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公众对医疗保健领域人工智能的看法:关注伦理问题,以实现以患者为中心的护理。

Public perceptions of artificial intelligence in healthcare: ethical concerns and opportunities for patient-centered care.

机构信息

Florida Atlantic University, Boca Raton, FL, USA.

University of South Florida, Tampa, FL, USA.

出版信息

BMC Med Ethics. 2024 Jun 22;25(1):74. doi: 10.1186/s12910-024-01066-4.


DOI:10.1186/s12910-024-01066-4
PMID:38909180
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11193174/
Abstract

BACKGROUND: In an effort to improve the quality of medical care, the philosophy of patient-centered care has become integrated into almost every aspect of the medical community. Despite its widespread acceptance, among patients and practitioners, there are concerns that rapid advancements in artificial intelligence may threaten elements of patient-centered care, such as personal relationships with care providers and patient-driven choices. This study explores the extent to which patients are confident in and comfortable with the use of these technologies when it comes to their own individual care and identifies areas that may align with or threaten elements of patient-centered care. METHODS: An exploratory, mixed-method approach was used to analyze survey data from 600 US-based adults in the State of Florida. The survey was administered through a leading market research provider (August 10-21, 2023), and responses were collected to be representative of the state's population based on age, gender, race/ethnicity, and political affiliation. RESULTS: Respondents were more comfortable with the use of AI in health-related tasks that were not associated with doctor-patient relationships, such as scheduling patient appointments or follow-ups (84.2%). Fear of losing the 'human touch' associated with doctors was a common theme within qualitative coding, suggesting a potential conflict between the implementation of AI and patient-centered care. In addition, decision self-efficacy was associated with higher levels of comfort with AI, but there were also concerns about losing decision-making control, workforce changes, and cost concerns. A small majority of participants mentioned that AI could be useful for doctors and lead to more equitable care but only when used within limits. CONCLUSION: The application of AI in medical care is rapidly advancing, but oversight, regulation, and guidance addressing critical aspects of patient-centered care are lacking. While there is no evidence that AI will undermine patient-physician relationships at this time, there is concern on the part of patients regarding the application of AI within medical care and specifically as it relates to their interaction with physicians. Medical guidance on incorporating AI while adhering to the principles of patient-centered care is needed to clarify how AI will augment medical care.

摘要

背景:为了提高医疗质量,以患者为中心的医疗理念已融入医疗界的方方面面。尽管患者和医务人员普遍接受了这一理念,但他们担心人工智能的快速发展可能会威胁到以患者为中心的医疗的某些方面,例如患者与医护人员的个人关系和患者驱动的选择。本研究探讨了患者在涉及自身个体护理时对这些技术的信任和舒适度程度,并确定了与以患者为中心的医疗相契合或可能对其构成威胁的领域。

方法:采用探索性混合方法,对佛罗里达州 600 名美国成年人的调查数据进行了分析。该调查由一家领先的市场研究提供商(2023 年 8 月 10 日至 21 日)进行管理,调查结果旨在根据年龄、性别、种族/民族和政治派别反映该州的人口特征。

结果:受访者更愿意在与医患关系无关的与健康相关的任务中使用人工智能,例如安排患者预约或随访(84.2%)。对与医生相关的“人情味”丧失的担忧是定性编码中的一个常见主题,这表明人工智能的实施与以患者为中心的医疗之间可能存在冲突。此外,决策自我效能感与对人工智能的更高舒适度水平相关,但也存在对丧失决策控制、劳动力变化和成本问题的担忧。大多数参与者提到,人工智能可以为医生提供帮助,并带来更公平的护理,但前提是在一定范围内使用。

结论:人工智能在医疗保健中的应用正在迅速发展,但在以患者为中心的医疗的关键方面缺乏监督、监管和指导。虽然目前没有证据表明人工智能会破坏医患关系,但患者对人工智能在医疗保健中的应用表示担忧,特别是与他们与医生的互动有关。需要医学指导来阐明人工智能将如何增强医疗保健,同时纳入人工智能并坚持以患者为中心的医疗原则。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ff2/11193174/3b2282a43510/12910_2024_1066_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ff2/11193174/d1a7ab40e903/12910_2024_1066_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ff2/11193174/3b2282a43510/12910_2024_1066_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ff2/11193174/d1a7ab40e903/12910_2024_1066_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ff2/11193174/3b2282a43510/12910_2024_1066_Fig2_HTML.jpg

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本文引用的文献

[1]
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