Using Artificial Intelligence for High-Volume Identification of Silicosis and Tuberculosis: A Bio-Ethics Approach

Abstract

Although Artificial Intelligence (AI) is being increasingly applied, considerable distrust about introducing “disruptive” technologies persists. Intrinsic and contextual factors influencing where and how such innovations are introduced therefore require careful scrutiny to ensure that health equity is promoted. To illustrate one such critical approach, we describe and appraise an AI application – the development of computer assisted diagnosis (CAD) to support more efficient adjudication of compensation claims from former gold miners with occupational lung disease in Southern Africa. In doing so, we apply a bio-ethical lens that considers the principles of beneficence, non-maleficence, autonomy and justice and add explicability as a core principle. We draw on the AI literature, our research on CAD validation and process efficiency, as well as apprehensions of users and stakeholders. Issues of concern included AI accuracy, biased training of AI systems, data privacy, impact on human skill development, transparency and accountability in AI use, as well as intellectual property ownership. We discuss ways in which each of these potential obstacles to successful use of CAD could be mitigated. We conclude that efforts to overcoming technical challenges in applying AI must be accompanied from the onset by attention to ensuring its ethical use.

Inteligencia artificial en salud y sus implicaciones bioéticas: una revisión sistemática

“…Desde este punto de vista, algunos estudios seleccionados en esta revisión establecieron una relación directa entre sus resultados y los principios bioéticos de beneficencia, no maleficencia, autonomía y justicia 14,20 . Otro principio considerado en la ética de la IA es la explicabilidad, que se ocupa del entendimiento de las herramientas que utilizan esta tecnología 13,14,18 .…”

“…En un estudio sobre la IA en el diagnóstico asistido por computadora, se aceleraron los pedidos de indemnización para los trabajadores mineros con cáncer de pulmón ocupacional 20 . Incluso con una baja demanda de inversiones públicas y privadas y un alto riesgo de descalificación de la herramienta en el ámbito legal, este enfoque proporciona un beneficio social comprobado cuando los protocolos éticos y el seguimiento son parte del proceso desde el principio.…”

“…Los estudios prospectivos podrán identificar mejor las debilidades de los modelos de IA en entornos clínicos heterogéneos e indicar formas de integrarlos en los flujos de trabajo clínicos actuales 6 . Sin embargo, los esfuerzos para superar los desafíos técnicos en la implementación de la IA deben seguir aspectos éticos desde el principio 20 .…”

Inteligência artificial em saúde e implicações bioéticas: uma revisão sistemática

“…Desse ponto de vista, alguns estudos selecionados nesta revisão estabeleceram uma relação direta entre seus resultados e os princípios bioéticos da beneficência, não maleficência, autonomia e justiça 14,20 . Outro princípio considerado na ética da IA é a explicabilidade, que trata do entendimento das ferramentas que utilizam essa tecnologia 13,14,18 .…”

Accuracy of Computer-Aided Detection of Occupational Lung Disease: Silicosis and Pulmonary Tuberculosis in Ex-Miners from the South African Gold Mines

“…The demonstration that at least one CAD system is capable of detecting silicosis in a population with a high background prevalence of prior TB is particularly noteworthy. The next stage is to use CAD in practice for this population, and to monitor and evaluate its impact on system efficiency [38], on satisfaction of clinicians and medical adjudicators, and on ethical practice [39].…”