A Stephenson
- Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Dolly Menna-Dack
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Randi Zlotnik Shaul
- Department of Bioethics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - James A Anderson
- Department of Bioethics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Melissa D McCradden
- Department of Bioethics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Genetics & Genome Biology, Peter Gilgan Centre for Research & Learning, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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24
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Bellini V, Badino M, Maffezzoni M, Bezzi F, Bignami E. Evolution of Hybrid Intelligence and Its Application in Evidence-Based Medicine: A Review. Med Sci Monit 2023; 29:e939366. [PMID: 36864706 PMCID: PMC9990324 DOI: 10.12659/msm.939366] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 01/17/2023] [Indexed: 02/16/2023] Open
Abstract
Modern medicine, both in clinical practice and research, has become more and more based on data, which is changing equally in type and quality with the advent and development of healthcare digitalization. The first part of the present paper aims to present the steps through which data, and subsequently clinical and research practice, have evolved from paper-based to digital, proposing a possible future of this digitalization in terms of potential applications and integration of digital tools in medical practice. Noting that digitalization is no more a possible future, but a concrete reality, there is a strong need for a new definition of evidence-based medicine, which must take into account the progressive integration of artificial intelligence (AI) in all decision-making processes. So, leaving behind the traditional research concept of human intelligence versus AI, poorly adaptable to real-world clinical practice, a Human and AI hybrid model, seen as a deep integration of AI and human thinking, is proposed as a new healthcare governance system. The second part of our review is focused on some of the major challenges the digitalization process has to face, particularly privacy issues, system complexity and opacity, and ethical concerns related to legal aspects and healthcare disparities. Analyzing these open issues, we aim to present some of the future directions that in our opinion should be pursued to implement AI in clinical practice.
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25
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Taber P, Armin JS, Orozco G, Del Fiol G, Erdrich J, Kawamoto K, Israni ST. Artificial Intelligence and Cancer Control: Toward Prioritizing Justice, Equity, Diversity, and Inclusion (JEDI) in Emerging Decision Support Technologies. Curr Oncol Rep 2023; 25:387-424. [PMID: 36811808 DOI: 10.1007/s11912-023-01376-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 02/24/2023]
Abstract
PURPOSE FOR REVIEW This perspective piece has two goals: first, to describe issues related to artificial intelligence-based applications for cancer control as they may impact health inequities or disparities; and second, to report on a review of systematic reviews and meta-analyses of artificial intelligence-based tools for cancer control to ascertain the extent to which discussions of justice, equity, diversity, inclusion, or health disparities manifest in syntheses of the field's best evidence. RECENT FINDINGS We found that, while a significant proportion of existing syntheses of research on AI-based tools in cancer control use formal bias assessment tools, the fairness or equitability of models is not yet systematically analyzable across studies. Issues related to real-world use of AI-based tools for cancer control, such as workflow considerations, measures of usability and acceptance, or tool architecture, are more visible in the literature, but still addressed only in a minority of reviews. Artificial intelligence is poised to bring significant benefits to a wide range of applications in cancer control, but more thorough and standardized evaluations and reporting of model fairness are required to build the evidence base for AI-based tool design for cancer and to ensure that these emerging technologies promote equitable healthcare.
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Affiliation(s)
- Peter Taber
- Department of Biomedical Informatics, University of Utah School of Medicine, 421 Wakara Way, Salt Lake City, UT, 84108, USA.
| | - Julie S Armin
- Department of Family and Community Medicine, University of Arizona College of Medicine, Tucson, AZ, USA
| | | | - Guilherme Del Fiol
- Department of Biomedical Informatics, University of Utah School of Medicine, 421 Wakara Way, Salt Lake City, UT, 84108, USA
| | - Jennifer Erdrich
- Division of Surgical Oncology, University of Arizona College of Medicine, Tucson, AZ, USA
| | - Kensaku Kawamoto
- Department of Biomedical Informatics, University of Utah School of Medicine, 421 Wakara Way, Salt Lake City, UT, 84108, USA
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26
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Yang DM, Chang TJ, Hung KF, Wang ML, Cheng YF, Chiang SH, Chen MF, Liao YT, Lai WQ, Liang KH. Smart healthcare: A prospective future medical approach for COVID-19. J Chin Med Assoc 2023; 86:138-146. [PMID: 36227021 PMCID: PMC9847685 DOI: 10.1097/jcma.0000000000000824] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
COVID-19 has greatly affected human life for over 3 years. In this review, we focus on smart healthcare solutions that address major requirements for coping with the COVID-19 pandemic, including (1) the continuous monitoring of severe acute respiratory syndrome coronavirus 2, (2) patient stratification with distinct short-term outcomes (eg, mild or severe diseases) and long-term outcomes (eg, long COVID), and (3) adherence to medication and treatments for patients with COVID-19. Smart healthcare often utilizes medical artificial intelligence (AI) and cloud computing and integrates cutting-edge biological and optoelectronic techniques. These are valuable technologies for addressing the unmet needs in the management of COVID. By leveraging deep learning/machine learning capabilities and big data, medical AI can perform precise prognosis predictions and provide reliable suggestions for physicians' decision-making. Through the assistance of the Internet of Medical Things, which encompasses wearable devices, smartphone apps, internet-based drug delivery systems, and telemedicine technologies, the status of mild cases can be continuously monitored and medications provided at home without the need for hospital care. In cases that develop into severe cases, emergency feedback can be provided through the hospital for rapid treatment. Smart healthcare can possibly prevent the development of severe COVID-19 cases and therefore lower the burden on intensive care units.
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Affiliation(s)
- De-Ming Yang
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Microscopy Service Laboratory, Basic Research Division, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Biophotonics, School of Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Address correspondence. Dr. De-Ming Yang, Microscopy Service Laboratory, Basic Research Division, Department of Medical Research, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, ROC. E-mail address: (D.-M. Yang). and Dr. Kung-Hao Liang, Laboratory of Systems Biomedical Science, Department of Medical Research, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, ROC. E-mail: (K.-H. Liang)
| | - Tai-Jay Chang
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Laboratory of Genome Research, Basic Research Division, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Biomedical science and Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Kai-Feng Hung
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Mong-Lien Wang
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yen-Fu Cheng
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Su-Hua Chiang
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Mei-Fang Chen
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yi-Ting Liao
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Laboratory of Systems Biomedical Science, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Food Safety and Health Risk Assessment, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Wei-Qun Lai
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Microscopy Service Laboratory, Basic Research Division, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Biophotonics, School of Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Kung-Hao Liang
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Laboratory of Systems Biomedical Science, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Food Safety and Health Risk Assessment, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Address correspondence. Dr. De-Ming Yang, Microscopy Service Laboratory, Basic Research Division, Department of Medical Research, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, ROC. E-mail address: (D.-M. Yang). and Dr. Kung-Hao Liang, Laboratory of Systems Biomedical Science, Department of Medical Research, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, ROC. E-mail: (K.-H. Liang)
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27
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Choorapoikayil S, Hof L, Old O, Steinbicker A, Meybohm P, Zacharowski K. How do I/we forecast tomorrow's transfusion? A focus on recipients' profiles. Transfus Clin Biol 2023; 30:27-30. [PMID: 36108949 DOI: 10.1016/j.tracli.2022.09.063] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Red blood cell (RBC) transfusion is a life-saving medical intervention and has an essential role in the management of surgical patients. However, blood donations and supply levels are decreasing, therefore there is an unmet need for the accurate prediction of the transfusion probability for surgical patients. Multiple methods have been established to predict the need for RBC transfusion. Maximum surgical blood order schedules are widely used in the clinical setting. However, these lists are not designed to accurately predict RBC utilization for an individual case as factors such as preoperative haemoglobin level, total body blood volume, comedications are not considered. Artificial intelligence and related technologies based on machine learning modelling are valuable alternatives to predict transfusion probability taking into account patient individual risk factors including among others comorbidities, laboratory parameters, use of oral anticoagulation, ASA score, surgeon's ID or applied blood saving measures. Overall, forecasting the need for a RBC transfusion can facilitate personalized medicine, quality assurance, decrease blood wastage, decrease costs, and increase patient safety. Furthermore, transfusion prediction models could facilitate blood management strategies before surgery.
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Affiliation(s)
- Suma Choorapoikayil
- Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Lotta Hof
- Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Oliver Old
- Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Andrea Steinbicker
- Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Patrick Meybohm
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Kai Zacharowski
- Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
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28
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Hantel A, Clancy DD, Kehl KL, Marron JM, Van Allen EM, Abel GA. A Process Framework for Ethically Deploying Artificial Intelligence in Oncology. J Clin Oncol 2022; 40:3907-3911. [PMID: 35849792 PMCID: PMC9746763 DOI: 10.1200/jco.22.01113] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/01/2022] [Accepted: 06/21/2022] [Indexed: 12/24/2022] Open
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29
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Javaid A, Zghyer F, Kim C, Spaulding EM, Isakadze N, Ding J, Kargillis D, Gao Y, Rahman F, Brown DE, Saria S, Martin SS, Kramer CM, Blumenthal RS, Marvel FA. Medicine 2032: The future of cardiovascular disease prevention with machine learning and digital health technology. Am J Prev Cardiol 2022; 12:100379. [PMID: 36090536 PMCID: PMC9460561 DOI: 10.1016/j.ajpc.2022.100379] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/21/2022] [Accepted: 08/28/2022] [Indexed: 11/30/2022] Open
Abstract
Machine learning (ML) refers to computational algorithms that iteratively improve their ability to recognize patterns in data. The digitization of our healthcare infrastructure is generating an abundance of data from electronic health records, imaging, wearables, and sensors that can be analyzed by ML algorithms to generate personalized risk assessments and promote guideline-directed medical management. ML's strength in generating insights from complex medical data to guide clinical decisions must be balanced with the potential to adversely affect patient privacy, safety, health equity, and clinical interpretability. This review provides a primer on key advances in ML for cardiovascular disease prevention and how they may impact clinical practice.
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Affiliation(s)
- Aamir Javaid
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Carnegie 591, Baltimore, MD 21287, USA
| | - Fawzi Zghyer
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Carnegie 591, Baltimore, MD 21287, USA
| | - Chang Kim
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Carnegie 591, Baltimore, MD 21287, USA
| | - Erin M. Spaulding
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Carnegie 591, Baltimore, MD 21287, USA
| | - Nino Isakadze
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Carnegie 591, Baltimore, MD 21287, USA
| | - Jie Ding
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Carnegie 591, Baltimore, MD 21287, USA
| | - Daniel Kargillis
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Carnegie 591, Baltimore, MD 21287, USA
| | - Yumin Gao
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Carnegie 591, Baltimore, MD 21287, USA
| | - Faisal Rahman
- Division of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Donald E. Brown
- School of Data Science, University of Virginia, Charlottesville, VA, USA
| | - Suchi Saria
- Machine Learning and Healthcare Laboratory, Departments of Computer Science, Statistics, and Health Policy, Malone Center for Engineering in Healthcare, and Armstrong Institute for Patient Safety and Quality, Johns Hopkins University, Baltimore, MD, USA
| | - Seth S. Martin
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Carnegie 591, Baltimore, MD 21287, USA
| | - Christopher M. Kramer
- Cardiovascular Division, Department of Medicine, University of Virginia Health, Charlottesville, VA, USA
| | - Roger S. Blumenthal
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Carnegie 591, Baltimore, MD 21287, USA
| | - Francoise A. Marvel
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Carnegie 591, Baltimore, MD 21287, USA
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30
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Gulumbe BH, Bazata AY, Bagwai MA. Campylobacter Species, Microbiological Source Tracking and Risk Assessment of Bacterial pathogens. BORNEO JOURNAL OF PHARMACY 2022. [DOI: 10.33084/bjop.v5i2.3363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Campylobacter species continue to remain critical pathogens of public health interest. They are responsible for approximately 500 million cases of gastroenteritis per year worldwide. Infection occurs through the consumption of contaminated food and water. Microbial risk assessment and source tracking are crucial epidemiological strategies to monitor the outbreak of campylobacteriosis effectively. Various methods have been proposed for microbial source tracking and risk assessment, most of which rely on conventional microbiological techniques such as detecting fecal indicator organisms and other novel microbial source tracking methods, including library-dependent microbial source tracking and library-independent source tracking approaches. However, both the traditional and novel methods have their setbacks. For example, while the conventional techniques are associated with a poor correlation between indicator organism and pathogen presence, on the other hand, it is impractical to interpret qPCR-generated markers to establish the exact human health risks even though it can give information regarding the potential source and relative human risk. Therefore, this article provides up-to-date information on campylobacteriosis, various approaches for source attribution, and risk assessment of bacterial pathogens, including next-generation sequencing approaches such as shotgun metagenomics, which effectively answer the questions of potential pathogens are there and in what quantities.
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