AI in the hands of imperfect users

Dana Moukheiber Haobo Ma Razan Zatarah + 8 lainnya

1 Juni 2023

The adoption of artificial intelligence (AI) algorithms is rapidly increasing in healthcare. Such algorithms may be shaped by various factors such as social determinants of health that can influence health outcomes. While AI algorithms have been proposed as a tool to expand the reach of quality healthcare to underserved communities and improve health equity, recent literature has raised concerns about the propagation of biases and healthcare disparities through implementation of these algorithms. Thus, it is critical to understand the sources of bias inherent in AI-based algorithms. This review aims to highlight the potential sources of bias within each step of developing AI algorithms in healthcare, starting from framing the problem, data collection, preprocessing, development, and validation, as well as their full implementation. For each of these steps, we also discuss strategies to mitigate the bias and disparities. A checklist was developed with recommendations for reducing bias during the development and implementation stages. It is important for developers and users of AI-based algorithms to keep these important considerations in mind to advance health equity for all populations.

N. Loyo-Berrios M. Tarver Ziad Obermeyer + 5 lainnya

12 September 2023

Health equity is a primary goal of healthcare stakeholders: patients and their advocacy groups, clinicians, other providers and their professional societies, bioethicists, payors and value based care organizations, regulatory agencies, legislators, and creators of artificial intelligence/machine learning (AI/ML)-enabled medical devices. Lack of equitable access to diagnosis and treatment may be improved through new digital health technologies, especially AI/ML, but these may also exacerbate disparities, depending on how bias is addressed. We propose an expanded Total Product Lifecycle (TPLC) framework for healthcare AI/ML, describing the sources and impacts of undesirable bias in AI/ML systems in each phase, how these can be analyzed using appropriate metrics, and how they can be potentially mitigated. The goal of these “Considerations” is to educate stakeholders on how potential AI/ML bias may impact healthcare outcomes and how to identify and mitigate inequities; to initiate a discussion between stakeholders on these issues, in order to ensure health equity along the expanded AI/ML TPLC framework, and ultimately, better health outcomes for all.

T. Tsuboyama Y. Fushimi T. Nakaura + 15 lainnya

4 Agustus 2023

In this review, we address the issue of fairness in the clinical integration of artificial intelligence (AI) in the medical field. As the clinical adoption of deep learning algorithms, a subfield of AI, progresses, concerns have arisen regarding the impact of AI biases and discrimination on patient health. This review aims to provide a comprehensive overview of concerns associated with AI fairness; discuss strategies to mitigate AI biases; and emphasize the need for cooperation among physicians, AI researchers, AI developers, policymakers, and patients to ensure equitable AI integration. First, we define and introduce the concept of fairness in AI applications in healthcare and radiology, emphasizing the benefits and challenges of incorporating AI into clinical practice. Next, we delve into concerns regarding fairness in healthcare, addressing the various causes of biases in AI and potential concerns such as misdiagnosis, unequal access to treatment, and ethical considerations. We then outline strategies for addressing fairness, such as the importance of diverse and representative data and algorithm audits. Additionally, we discuss ethical and legal considerations such as data privacy, responsibility, accountability, transparency, and explainability in AI. Finally, we present the Fairness of Artificial Intelligence Recommendations in healthcare (FAIR) statement to offer best practices. Through these efforts, we aim to provide a foundation for discussing the responsible and equitable implementation and deployment of AI in healthcare.

Abdulrahman I. Alshaya Atheer Aldairem Sumaya N Almohareb + 10 lainnya

22 September 2023

Introduction Healthcare systems are complex and challenging for all stakeholders, but artificial intelligence (AI) has transformed various fields, including healthcare, with the potential to improve patient care and quality of life. Rapid AI advancements can revolutionize healthcare by integrating it into clinical practice. Reporting AI’s role in clinical practice is crucial for successful implementation by equipping healthcare providers with essential knowledge and tools. Research Significance This review article provides a comprehensive and up-to-date overview of the current state of AI in clinical practice, including its potential applications in disease diagnosis, treatment recommendations, and patient engagement. It also discusses the associated challenges, covering ethical and legal considerations and the need for human expertise. By doing so, it enhances understanding of AI’s significance in healthcare and supports healthcare organizations in effectively adopting AI technologies. Materials and Methods The current investigation analyzed the use of AI in the healthcare system with a comprehensive review of relevant indexed literature, such as PubMed/Medline, Scopus, and EMBASE, with no time constraints but limited to articles published in English. The focused question explores the impact of applying AI in healthcare settings and the potential outcomes of this application. Results Integrating AI into healthcare holds excellent potential for improving disease diagnosis, treatment selection, and clinical laboratory testing. AI tools can leverage large datasets and identify patterns to surpass human performance in several healthcare aspects. AI offers increased accuracy, reduced costs, and time savings while minimizing human errors. It can revolutionize personalized medicine, optimize medication dosages, enhance population health management, establish guidelines, provide virtual health assistants, support mental health care, improve patient education, and influence patient-physician trust. Conclusion AI can be used to diagnose diseases, develop personalized treatment plans, and assist clinicians with decision-making. Rather than simply automating tasks, AI is about developing technologies that can enhance patient care across healthcare settings. However, challenges related to data privacy, bias, and the need for human expertise must be addressed for the responsible and effective implementation of AI in healthcare.

Emilio Ferrara

16 April 2023

The significant advancements in applying artificial intelligence (AI) to healthcare decision-making, medical diagnosis, and other domains have simultaneously raised concerns about the fairness and bias of AI systems. This is particularly critical in areas like healthcare, employment, criminal justice, credit scoring, and increasingly, in generative AI models (GenAI) that produce synthetic media. Such systems can lead to unfair outcomes and perpetuate existing inequalities, including generative biases that affect the representation of individuals in synthetic data. This survey study offers a succinct, comprehensive overview of fairness and bias in AI, addressing their sources, impacts, and mitigation strategies. We review sources of bias, such as data, algorithm, and human decision biases—highlighting the emergent issue of generative AI bias, where models may reproduce and amplify societal stereotypes. We assess the societal impact of biased AI systems, focusing on perpetuating inequalities and reinforcing harmful stereotypes, especially as generative AI becomes more prevalent in creating content that influences public perception. We explore various proposed mitigation strategies, discuss the ethical considerations of their implementation, and emphasize the need for interdisciplinary collaboration to ensure effectiveness. Through a systematic literature review spanning multiple academic disciplines, we present definitions of AI bias and its different types, including a detailed look at generative AI bias. We discuss the negative impacts of AI bias on individuals and society and provide an overview of current approaches to mitigate AI bias, including data pre-processing, model selection, and post-processing. We emphasize the unique challenges presented by generative AI models and the importance of strategies specifically tailored to address these. Addressing bias in AI requires a holistic approach involving diverse and representative datasets, enhanced transparency and accountability in AI systems, and the exploration of alternative AI paradigms that prioritize fairness and ethical considerations. This survey contributes to the ongoing discussion on developing fair and unbiased AI systems by providing an overview of the sources, impacts, and mitigation strategies related to AI bias, with a particular focus on the emerging field of generative AI.