scholarly journals No-boundary thinking: a viable solution to ethical data-driven AI in precision medicine

AI and Ethics ◽  
2021 ◽  
Author(s):  
Tayo Obafemi-Ajayi ◽  
Andy Perkins ◽  
Bindu Nanduri ◽  
Donald C. Wunsch II ◽  
James A. Foster ◽  
...  
Keyword(s):  
Precision Medicine ◽  
Problem Definition ◽  
Great Promise ◽  
Personal Lives ◽  
Domain Experts ◽  
Ethical Implications ◽  
Basic Assumptions ◽  
Ethical Decisions ◽  
Viable Solution ◽  
Convergent Approach

AbstractToday Artificial Intelligence (AI) supports difficult decisions about policy, health, and our personal lives. The AI algorithms we develop and deploy to make sense of information, are informed by data, and based on models that capture and use pertinent details of the population or phenomenon being analyzed. For any application area, more importantly in precision medicine which directly impacts human lives, the data upon which algorithms are run must be procured, cleaned, and organized well to assure reliable and interpretable results, and to assure that they do not perpetrate or amplify human prejudices. This must be done without violating basic assumptions of the algorithms in use. Algorithmic results need to be clearly communicated to stakeholders and domain experts to enable sound conclusions. Our position is that AI holds great promise for supporting precision medicine, but we need to move forward with great care, with consideration for possible ethical implications. We make the case that a no-boundary or convergent approach is essential to support sound and ethical decisions. No-boundary thinking supports problem definition and solving with teams of experts possessing diverse perspectives. When dealing with AI and the data needed to use AI, there is a spectrum of activities that needs the attention of a no-boundary team. This is necessary if we are to draw viable conclusions and develop actions and policies based on the AI, the data, and the scientific foundations of the domain in question.

Values, Ethics, and Justice

2004 ◽  
Author(s):  
Audrey Kobayashi ◽  
James Proctor
Keyword(s):  
Ethical Issues ◽  
Focus Attention ◽  
Research Subjects ◽  
Personal Lives ◽  
Moral Principles ◽  
Ethical Implications ◽  
Societal Issues ◽  
The World ◽  
The Relationship ◽  
American Geography

Questions of ethics, values, justice, and the moral principles according to which we engage in geographical scholarship, have always been a part of geography, but for the past two decades—and perhaps even more significantly, since the events of September 11, 2001—they have become a central part of the lexicon of American and international geographical scholarship. The Values, Justice and Ethics Specialty Group (VJESG) was formed in 1997 to respond to a felt need for geographers to focus on both the ethical issues that inform our academic work, and the ways in which that work is connected to larger societal issues. The concerns of the group have been less with a particular range of topics or approaches than with the ethical questions that cut across the entire discipline, on the assumption that such questions are bounded neither by subject matter nor by theoretical constraints. The group was formed at a time when questions of whether geographers should be concerned about the moral, ethical implications of their work had long since been replaced with questions of how geographers could focus attention on these issues. Concern is with the very difficult questions that link personal commitment, or reflexivity, with larger questions of research and pedagogy. One of the best sources of evidence of the importance of such questions, and of the intellectual sophistication with which they are being asked, is the journal Ethics, Place and Environment, inaugurated in 1998. This group felt a need, therefore, for a geographical forum in which to explore the relationship between American geography and the world in which it operates. While a relatively small number of geographers works in a more narrowly defined field that might be called moral philosophy (Sack 1997; Smith 1997,1998a, 2000), for the vast majority, ethical questions connect the academic and the personal lives of geographical practitioners, in ways that influence directly the questions they ask, the methodological and theoretical choices they make, and, perhaps most importantly, their personal relations with their research subjects and their own communities. As I. Hay (1998: 73) suggests, “the place to start that process is on our [geographers’] own professional bodies.”

Morphological Ontology Design Engineering

2016 ◽  
pp. 262-291 ◽  
Author(s):  
Joey Jansen van Vuuren ◽  
Louise Leenen ◽  
Marthie M. Grobler ◽  
Ka Fai Peter Chan ◽  
Zubeida C. Khan
Keyword(s):  
South African ◽  
Mixed Methods Research ◽  
Domain Knowledge ◽  
Design Science ◽  
Problem Definition ◽  
Design Engineering ◽  
Domain Experts ◽  
Ontology Design ◽  
Structured Problems ◽  
Science Methodology

In the Social-technical domain scientists are often confronted with a class of problems that are termed messy, ill-structured or wicked. These problems address complex issues that not well-defined, contain unresolvable uncertainties, and are characterized by a lack of common agreement on problem definition. This chapter proposes a new mixed methods research technique, Morphological Ontology Design Engineering (MODE), which can be applied to develop models for ill-structured problems. MODE combines three different research methodologies into a single, methodology. MODE draws from research paradigms that include exploratory and descriptive research approaches to develop models. General morphological analysis offers a systematic method to extract meaningful information from domain experts, while ontology based representation is used to logically represent domain knowledge. The design science methodology guides the entire process. MODE is applied to a case study where an ontological model is developed to support the implementation of a South African national cybersecurity policy.

scholarly journals Two Threats to Precision Medicine Equity

2019 ◽  
Vol 29 (Supp) ◽  
pp. 629-640
Author(s):  
Dayna Bowen Matthew
Keyword(s):  
United States ◽  
Precision Medicine ◽  
Care Delivery ◽  
Research Effort ◽  
The United States ◽  
Medical Product ◽  
Great Promise ◽  
Sequencing Technologies ◽  
Legal Duty ◽  
Precision Medicine Initiative

In January 2015, President Barack Obama unveiled the “Precision Medicine Initiative,” a nationwide research effort to help bring an effective, preventive, and therapeutic approach to medicine. The purpose of the initiative is to bring a precise understanding of the genetic and environmental determi­nants of disease into clinical settings across the United States.1 The announcement was coupled with $216 million provided in the President’s proposed budget for a million-person national research cohort including public and private partnerships with academic medical centers, research­ers, foundations, privacy experts, medical ethicists, and medical product innovators. The Initiative promises to expand the use of precision medicine in cancer research and modernize regulatory approval processes for genome sequencing technologies. In response, Congress passed the 21st Century Cures Act in December 2016, authorizing a total of $1.5 billion over 10 years for the program.2 Although the Precision Medicine Initiative heralds great promise for the future of disease treatment and eradication, its implementation and development must be carefully guided to ensure that the millions of federal dollars expended will be spent equitably. This commentary discusses two key threats to the Precision Medicine Initia­tive’s ability to proceed in a manner consis­tent with the United States Constitutional requirement that the federal government shall not “deny to any person . . . the equal protection of the laws.”3 In short, this com­mentary sounds two cautionary notes, in order to advance precision medicine equity. First, achieving precision medicine equity will require scientists and clinicians to fulfill their intellectual, moral, and indeed legal duty to work against abusive uses of preci­sion medicine science to advance distorted views of racial group variation.Precision medicine scientists must decisively denounce and distinguish this Initiative from the pseudo-science of eugenics – the im­moral and deadly pseudo-science that gave racist and nationalist ideologies what Troy Duster called a “halo of legitimacy” during the first half of the 20th century.4 Second, to combat the social threat to precision medicine, scientists must incorporate a comprehensive, ecological understanding of the fundamental social and environ­mental determinants of health outcomes in all research. Only then will the Precision Medicine Initiative live up to its potential to improve and indeed transform health care delivery for all patients, regardless of race, color, or national origin.Ethn Dis: 2019;29(Suppl 3):629-640; doi:10.18865/ed.29.S3.629

scholarly journals Factors Influencing Precision Medicine Knowledge and Attitudes

2020 ◽  
Author(s):  
Rohini Chakravarthy ◽  
Sarah Stallings ◽  
Michael Williams ◽  
Megan Hollister ◽  
Mario Davidson ◽  
...  
Keyword(s):  
Health Disparities ◽  
Precision Medicine ◽  
Biomedical Research ◽  
Positive Association ◽  
European Ancestry ◽  
Great Promise ◽  
Linear Regression Models ◽  
Sociodemographic Variables ◽  
Medicine Research ◽  
Diversity And Inclusion

ABSTRACTPrecision medicine holds great promise for improving health and reducing health disparities that can be most fully realized by advancing diversity and inclusion in research participants. Without engaging underrepresented groups, precision medicine could not only fail to achieve its promise but also further exacerbate the health disparities already burdening the most vulnerable. Yet underrepresentation by people of non-European ancestry continues in precision medicine research and there are disparities across racial groups in the uptake of precision medicine applications and services. Studies have explored possible explanations for population differences in precision medicine participation, but full appreciation of the factors involved is still developing. To better inform the potential for addressing health disparities through PM, we assessed the relationship of precision medicine knowledge and trust in biomedical research with sociodemographic variables. Using a series of linear regression models applied to survey data collected in a diverse sample, we analyzed variation in both precision medicine knowledge and trust in biomedical research with socioeconomic factors as a way to understand the range of precision medicine knowledge (PMK) in a broadly representative group and its relationship to trust in research and demographic characteristics. Our results demonstrate that identifying as Black, while significantly PMK, explains only 1.5% of the PMK variance in unadjusted models and 7% of overall variance in models adjusted for meaningful covariates such as age, marital status, employment, and education. We also found a positive association between PMK and trust in biomedical research. These results indicate that race is a factor affecting PMK, even after accounting for differences in sociodemographic variables. Additional work is needed, however, to identify other factors contributing to variation in PMK as we work to increase diversity and inclusion in precision medicine applications.

scholarly journals Deep learning in systems medicine

2020 ◽  
Author(s):  
Haiying Wang ◽  
Estelle Pujos-Guillot ◽  
Blandine Comte ◽  
Joao Luis de Miranda ◽  
Vojtech Spiwok ◽  
...  
Keyword(s):  
Deep Learning ◽  
Precision Medicine ◽  
Human Body ◽  
Review Paper ◽  
Heterogeneous Data ◽  
Clinical Impact ◽  
High Dimensional ◽  
Great Promise ◽  
Systems Medicine ◽  
Prevention And Treatment

Abstract Systems medicine (SM) has emerged as a powerful tool for studying the human body at the systems level with the aim of improving our understanding, prevention and treatment of complex diseases. Being able to automatically extract relevant features needed for a given task from high-dimensional, heterogeneous data, deep learning (DL) holds great promise in this endeavour. This review paper addresses the main developments of DL algorithms and a set of general topics where DL is decisive, namely, within the SM landscape. It discusses how DL can be applied to SM with an emphasis on the applications to predictive, preventive and precision medicine. Several key challenges have been highlighted including delivering clinical impact and improving interpretability. We used some prototypical examples to highlight the relevance and significance of the adoption of DL in SM, one of them is involving the creation of a model for personalized Parkinson’s disease. The review offers valuable insights and informs the research in DL and SM.

scholarly journals ML-MEDIC: A Preliminary Study of an Interactive Visual Analysis Tool Facilitating Clinical Applications of Machine Learning for Precision Medicine

2020 ◽  
Vol 10 (9) ◽  
pp. 3309
Author(s):  
Laura Stevens ◽  
David Kao ◽  
Jennifer Hall ◽  
Carsten Görg ◽  
Kaitlyn Abdo ◽  
...  
Keyword(s):  
Machine Learning ◽  
Clinical Research ◽  
Precision Medicine ◽  
Visual Analysis ◽  
Heart Association ◽  
Analysis Tool ◽  
Domain Experts ◽  
Expert Review ◽  
Interactive Tools ◽  
Applications Of Machine Learning

Accessible interactive tools that integrate machine learning methods with clinical research and reduce the programming experience required are needed to move science forward. Here, we present Machine Learning for Medical Exploration and Data-Inspired Care (ML-MEDIC), a point-and-click, interactive tool with a visual interface for facilitating machine learning and statistical analyses in clinical research. We deployed ML-MEDIC in the American Heart Association (AHA) Precision Medicine Platform to provide secure internet access and facilitate collaboration. ML-MEDIC’s efficacy for facilitating the adoption of machine learning was evaluated through two case studies in collaboration with clinical domain experts. A domain expert review was also conducted to obtain an impression of the usability and potential limitations.

scholarly journals Genome Editing Redefines Precision Medicine in the Cardiovascular Field

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Elda Dzilic ◽  
Harald Lahm ◽  
Martina Dreßen ◽  
Marcus-André Deutsch ◽  
Rüdiger Lange ◽  
...  
Keyword(s):  
Stem Cells ◽  
Regenerative Medicine ◽  
Precision Medicine ◽  
Genome Editing ◽  
Pluripotent Stem Cells ◽  
New Technologies ◽  
Basic Research ◽  
Disease Modelling ◽  
Ethical Implications ◽  
Regenerative Therapies

Genome editing is a powerful tool to study the function of specific genes and proteins important for development or disease. Recent technologies, especially CRISPR/Cas9 which is characterized by convenient handling and high precision, revolutionized the field of genome editing. Such tools have enormous potential for basic science as well as for regenerative medicine. Nevertheless, there are still several hurdles that have to be overcome, but patient-tailored therapies, termed precision medicine, seem to be within reach. In this review, we focus on the achievements and limitations of genome editing in the cardiovascular field. We explore different areas of cardiac research and highlight the most important developments: (1) the potential of genome editing in human pluripotent stem cells in basic research for disease modelling, drug screening, or reprogramming approaches and (2) the potential and remaining challenges of genome editing for regenerative therapies. Finally, we discuss social and ethical implications of these new technologies.

scholarly journals Resuming hip and knee arthroplasty after COVID-19: ethical implications for wellbeing, safety and the economy

2020 ◽  
Vol 30 (5) ◽  
pp. 492-499 ◽  
Author(s):  
Nanne P Kort ◽  
Luigi Zagra ◽  
Enrique Gomez Barrena ◽  
Reha N Tandogan ◽  
Martin Thaler ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Evidence Base ◽  
Reliable Data ◽  
Economic Consequences ◽  
Ethical Implications ◽  
Ethical Decisions ◽  
Hip And Knee Arthroplasty

Reinstating elective hip and knee arthroplasty services presents significant challenges. We need to be honest about the scale of the obstacles ahead and realise that the health challenges and economic consequences of the COVID-19 pandemic are potentially devastating. We must also prepare to make difficult ethical decisions about restarting elective hip and knee arthroplasty. These decisions should be based on the existing evidence-base, reliable data, the recommendations of experts, and regional circumstances.

scholarly journals Considering religion and spirituality in precision medicine

2019 ◽  
Vol 10 (1) ◽  
pp. 195-203
Author(s):  
Karen H K Yeary ◽  
Kassandra I Alcaraz ◽  
Kimlin Tam Ashing ◽  
Chungyi Chiu ◽  
Shannon M Christy ◽  
...  
Keyword(s):  
Precision Medicine ◽  
Health Beliefs ◽  
Treatment Strategies ◽  
Great Promise ◽  
Religion And Spirituality ◽  
Clinical Practices ◽  
Patient Centered ◽  
Treatment Context ◽  
The Individual ◽  
High Level

Abstract The emerging era of precision medicine (PM) holds great promise for patient care by considering individual, environmental, and lifestyle factors to optimize treatment. Context is centrally important to PM, yet, to date, little attention has been given to the unique context of religion and spirituality (R/S) and their applicability to PM. R/S can support and reinforce health beliefs and behaviors that affect health outcomes. The purpose of this article is to discuss how R/S can be considered in PM at multiple levels of context and recommend strategies for integrating R/S in PM. We conducted a descriptive, integrative literature review of R/S at the individual, institutional, and societal levels, with the aim of focusing on R/S factors with a high level of salience to PM. We discuss the utility of considering R/S in the suitability and uptake of PM prevention and treatment strategies by providing specific examples of how R/S influences health beliefs and practices at each level. We also propose future directions in research and practice to foster greater understanding and integration of R/S to enhance the acceptability and patient responsiveness of PM research approaches and clinical practices. Elucidating the context of R/S and its value to PM can advance efforts toward a more whole-person and patient-centered approach to improve individual and population health.

scholarly journals Plasma metabolomic profiles enhance precision medicine for volunteers of normal health

2015 ◽  
Vol 112 (35) ◽  
pp. E4901-E4910 ◽  
Author(s):  
Lining Guo ◽  
Michael V. Milburn ◽  
John A. Ryals ◽  
Shaun C. Lonergan ◽  
Matthew W. Mitchell ◽  
...  
Keyword(s):  
Precision Medicine ◽  
Gut Microbiome ◽  
Disease Risk ◽  
Disease Diagnosis ◽  
Carnitine Deficiency ◽  
Great Promise ◽  
Therapeutic Effects ◽  
Metabolic Abnormalities ◽  
Next Generation Sequencing Ngs ◽  
Normal Health

Precision medicine, taking account of human individuality in genes, environment, and lifestyle for early disease diagnosis and individualized therapy, has shown great promise to transform medical care. Nontargeted metabolomics, with the ability to detect broad classes of biochemicals, can provide a comprehensive functional phenotype integrating clinical phenotypes with genetic and nongenetic factors. To test the application of metabolomics in individual diagnosis, we conducted a metabolomics analysis on plasma samples collected from 80 volunteers of normal health with complete medical records and three-generation pedigrees. Using a broad-spectrum metabolomics platform consisting of liquid chromatography and GC coupled with MS, we profiled nearly 600 metabolites covering 72 biochemical pathways in all major branches of biosynthesis, catabolism, gut microbiome activities, and xenobiotics. Statistical analysis revealed a considerable range of variation and potential metabolic abnormalities across the individuals in this cohort. Examination of the convergence of metabolomics profiles with whole-exon sequences (WESs) provided an effective approach to assess and interpret clinical significance of genetic mutations, as shown in a number of cases, including fructose intolerance, xanthinuria, and carnitine deficiency. Metabolic abnormalities consistent with early indications of diabetes, liver dysfunction, and disruption of gut microbiome homeostasis were identified in several volunteers. Additionally, diverse metabolic responses to medications among the volunteers may assist to identify therapeutic effects and sensitivity to toxicity. The results of this study demonstrate that metabolomics could be an effective approach to complement next generation sequencing (NGS) for disease risk analysis, disease monitoring, and drug management in our goal toward precision care.

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