Preventing harm from non-conscious bias in medical generative AI

The Lancet Digital Health, Journal Year: 2023, Volume and Issue: 6(1), P. e2 - e3

Published: Dec. 18, 2023

Large language models such as OpenAI's GPT-4 have the potential to transform medicine1Clusmann J Kolbinger FR Muti HS et al.The future landscape of large in medicine.Commun Med (Lond). 2023; 3: 141Crossref PubMed Google Scholar by enabling automation a range tasks, including writing discharge summaries,2Patel SB Lam K ChatGPT: summaries?.Lancet Digit Health. 5: e107-e108Summary Full Text PDF Scopus (159) answering patient questions,3Ayers JW Poliak A Dredze M al.Comparing physician and artificial intelligence chatbot responses questions posted public social media forum.JAMA Intern Med. 183: 589-596Crossref (156) supporting clinical treatment planning.4Dennstädt F Hastings Putora PM al.Exploring capabilities ChatGPT radiation oncology.Adv Radiat Oncol. (published online Nov 4.)https://doi.org/10.1016/j.adro.2023.101400Summary These are so useful that their adoption has been immediate, efforts already well underway integrate them with ubiquitous information systems. However, unchecked use technology cause harm. An ambitious study Travis Zack Eric Lehman colleagues5Zack T E Suzgun al.Assessing perpetuate racial gender biases health care: model evaluation study.Lancet 2024; 6: e12-e22Summary The Lancet Digital Health comprehensively shows exhibits bias across clinically relevant generation cases for medical education, support differential diagnostic reasoning, plan recommendation, subjective assessments patients. For each these was found exaggerate known disease prevalence differences between groups, over-represent stereotypes problematic representations minority amplify harmful societal biases. findings seriously concerning line previous research about large-scale generative more broadly. falls short providing actionable recommendations on how can safely be incorporated into workflows given findings. Strategies mitigate very active area, commonly divided approaches augment or alter training data, strategies enhance provide additional training, execution, apply corrections post-processing.6Gallegos IO Rossi RA Barrow al.Bias fairness models: survey.arXiv. Sept 2.) (preprint).https://doi.org/10.48550/arXiv.2309.00770Google Supplementing through data augmentation reinforcement learning from human feedback might help some extent, but unlikely completely successful it is largely outside underlying avoid completely. In addition, note, hospital systems adopting closed limited redevelop itself, even though this principle possible open-source models, individual hospitals sufficient resources resolve all problems. Thus, follows biased will deployed. Attempts debias results instruction also likely fail: no possibility self-awareness self-reflection, consistent world which outputs expected correspond. observed study, explicitly instructing perform equitably probably not desired outcome, result overcorrecting worse bias. Worryingly, deployment clinician loop fully address problem—biased behaviour lead become biased, rather than outcome reducing bias.7Vicente L Matute H Humans inherit biases.Sci Rep. 1315737Crossref (0) How, then, deployed? It there one-size-fits-all solution, rather, complex preprocessing postprocessing workarounds developed depending nature task. example, example case vignettes suffice if prompts prespecified demographics examples according detailed preverified estimate prevalence. To options considerations reasoning planning, seems imperative coupled an external verifiable source bias-free knowledge using retrieval-augmented8Shi W Zhuang Y Zhu Iwinski Wattenbarger Wang MD Retrieval-augmented adolescent idiopathic scoliosis patients shared decision-making.https://dl.acm.org/doi/10.1145/3584371.3612956Date accessed: November 28, 2023Google generation, suggestions generated directly model. Finally, tasks related characteristics level honesty pain severity, altogether inappropriate at stage development type Advances offer many exciting possibilities medicine, reduce time-consuming burden documentation9Wosny Strasser LM Experience care professionals digital tools hospital: qualitative systematic review.JMIR Hum Factors. 10e50357Crossref thereby free time human-focused work. workflows, still effect should considered, overall net benefit enormous, risk mitigation straightforward other applications technology. decision making risks potentially severe substantial requirement diligent implementation repeating algorithmic harms those made past.10Obermeyer Z Powers B Vogeli C Mullainathan S Dissecting algorithm used manage populations.Science. 2019; 366: 447-453Crossref (1746) I declare competing interests. Assessing studyOur highlight urgent need comprehensive transparent LLM intended before they integrated care. We discuss sources implementation. Full-Text Open Access

Language: Английский

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Unveiling the digital future: perspectives of Hungarian physicians under 35 years old on eHealth solutions

Frontiers in Digital Health, Journal Year: 2025, Volume and Issue: 6

Published: Jan. 27, 2025

The COVID-19 pandemic has catalysed the emergence of digital solutions in all areas medicine. Our prior study on health related experiences and opinions Hungarian physicians highlights crucial role age shaping attitudes towards among medical doctors. aim was to examine how under 35-year-old relate technologies, advantages disadvantages they perceive, would like incorporate these technologies into their everyday practice. As part "E-physicians E-patients Hungary" study, we conducted an online representative survey practitioners Hungary between July 2021 May 2022 (n = 1,774). main target group our research were 35 years age: n 399 (25.3%). Besides descriptive statistical analyses, cluster analysis binary logistic regression applied analyse young group. confirmed that younger doctors perceived more (on average 7.07 items vs. 8.52 items) 4.06 4.42) solutions. They also demonstrated greater familiarity with (8.27 9.79) use (1.94 2.66) a broader spectrum technologies. Proficiency active utilization diverse correlates comprehensive understanding both pros cons, as well realistic self-assessment further improvement. Doctors express notable demand for significantly increased incentives, terms knowledge transfer/training infrastructure incentives. Multivariate analyses revealed doctors, compared older counterparts, enhanced patient adherence one greatest benefits Additionally, expect could reduce burnout. results underscore inevitable transformation 21st-century physician role: success hinges involvement management, which requires proper education professional support navigating space. Digital can be bridge different generations where people help colleagues navigate world.

Language: Английский

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“Terrible Stuff. We've Been Had” – Hospital Workers Recount Their Experiences Six Months after Implementation of a New Electronic Health Record – a Qualitative Study

Published: Jan. 1, 2025

Language: Английский

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Benefits and Project Management to Improve Success of IS/IT Projects in Healthcare

IGI Global eBooks, Journal Year: 2025, Volume and Issue: unknown, P. 313 - 354

Published: March 7, 2025

The rapidly changing business environment is putting growing pressure on organizations to deliver successful projects that align with their strategic objectives. As a result, the use of emerging information systems and technology (IS/IT) has expanded significantly across various sectors, healthcare being major area focus. Two critical factors have driven surge in Health IS/IT investments. First, rising burden chronic diseases led costs increasing at much faster pace. Second, there recognized need greatly improve quality safety health delivery. These strong investments enhance speed accuracy sharing, which crucial for supporting clinical decision-making. However, many implementations faced low success rates. authors suggest by integrating Project Management approach Benefits approach, can these outcomes, ensuring effective realization benefits from project success.

Language: Английский

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Evidence for Digital Mental Health Assessment Tools: Protocol for a Systematic Review on Diagnostic Accuracy Across All Age Groups (Preprint)

Published: March 5, 2025

Digital assessments in health care are increasingly used to aid clinicians diagnosing mental conditions. Particularly since the quarantine and isolation guidelines of COVID-19 pandemic moved much online, there has been an accelerated adoption digital tools for assessment. The diagnostic accuracy a range psychiatric conditions yet be fully explored, especially their use populations older adults children. This systematic review aims evaluate current landscape evidence self-report question- answer-based all ages various Preferred Reporting Items Systematic Meta-Analysis Protocols (PRISMA-P) guided development this protocol. protocol registered with International Prospective Register Reviews (PROSPERO). searches were by PICO framework (population, intervention, comparator, outcome). A search was conducted following databases literature published 2021: MEDLINE, Embase, Cochrane Library, Applied Social Sciences Index Abstracts (ASSIA), Web Science Core Collection, Cumulative Nursing Allied Health Literature (CINAHL), PsychINFO. Searches clinical trial hand searching reference lists will completed. Two authors independently screen titles abstracts identified articles select studies according eligibility criteria, resolving inconsistencies through discussion. Full texts then screened same process. two extract data using Covidence extraction tool. Quality Assessment Diagnostic Accuracy Studies-2 (QUADAS-2) tool assess risk bias each full text inclusion. descriptive summary findings presented along tables. Scoping began December 2024. completed January 2025. identification relevant gray is aimed April 2025, final expected June across different (including children elderly), particularly due exponential increase such tools. provide wider deployment assessment wide age range. There also discussion about future research avenues policy around assessments. (PROSPERO) CRD420250654734; https://www.crd.york.ac.uk/PROSPERO/view/CRD420250654734

Language: Английский

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Promoting mental health in the age of new digital tools: balancing challenges and opportunities of social media, chatbots, and wearables

Frontiers in Digital Health, Journal Year: 2025, Volume and Issue: 7

Published: March 13, 2025

The promotion of mental health is essential for global health, affecting millions with disorders such as anxiety and depression. Although stigma discrimination hinder progress, these conditions are often preventable or manageable at minimal cost. adoption digital tools in promotion, including telemedicine, online therapy, social media, wearables, offers promising new avenues to address issues. This review proposes a framework that focuses on the use enhance literacy, foster behavioral change, support sustained positive behaviors. Platforms TikTok, Facebook, Instagram can effectively disseminate information, increase awareness, accountability. Artificial intelligence-driven virtual agents offer personalised interventions, providing motivational customised advice. Additionally, wearable technology (e.g., fitness trackers smartwatches) enables real-time monitoring vital metrics, encouraging ongoing healthy activities. Nonetheless, technologies introduce challenges privacy issues, data security, equitable access resources, raising class rights protect privacy, guard against algorithm bias, prevent personality-changing manipulations. absence human interaction fully solutions also raises concerns about lack empathy emotional connection. For optimal integration conventional care practices adaptation diverse cultural backgrounds necessary. results this suggest tools, when carefully implemented, significantly improve outcomes by making more accessible, tailored, effective, especially underserved communities.

Language: Английский

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A balancing act: the promise and pitfalls of clinical decision support

Baylor University Medical Center Proceedings, Journal Year: 2025, Volume and Issue: 38(3), P. 233 - 234

Published: March 24, 2025

Language: Английский

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Healthcare Professionals’ Perceived Challenges and Benefits of Digital Patient-Reported Data for In-Hospital Postoperative Pain Monitoring: A Qualitative Study

Published: Jan. 1, 2025

Language: Английский

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The Paradoxes of Digital Tools in Hospitals: A Qualitative Interview Study (Preprint)

Published: Jan. 8, 2024

Digital tools are progressively reshaping the daily work of health care professionals (HCPs) in hospitals. While this transformation holds substantial promise, it leads to frustrating experiences, raising concerns about negative impacts on clinicians’ well-being. The goal study was comprehensively explore lived experiences HCPs navigating digital throughout their routines. Qualitative in-depth interviews with 52 representing 24 medical specialties across 14 hospitals Switzerland were performed. Inductive thematic analysis revealed 4 main themes: tool use, workflow and processes, HCPs’ experience delivery, management change. Within these themes, 6 intriguing paradoxes emerged, we hypothesized that might partly explain persistence challenges facing hospital digitalization: promise efficiency reality inefficiency, shift from face interface, juggling frustration dedication, illusion information access trust, complexity intersection workflows paths, opportunities shadow IT. Our highlights central importance acknowledging considering support technology avoid or mitigate any potential arise digitalization. viewpoints add relevant insights into long-standing informatics problems may suggest new strategies follow when tackling future challenges.

Language: Английский

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The Paradoxes of Digital Tools in Hospitals: A Qualitative Interview Study (Preprint)

Journal of Medical Internet Research, Journal Year: 2024, Volume and Issue: 26, P. e56095 - e56095

Published: July 15, 2024

Digital tools are progressively reshaping the daily work of health care professionals (HCPs) in hospitals. While this transformation holds substantial promise, it leads to frustrating experiences, raising concerns about negative impacts on clinicians' well-being.

Language: Английский

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