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Healthcare
Clinical AI, diagnostic bias, patient safety and medical-device regulation — the healthcare front of AI ethics, daily.
Ethics and governance of trustworthy medical artificial intelligence
BACKGROUND: The growing application of artificial intelligence (AI) in healthcare has brought technological breakthroughs to traditional diagnosis and treatment, but it is accompanied by many risks and challenges. These adverse effects are also seen as ethical issues and affect trustworthiness in medical AI and need to be managed through identification, prognosis and monitoring. METHODS: We adopted a multidisciplinary approach and summarized five subjects that influence the trustworthiness of me
Survey of Explainable AI Techniques in Healthcare
Artificial intelligence (AI) with deep learning models has been widely applied in numerous domains, including medical imaging and healthcare tasks. In the medical field, any judgment or decision is fraught with risk. A doctor will carefully judge whether a patient is sick before forming a reasonable explanation based on the patient's symptoms and/or an examination. Therefore, to be a viable and accepted tool, AI needs to mimic human judgment and interpretation skills. Specifically, explainable A
A systematic literature review of artificial intelligence in the healthcare sector: Benefits, challenges, methodologies, and functionalities
Administrative and medical processes of the healthcare organizations are rapidly changing because of the use of artificial intelligence (AI) systems. This change demonstrates the critical impact of AI at multiple activities, particularly in medical processes related to early detection and diagnosis. Previous studies suggest that AI can raise the quality of services in the healthcare industry. AI-based technologies have reported to improve human life quality, making life easier, safer and more pr
Comparing scientific abstracts generated by ChatGPT to original abstracts using an artificial intelligence output detector, plagiarism detector, and blinded human reviewers
Abstract Background Large language models such as ChatGPT can produce increasingly realistic text, with unknown information on the accuracy and integrity of using these models in scientific writing. Methods We gathered ten research abstracts from five high impact factor medical journals (n=50) and asked ChatGPT to generate research abstracts based on their titles and journals. We evaluated the abstracts using an artificial intelligence (AI) output detector, plagiarism detector, and had blinded h
Economics of Artificial Intelligence in Healthcare: Diagnosis vs. Treatment
Motivation: The price of medical treatment continues to rise due to (i) an increasing population; (ii) an aging human growth; (iii) disease prevalence; (iv) a rise in the frequency of patients that utilize health care services; and (v) increase in the price. Objective: Artificial Intelligence (AI) is already well-known for its superiority in various healthcare applications, including the segmentation of lesions in images, speech recognition, smartphone personal assistants, navigation, ride-shari
A Call to Action on Assessing and Mitigating Bias in Artificial Intelligence Applications for Mental Health
Advances in computer science and data-analytic methods are driving a new era in mental health research and application. Artificial intelligence (AI) technologies hold the potential to enhance the assessment, diagnosis, and treatment of people experiencing mental health problems and to increase the reach and impact of mental health care. However, AI applications will not mitigate mental health disparities if they are built from historical data that reflect underlying social biases and inequities.
Artificial intelligence in medical education: a cross-sectional needs assessment
BACKGROUND: As the information age wanes, enabling the prevalence of the artificial intelligence age; expectations, responsibilities, and job definitions need to be redefined for those who provide services in healthcare. This study examined the perceptions of future physicians on the possible influences of artificial intelligence on medicine, and to determine the needs that might be helpful for curriculum restructuring. METHODS: A cross-sectional multi-centre study was conducted among medical st
Multimodal machine learning in precision health: A scoping review
Machine learning is frequently being leveraged to tackle problems in the health sector including utilization for clinical decision-support. Its use has historically been focused on single modal data. Attempts to improve prediction and mimic the multimodal nature of clinical expert decision-making has been met in the biomedical field of machine learning by fusing disparate data. This review was conducted to summarize the current studies in this field and identify topics ripe for future research.
Real-world data: a brief review of the methods, applications, challenges and opportunities
BACKGROUND: The increased adoption of the internet, social media, wearable devices, e-health services, and other technology-driven services in medicine and healthcare has led to the rapid generation of various types of digital data, providing a valuable data source beyond the confines of traditional clinical trials, epidemiological studies, and lab-based experiments. METHODS: We provide a brief overview on the type and sources of real-world data and the common models and approaches to utilize an
Deep generative molecular design reshapes drug discovery
Recent advances and accomplishments of artificial intelligence (AI) and deep generative models have established their usefulness in medicinal applications, especially in drug discovery and development. To correctly apply AI, the developer and user face questions such as which protocols to consider, which factors to scrutinize, and how the deep generative models can integrate the relevant disciplines. This review summarizes classical and newly developed AI approaches, providing an updated and acc
The 2022 Europe report of the Lancet Countdown on health and climate change: towards a climate resilient future
In the past few decades, major public health advances have happened in Europe, with drastic decreases in premature mortality and a life expectancy increase of almost 9 years since 1980. European countries have some of the best health-care systems in the world. However, \nEurope is challenged with unprecedented and overlapping crises that are detrimental to human health and livelihoods and threaten adaptive capacity, including the COVID-19 pandemic, the Russian invasion of Ukraine, the fastes
Explainable medical imaging AI needs human-centered design: guidelines and evidence from a systematic review
Transparency in Machine Learning (ML), often also referred to as interpretability or explainability, attempts to reveal the working mechanisms of complex models. From a human-centered design perspective, transparency is not a property of the ML model but an affordance, i.e., a relationship between algorithm and users. Thus, prototyping and user evaluations are critical to attaining solutions that afford transparency. Following human-centered design principles in highly specialized and high stake
Influence of AI ethics awareness, attitude, anxiety, and self-efficacy on nursing students’ behavioral intentions
Abstract Background Artificial intelligence (AI) technology has recently seen rapid advancement, with an expanding role and scope in nursing education and healthcare. This study identifies the influence of AI ethics awareness, attitude toward AI, anxiety, and self-efficacy on nursing students’ behavioral intentions to use AI-based healthcare technology. Methods The participants included 189 nursing students in Gyeonggi-do, with data collected from November to December 2021 using self-reported qu
A deep learning model for detection of Alzheimer's disease based on retinal photographs: a retrospective, multicentre case-control study
BACKGROUND: There is no simple model to screen for Alzheimer's disease, partly because the diagnosis of Alzheimer's disease itself is complex-typically involving expensive and sometimes invasive tests not commonly available outside highly specialised clinical settings. We aimed to develop a deep learning algorithm that could use retinal photographs alone, which is the most common method of non-invasive imaging the retina to detect Alzheimer's disease-dementia. METHODS: In this retrospective, mul
Integrated multimodal artificial intelligence framework for healthcare applications
Artificial intelligence (AI) systems hold great promise to improve healthcare over the next decades. Specifically, AI systems leveraging multiple data sources and input modalities are poised to become a viable method to deliver more accurate results and deployable pipelines across a wide range of applications. In this work, we propose and evaluate a unified Holistic AI in Medicine (HAIM) framework to facilitate the generation and testing of AI systems that leverage multimodal inputs. Our approac
Expert-level detection of pathologies from unannotated chest X-ray images via self-supervised learning
In tasks involving the interpretation of medical images, suitably trained machine-learning models often exceed the performance of medical experts. Yet such a high-level of performance typically requires that the models be trained with relevant datasets that have been painstakingly annotated by experts. Here we show that a self-supervised model trained on chest X-ray images that lack explicit annotations performs pathology-classification tasks with accuracies comparable to those of radiologists.
Competencies for the Use of Artificial Intelligence–Based Tools by Health Care Professionals
PURPOSE: The expanded use of clinical tools that incorporate artificial intelligence (AI) methods has generated calls for specific competencies for effective and ethical use. This qualitative study used expert interviews to define AI-related clinical competencies for health care professionals. METHOD: In 2021, a multidisciplinary team interviewed 15 experts in the use of AI-based tools in health care settings about the clinical competencies health care professionals need to work effectively with
Multimodal biomedical AI
The increasing availability of biomedical data from large biobanks, electronic health records, medical imaging, wearable and ambient biosensors, and the lower cost of genome and microbiome sequencing have set the stage for the development of multimodal artificial intelligence solutions that capture the complexity of human health and disease. In this Review, we outline the key applications enabled, along with the technical and analytical challenges. We explore opportunities in personalized medici
The Metaverse: A New Challenge for the Healthcare System: A Scoping Review
(1) Background: The metaverse is now a reality, and it interests the scientific community, the educational setting, and medical care. Considering the number of people in front of screens, especially children and adolescents, the metaverse could and should become a place of health promotion. Consequently, the objective of the present study was to review the current literature to detect articles that connected the metaverse with prevention and treatment, education and training, and research settin
The health digital twin to tackle cardiovascular disease—a review of an emerging interdisciplinary field
Potential benefits of precision medicine in cardiovascular disease (CVD) include more accurate phenotyping of individual patients with the same condition or presentation, using multiple clinical, imaging, molecular and other variables to guide diagnosis and treatment. An approach to realising this potential is the digital twin concept, whereby a virtual representation of a patient is constructed and receives real-time updates of a range of data variables in order to predict disease and optimise
Federated learning-based AI approaches in smart healthcare: concepts, taxonomies, challenges and open issues
Prevalence of symptoms, comorbidities, fibrin amyloid microclots and platelet pathology in individuals with Long COVID/Post-Acute Sequelae of COVID-19 (PASC)
BACKGROUND: Fibrin(ogen) amyloid microclots and platelet hyperactivation previously reported as a novel finding in South African patients with the coronavirus 2019 disease (COVID-19) and Long COVID/Post-Acute Sequelae of COVID-19 (PASC), might form a suitable set of foci for the clinical treatment of the symptoms of Long COVID/PASC. A Long COVID/PASC Registry was subsequently established as an online platform where patients can report Long COVID/PASC symptoms and previous comorbidities. METHODS:
Acute Pancreatitis: Diagnosis and Treatment
Acute pancreatitis is a common indication for hospital admission, increasing in incidence, including in children, pregnancy and the elderly. Moderately severe acute pancreatitis with fluid and/or necrotic collections causes substantial morbidity, and severe disease with persistent organ failure causes significant mortality. The diagnosis requires two of upper abdominal pain, amylase/lipase ≥ 3 ×upper limit of normal, and/or cross-sectional imaging findings. Gallstones and ethanol predominate whi
Drug repurposing: a systematic review on root causes, barriers and facilitators
BACKGROUND: Repurposing is a drug development strategy receiving heightened attention after the Food and Drug Administration granted emergency use authorization of several repurposed drugs to treat Covid-19. There remain knowledge gaps on the root causes, facilitators and barriers for repurposing. METHOD: This systematic review used controlled vocabulary and free text terms to search ABI/Informa, Academic Search Premier, Business Source Complete, Cochrane Library, EconLit, Google Scholar, Ovid E
An Overview of Artificial Intelligence Ethics
Artificial intelligence (AI) has profoundly changed and will continue to change our lives. AI is being applied in more and more fields and scenarios such as autonomous driving, medical care, media, finance, industrial robots, and internet services. The widespread application of AI and its deep integration with the economy and society have improved efficiency and produced benefits. At the same time, it will inevitably impact the existing social order and raise ethical concerns. Ethical issues, su
Recent progress on vascular endothelial growth factor receptor inhibitors with dual targeting capabilities for tumor therapy
Vascular endothelial growth factor receptors (VEGFRs) are a family of receptor protein tyrosine kinases that play an important role in the regulation of tumor-induced angiogenesis. Currently, VEGFR inhibitors have been widely used in the treatment of various tumors. However, current VEGFR inhibitors are limited to a certain extent due to limited clinical efficacy and potential toxicity, which hinder their clinical application. Thus, the development of new strategies to improve the clinical outco
Challenges to implementing artificial intelligence in healthcare: a qualitative interview study with healthcare leaders in Sweden
BACKGROUND: Artificial intelligence (AI) for healthcare presents potential solutions to some of the challenges faced by health systems around the world. However, it is well established in implementation and innovation research that novel technologies are often resisted by healthcare leaders, which contributes to their slow and variable uptake. Although research on various stakeholders' perspectives on AI implementation has been undertaken, very few studies have investigated leaders' perspectives
Robot-Assisted Minimally Invasive Surgery—Surgical Robotics in the Data Age
Telesurgical robotics, as a technical solution for robot-assisted minimally invasive surgery (RAMIS), has become the first domain within medicosurgical robotics that achieved a true global clinical adoption. Its relative success (still at a low single-digit percentile total market penetration) roots in the particular human-in-the-loop control, in which the trained surgeon is always kept responsible for the clinical outcome achieved by the robot-actuated invasive tools. Nowadays, this paradigm is
VitalDB, a high-fidelity multi-parameter vital signs database in surgical patients
In modern anesthesia, multiple medical devices are used simultaneously to comprehensively monitor real-time vital signs to optimize patient care and improve surgical outcomes. However, interpreting the dynamic changes of time-series biosignals and their correlations is a difficult task even for experienced anesthesiologists. Recent advanced machine learning technologies have shown promising results in biosignal analysis, however, research and development in this area is relatively slow due to th
Clinical artificial intelligence quality improvement: towards continual monitoring and updating of AI algorithms in healthcare
Machine learning (ML) and artificial intelligence (AI) algorithms have the potential to derive insights from clinical data and improve patient outcomes. However, these highly complex systems are sensitive to changes in the environment and liable to performance decay. Even after their successful integration into clinical practice, ML/AI algorithms should be continuously monitored and updated to ensure their long-term safety and effectiveness. To bring AI into maturity in clinical care, we advocat
Transparency of AI in Healthcare as a Multilayered System of Accountabilities: Between Legal Requirements and Technical Limitations
The lack of transparency is one of the artificial intelligence (AI)'s fundamental challenges, but the concept of transparency might be even more opaque than AI itself. Researchers in different fields who attempt to provide the solutions to improve AI's transparency articulate different but neighboring concepts that include, besides transparency, explainability and interpretability. Yet, there is no common taxonomy neither within one field (such as data science) nor between different fields (law
Climate Change and Cascading Risks from Infectious Disease
Climate change is adversely affecting the burden of infectious disease throughout the world, which is a health security threat. Climate-sensitive infectious disease includes vector-borne diseases such as malaria, whose transmission potential is expected to increase because of enhanced climatic suitability for the mosquito vector in Asia, sub-Saharan Africa, and South America. Climatic suitability for the mosquitoes that can carry dengue, Zika, and chikungunya is also likely to increase, facilita
Reporting guideline for the early stage clinical evaluation of decision support systems driven by artificial intelligence: DECIDE-AI
DECIDE-AI is a stage specific reporting guideline for the early, small scale and live clinical evaluation of decision support systems based on artificial intelligence
Reporting guideline for the early-stage clinical evaluation of decision support systems driven by artificial intelligence: DECIDE-AI
A multi-modal open dataset for mental-disorder analysis
According to the WHO, the number of mental disorder patients, especially depression patients, has overgrown and become a leading contributor to the global burden of disease. With the rising of tools such as artificial intelligence, using physiological data to explore new possible physiological indicators of mental disorder and creating new applications for mental disorder diagnosis has become a new research hot topic. We present a multi-modal open dataset for mental-disorder analysis. The datase
Transfer learning for medical image classification: a literature review
BACKGROUND: Transfer learning (TL) with convolutional neural networks aims to improve performances on a new task by leveraging the knowledge of similar tasks learned in advance. It has made a major contribution to medical image analysis as it overcomes the data scarcity problem as well as it saves time and hardware resources. However, transfer learning has been arbitrarily configured in the majority of studies. This review paper attempts to provide guidance for selecting a model and TL approache
Machine learning for medical imaging: methodological failures and recommendations for the future
Research in computer analysis of medical images bears many promises to improve patients' health. However, a number of systematic challenges are slowing down the progress of the field, from limitations of the data, such as biases, to research incentives, such as optimizing for publication. In this paper we review roadblocks to developing and assessing methods. Building our analysis on evidence from the literature and data challenges, we show that at every step, potential biases can creep in. On a
Evaluating the Therapeutic Alliance With a Free-Text CBT Conversational Agent (Wysa): A Mixed-Methods Study
The present study aims to examine whether users perceive a therapeutic alliance with an AI conversational agent (Wysa) and observe changes in the t‘herapeutic alliance over a brief time period. A sample of users who screened positively on the PHQ-4 for anxiety or depression symptoms ( N = 1,205) of the digital mental health application (app) Wysa were administered the WAI-SR within 5 days of installing the app and gave a second assessment on the same measure after 3 days ( N = 226). The anonymis
Natural language processing applied to mental illness detection: a narrative review
Mental illness is highly prevalent nowadays, constituting a major cause of distress in people's life with impact on society's health and well-being. Mental illness is a complex multi-factorial disease associated with individual risk factors and a variety of socioeconomic, clinical associations. In order to capture these complex associations expressed in a wide variety of textual data, including social media posts, interviews, and clinical notes, natural language processing (NLP) methods demonstr
The medical algorithmic audit
Artificial intelligence systems for health care, like any other medical device, have the potential to fail. However, specific qualities of artificial intelligence systems, such as the tendency to learn spurious correlates in training data, poor generalisability to new deployment settings, and a paucity of reliable explainability mechanisms, mean they can yield unpredictable errors that might be entirely missed without proactive investigation. We propose a medical algorithmic audit framework that