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人工智能与初级医疗保健的未来:对英国全科医生观点的探索性定性研究

Artificial Intelligence and the Future of Primary Care: Exploratory Qualitative Study of UK General Practitioners' Views.

作者信息

Blease Charlotte, Kaptchuk Ted J, Bernstein Michael H, Mandl Kenneth D, Halamka John D, DesRoches Catherine M

机构信息

General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.

School of Psychology, University College Dublin, Dublin, Ireland.

出版信息

J Med Internet Res. 2019 Mar 20;21(3):e12802. doi: 10.2196/12802.

Abstract

BACKGROUND

The potential for machine learning to disrupt the medical profession is the subject of ongoing debate within biomedical informatics and related fields.

OBJECTIVE

This study aimed to explore general practitioners' (GPs') opinions about the potential impact of future technology on key tasks in primary care.

METHODS

In June 2018, we conducted a Web-based survey of 720 UK GPs' opinions about the likelihood of future technology to fully replace GPs in performing 6 key primary care tasks, and, if respondents considered replacement for a particular task likely, to estimate how soon the technological capacity might emerge. This study involved qualitative descriptive analysis of written responses ("comments") to an open-ended question in the survey.

RESULTS

Comments were classified into 3 major categories in relation to primary care: (1) limitations of future technology, (2) potential benefits of future technology, and (3) social and ethical concerns. Perceived limitations included the beliefs that communication and empathy are exclusively human competencies; many GPs also considered clinical reasoning and the ability to provide value-based care as necessitating physicians' judgments. Perceived benefits of technology included expectations about improved efficiencies, in particular with respect to the reduction of administrative burdens on physicians. Social and ethical concerns encompassed multiple, divergent themes including the need to train more doctors to overcome workforce shortfalls and misgivings about the acceptability of future technology to patients. However, some GPs believed that the failure to adopt technological innovations could incur harms to both patients and physicians.

CONCLUSIONS

This study presents timely information on physicians' views about the scope of artificial intelligence (AI) in primary care. Overwhelmingly, GPs considered the potential of AI to be limited. These views differ from the predictions of biomedical informaticians. More extensive, stand-alone qualitative work would provide a more in-depth understanding of GPs' views.

摘要

背景

机器学习对医学专业的潜在影响是生物医学信息学及相关领域正在进行的辩论主题。

目的

本研究旨在探讨全科医生(GP)对未来技术对初级保健关键任务的潜在影响的看法。

方法

2018年6月,我们对720名英国全科医生进行了一项基于网络的调查,了解他们对未来技术在执行6项关键初级保健任务时完全取代全科医生可能性的看法,以及如果受访者认为某项特定任务可能被取代,估计技术能力可能出现的时间。本研究涉及对调查问卷中一个开放式问题的书面回答(“评论”)进行定性描述分析。

结果

与初级保健相关的评论分为三大类:(1)未来技术的局限性,(2)未来技术的潜在益处,(3)社会和伦理问题。感知到的局限性包括认为沟通和同理心是人类独有的能力;许多全科医生还认为临床推理和提供基于价值的护理的能力需要医生的判断。技术的潜在益处包括对提高效率的期望,特别是在减轻医生行政负担方面。社会和伦理问题涵盖多个不同主题,包括需要培训更多医生以克服劳动力短缺以及对未来技术对患者可接受性的疑虑。然而,一些全科医生认为不采用技术创新可能会对患者和医生都造成伤害。

结论

本研究及时提供了医生对人工智能(AI)在初级保健中应用范围的看法。绝大多数全科医生认为人工智能的潜力有限。这些观点与生物医学信息学家的预测不同。更广泛的独立定性研究将更深入地了解全科医生的观点。

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