Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Center for Advanced Endoscopy, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Gut. 2022 Sep;71(9):1909-1915. doi: 10.1136/gutjnl-2021-326271. Epub 2022 Jun 10.
Artificial intelligence (AI) and machine learning (ML) systems are increasingly used in medicine to improve clinical decision-making and healthcare delivery. In gastroenterology and hepatology, studies have explored a myriad of opportunities for AI/ML applications which are already making the transition to bedside. Despite these advances, there is a risk that biases and health inequities can be introduced or exacerbated by these technologies. If unrecognised, these technologies could generate or worsen systematic racial, ethnic and sex disparities when deployed on a large scale. There are several mechanisms through which AI/ML could contribute to health inequities in gastroenterology and hepatology, including diagnosis of oesophageal cancer, management of inflammatory bowel disease (IBD), liver transplantation, colorectal cancer screening and many others. This review adapts a framework for ethical AI/ML development and application to gastroenterology and hepatology such that clinical practice is advanced while minimising bias and optimising health equity.
人工智能(AI)和机器学习(ML)系统在医学领域的应用日益广泛,以改善临床决策和医疗服务。在胃肠病学和肝脏病学中,研究已经探索了无数的 AI/ML 应用机会,这些机会已经开始转化为床边实践。尽管取得了这些进展,但这些技术可能会带来或加剧偏见和健康不平等。如果这些技术得不到识别,那么在大规模部署时,这些技术可能会产生或加剧系统性的种族、族裔和性别差异。人工智能/机器学习可能通过多种机制导致胃肠病学和肝脏病学中的健康不平等,包括食管癌的诊断、炎症性肠病(IBD)的管理、肝移植、结直肠癌筛查等。本综述采用了一个适用于胃肠病学和肝脏病学的 AI/ML 开发和应用的伦理框架,在推进临床实践的同时,最大限度地减少偏见并优化健康公平。
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