Khoury Zaid H, Ferguson Alexys, Price Jeffery B, Sultan Ahmed S, Wang Rong
Department of Oral Diagnostic Sciences and Research, School of Dentistry, Meharry Medical College, Nashville, TN, United States.
Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD, United States.
Front Oral Health. 2024 Jul 18;5:1408867. doi: 10.3389/froh.2024.1408867. eCollection 2024.
Oral diseases pose a significant burden on global healthcare. While many oral conditions are preventable and manageable through regular dental office visits, a substantial portion of the population faces obstacles in accessing essential and affordable quality oral healthcare. In this mini review, we describe the issue of inequity and bias in oral healthcare and discuss various strategies to address these challenges, with an emphasis on the application of artificial intelligence (AI). Recent advances in AI technologies have led to significant performance improvements in oral healthcare. AI also holds tremendous potential for advancing equity in oral healthcare, yet its application must be approached with caution to prevent the exacerbation of inequities. The "black box" approaches of some advanced AI models raise uncertainty about their operations and decision-making processes. To this end, we discuss the use of interpretable and explainable AI techniques in enhancing transparency and trustworthiness. Those techniques, aimed at augmenting rather than replacing oral health practitioners' judgment and skills, have the potential to achieve personalized dental and oral care that is unbiased, equitable, and transparent. Overall, achieving equity in oral healthcare through the responsible use of AI requires collective efforts from all stakeholders involved in the design, implementation, regulation, and utilization of AI systems. We use the United States as an example due to its uniquely diverse population, making it an excellent model for our discussion. However, the general and responsible AI strategies suggested in this article can be applied to address equity in oral healthcare on a global level.
口腔疾病给全球医疗保健带来了沉重负担。虽然许多口腔疾病可以通过定期看牙医来预防和控制,但很大一部分人口在获得基本且负担得起的优质口腔医疗保健方面面临障碍。在这篇小型综述中,我们描述了口腔医疗保健中的不公平和偏见问题,并讨论了应对这些挑战的各种策略,重点是人工智能(AI)的应用。人工智能技术的最新进展已使口腔医疗保健的性能有了显著提升。人工智能在促进口腔医疗保健公平性方面也具有巨大潜力,但其应用必须谨慎对待,以防止不公平现象加剧。一些先进人工智能模型的“黑箱”方法使其操作和决策过程存在不确定性。为此,我们讨论了使用可解释和可说明的人工智能技术来提高透明度和可信度。这些技术旨在增强而非取代口腔健康从业者的判断和技能,有可能实现无偏见、公平且透明的个性化牙科和口腔护理。总体而言,通过负责任地使用人工智能来实现口腔医疗保健的公平性需要参与人工智能系统设计、实施、监管和使用的所有利益相关者共同努力。我们以美国为例,因其人口具有独特的多样性,使其成为我们讨论的理想范例。然而,本文提出的一般且负责任的人工智能策略可应用于在全球范围内解决口腔医疗保健的公平性问题。