scholarly journals Co-design and ethical artificial intelligence for health: An agenda for critical research and practice

2021 ◽  
Vol 8 (2) ◽  
pp. 205395172110652
Author(s):  
Joseph Donia ◽  
James A. Shaw
Keyword(s):  
Artificial Intelligence ◽  
Health Care ◽  
Public Involvement ◽  
Digital Health ◽  
Patient And Public Involvement ◽  
Research Literature ◽  
Ethical Challenges ◽  
Critical Data ◽  
Health Studies ◽  
Normative Issues

Applications of artificial intelligence/machine learning (AI/ML) in health care are dynamic and rapidly growing. One strategy for anticipating and addressing ethical challenges related to AI/ML for health care is patient and public involvement in the design of those technologies – often referred to as ‘co-design’. Co-design has a diverse intellectual and practical history, however, and has been conceptualized in many different ways. Moreover, AI/ML introduces challenges to co-design that are often underappreciated. Informed by perspectives from critical data studies and critical digital health studies, we review the research literature on involvement in health care, and involvement in design, and examine the extent to which co-design as commonly conceptualized is capable of addressing the range of normative issues raised by AI/ML for health care. We suggest that AI/ML technologies have amplified and modified existing challenges related to patient and public involvement, and created entirely new challenges. We outline three pitfalls associated with co-design for ethical AI/ML for health care and conclude with suggestions for addressing these practical and conceptual challenges.

Clinical Integration of Digital Solutions in Health Care: An Overview of the Current Landscape of Digital Technologies in Cancer Care

2018 ◽  
pp. 1-9 ◽  
Author(s):  
Shivank Garg ◽  
Noelle L. Williams ◽  
Andrew Ip ◽  
Adam P. Dicker
Keyword(s):  
Quality Of Life ◽  
Artificial Intelligence ◽  
Health Care ◽  
Data Collection ◽  
Patient Outcomes ◽  
Cancer Care ◽  
Digital Health ◽  
Health Technologies ◽  
Health Care Value

Digital health constitutes a merger of both software and hardware technology with health care delivery and management, and encompasses a number of domains, from wearable devices to artificial intelligence, each associated with widely disparate interaction and data collection models. In this review, we focus on the landscape of the current integration of digital health technology in cancer care by subdividing digital health technologies into the following sections: connected devices, digital patient information collection, telehealth, and digital assistants. In these sections, we give an overview of the potential clinical impact of such technologies as they pertain to key domains, including patient education, patient outcomes, quality of life, and health care value. We performed a search of PubMed ( www.ncbi.nlm.nih.gov/pubmed ) and www.ClinicalTrials.gov for numerous terms related to digital health technologies, including digital health, connected devices, smart devices, wearables, activity trackers, connected sensors, remote monitoring, electronic surveys, electronic patient-reported outcomes, telehealth, telemedicine, artificial intelligence, chatbot, and digital assistants. The terms health care and cancer were appended to the previously mentioned terms to filter results for cancer-specific applications. From these results, studies were included that exemplified use of the various domains of digital health technologies in oncologic care. Digital health encompasses the integration of a vast array of technologies with health care, each associated with varied methods of data collection and information flow. Integration of these technologies into clinical practice has seen applications throughout the spectrum of care, including cancer screening, on-treatment patient management, acute post-treatment follow-up, and survivorship. Implementation of these systems may serve to reduce costs and workflow inefficiencies, as well as to improve overall health care value, patient outcomes, and quality of life.

scholarly journals What is happening to laboratory medicine in Denmark?

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Per E. Jørgensen
Keyword(s):  
Artificial Intelligence ◽  
Health Care ◽  
Digital Health ◽  
Laboratory Medicine ◽  
Positive Development ◽  
Scandinavian Country ◽  
Health Records ◽  
Current Trends ◽  
Technological Developments ◽  
Almost All

Abstract A number of current trends will affect and probably change laboratory medicine, as we know it. Scientific and technological developments, digital health with big data and artificial intelligence, and centralization will change the interfaces among the specialties of laboratory medicine. They might even challenge the identity of some specialties. Other trends such as demographic changes, increased complexity of health care, digital health with electronic health records, and more demanding and well-informed patients will change the way laboratory medicine specialties deliver their services. This paper discusses the possible changes of laboratory medicine in Denmark – a Scandinavian country where almost all hospitals are public. If Danish laboratories grasp the new possibilities instead of trying to avoid them, laboratory medicine is likely to prosper. Such a positive development will call upon good leadership and a genuine willingness among laboratory specialist to adapt to a future where their own specialty might be very different from today.

scholarly journals Artificial Intelligence and Big Data in Diabetes Care: A Position Statement of the Italian Association of Medical Diabetologists (Preprint)

2019 ◽  
Author(s):  
Nicoletta Musacchio ◽  
Annalisa Giancaterini ◽  
Giacomo Guaita ◽  
Alessandro Ozzello ◽  
Maria A Pellegrini ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Machine Learning ◽  
Health Care ◽  
Diabetes Care ◽  
Digital Health ◽  
Descriptive Analysis ◽  
Careful Analysis ◽  
Great Opportunity ◽  
Italian Association ◽  
Number Of Patients

UNSTRUCTURED Since the last decade, most of our daily activities have become digital. Digital health takes into account the ever-increasing synergy between advanced medical technologies, innovation, and digital communication. Thanks to machine learning, we are not limited anymore to a descriptive analysis of the data, as we can obtain greater value by identifying and predicting patterns resulting from inductive reasoning. Machine learning software programs that disclose the reasoning behind a prediction allow for “what-if” models by which it is possible to understand if and how, by changing certain factors, one may improve the outcomes, thereby identifying the optimal behavior. Currently, diabetes care is facing several challenges: the decreasing number of diabetologists, the increasing number of patients, the reduced time allowed for medical visits, the growing complexity of the disease both from the standpoints of clinical and patient care, the difficulty of achieving the relevant clinical targets, the growing burden of disease management for both the health care professional and the patient, and the health care accessibility and sustainability. In this context, new digital technologies and the use of artificial intelligence are certainly a great opportunity. Herein, we report the results of a careful analysis of the current literature and represent the vision of the Italian Association of Medical Diabetologists (AMD) on this controversial topic that, if well used, may be the key for a great scientific innovation. AMD believes that the use of artificial intelligence will enable the conversion of data (descriptive) into knowledge of the factors that “affect” the behavior and correlations (predictive), thereby identifying the key aspects that may establish an improvement of the expected results (prescriptive). Artificial intelligence can therefore become a tool of great technical support to help diabetologists become fully responsible of the individual patient, thereby assuring customized and precise medicine. This, in turn, will allow for comprehensive therapies to be built in accordance with the evidence criteria that should always be the ground for any therapeutic choice.

scholarly journals Listening to the Silence: What does unrecorded information in the Electronic Health Record tell us? Findings from a Patient and Public Involvement Event

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Julie George ◽  
Serena Luchenski ◽  
Elizabeth Williamson ◽  
Amitava Banerjee ◽  
Peter E Saunders
Keyword(s):  
Missing Data ◽  
Public Involvement ◽  
Digital Health ◽  
Transmitted Disease ◽  
Patient And Public Involvement ◽  
Extensive Literature ◽  
Sensitive Information ◽  
Framework Analysis ◽  
Electronic Health ◽  
The Impact

ABSTRACTObjectivesHandling missing information is an important methodological challenge in electronic health records research, with the reasons for missingness dictating how missing data should be handled. While there is extensive literature on methodological approaches to handling missing data, there is relatively little research with patients or clinicians investigating why information may be unrecorded in the medical records. A patient and public involvement event was held, embedded with a wider EHR event (UCL Festival of Digital Science - March 2016), to explore unrecorded information from a patient and researcher point of view with a view to developing further research in this area. ApproachCo-chaired by an academic and lay chair, members of the Farr Patient and Public Involvement Forum, academics, students and the general public attended workshop held during the Festival of Digital Health. A brief exercise was used to demonstrate the impact of missing data. Participants then worked in small facilitated groups to discuss situations where information about them (or people they knew) had not been recorded, the reasons why this information was not recorded and what the impact (or potential impact) was on the patient. A standardised data form was used by facilitators to record participants’ conversations. The data forms were summarised into Excel and a brief thematic analysis was conducted. A written evaluation of the workshop was also completed by participants and included in the analysis. ResultsThe evaluation was overwhelming positive about embedding PPI workshop within an event with a wider remit, from both researchers and patient and public representatives. Preliminary findings on reasons for missingness included change of address or provider (both general practice and secondary care), individual clinician approaches to recording data, process of computerisation of medical notes, early stages of disease not reported to GP and unwillingness to disclose more sensitive information such as sexually transmitted disease. Discussion also included reasons for misrepresented or other errors with data. Further findings from the framework analysis will be presented. ConclusionThis exploratory workshop showed that patient and public involvement events can be embedded successfully within events aimed at professionals. Preliminary findings suggest that reasons for missingness often related to features of the provider or clinician as well as the patient.

scholarly journals Men’s view on participation in decisions about Prostate-Specific Antigen (PSA) screening: Patient and public involvement in development of a survey

2020 ◽  
Author(s):  
Søren Birkeland ◽  
Susanne S Pedersen ◽  
Anders K Haakonsson ◽  
Michael J Barry ◽  
Nina Rottmann
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Prostate Specific Antigen ◽  
Public Involvement ◽  
Specific Antigen ◽  
Patient And Public Involvement ◽  
Fine Tuning ◽  
Case Vignette ◽  
Psa Screening ◽  
Participation In Decision Making

Abstract Background: Prostate-Specific Antigen (PSA) screening for early detection of prostate cancer (PCa) may prevent some cancer deaths, but also may miss some cancers or lead to unnecessary and potentially harmful treatment. Therefore, involving patients in decision-making about PSA screening is recommended. However, we know little about the attitude of men regarding participation in decisions about PSA screening and how to assess such attitudes. The purpose of this paper is to describe patient and public participation in the development of a national, web-based case vignette survey for studying men’s view on participation in decision-making about PSA screening. Methods: The project group developed a first draft plan for the survey, its vignettes and choice of measurements. This included multiple vignette variants representing various levels of patient participation in decision-making about PSA screening with different outcomes. Additionally, it included questions on respondents’ satisfaction with imagined courses of health care, their propensity to initiate a malpractice complaint, their own health care experiences, socio-demography, personality, and preferences for control regarding health care decision-making. Following feedback from a workshop with academic peers on the draft plan, a group of 30 adult men was engaged to help develop case vignette versions and questionnaire items by providing feedback on structure, comprehension, response patterns, and time required to complete the survey. Furthermore, a panel of three patients with PCa experience was assembled to assist development through a separate review-and-feedback process. Results: Based on reviews of survey drafts, the large group made further suggestions about construction of the survey (e.g. clarification and modification of case vignette versions, deletion of items and adjustment of wording, instructions to guide respondents, replacement of technical terms, and optimization of sequence of survey elements). The patient panel ensured fine-tuning of vignette versions and questionnaire items and helped review the internet version of the survey. Conclusions: Patient and public involvement during various phases of the survey development helped to improve survey structure and content. The survey exemplifies a way to measure health care users’ satisfaction with imagined courses of health care and wish to complain, taking into account their characteristics.

scholarly journals Why Do People Undergo THR and What Do They Expect to Gain—A Comparison of the Views of Patients and Health Care Professionals

2020 ◽  
Vol 7 (6) ◽  
pp. 1778-1787
Author(s):  
Shayan Bahadori ◽  
Sarah Collard ◽  
Jonathan Mark Williams ◽  
Ian Swain
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Public Involvement ◽  
Well Being ◽  
Patient And Public Involvement ◽  
Future Research ◽  
Activity Monitors ◽  
Dog Walking ◽  
Future Research Project

Little concerted effort has been made to understand why individuals undergo total hip replacement (THR) surgery and their rehabilitation goals. Similarly, insight of views and perspective of health care professionals’ (HCPs) regarding surgery and what objective measures help them with decision-making is lacking. This patient and public involvement report aimed to explore both patients’ and HCPs’ perspectives of THR surgery. Twenty patients, 10 pre-THR, 10 post-THR, 9 physiotherapists, and 6 surgeons took part. Results suggest a consensus among patients and HCPs on pain reduction being the main reason for undergoing THR. The inability to carry out simple daily activities such as dog walking and sleep deprivation had a significant effect on patients’ mental and physical well-being. This article is the first to explore the views of THR patients and HCPs on reasons behind THR surgery amalgamated into a single report. As walking is important, wearable activity monitors are suggested as a possible motivator to enhance patient compliance to self-care rehabilitation and increase quality of life. A future research project on the use of such wearable activity monitors in enhancing mobility post-THR is therefore planned.

scholarly journals Same description, different values. How service users and providers define patient and public involvement in health care

2011 ◽  
Vol 16 (3) ◽  
pp. 266-276 ◽  
Author(s):  
Marit By Rise ◽  
Marit Solbjør ◽  
Mariela C. Lara ◽  
Heidi Westerlund ◽  
Hilde Grimstad ◽  
...  
Keyword(s):  
Health Care ◽  
Public Involvement ◽  
Patient And Public Involvement ◽  
Service Users

scholarly journals Management of Medico-Legal Risks in Digital Health Era: A Scoping Review

2022 ◽  
Vol 8 ◽  
Author(s):  
Antonio Oliva ◽  
Simone Grassi ◽  
Giuseppe Vetrugno ◽  
Riccardo Rossi ◽  
Gabriele Della Morte ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Scoping Review ◽  
Cognitive Biases ◽  
Digital Health ◽  
The United States ◽  
Ethical Challenges ◽  
Ethical Implications ◽  
General Terms ◽  
Legal Risks ◽  
Clinical Risks

Artificial intelligence needs big data to develop reliable predictions. Therefore, storing and processing health data is essential for the new diagnostic and decisional technologies but, at the same time, represents a risk for privacy protection. This scoping review is aimed at underlying the medico-legal and ethical implications of the main artificial intelligence applications to healthcare, also focusing on the issues of the COVID-19 era. Starting from a summary of the United States (US) and European Union (EU) regulatory frameworks, the current medico-legal and ethical challenges are discussed in general terms before focusing on the specific issues regarding informed consent, medical malpractice/cognitive biases, automation and interconnectedness of medical devices, diagnostic algorithms and telemedicine. We aim at underlying that education of physicians on the management of this (new) kind of clinical risks can enhance compliance with regulations and avoid legal risks for the healthcare professionals and institutions.

Sign in / Sign up

Export Citation Format

Share Document