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Byrne AL, Mulvogue J, Adhikari S, Cutmore E. Discriminative and exploitive stereotypes: Artificial intelligence generated images of aged care nurses and the impacts on recruitment and retention. Nurs Inq 2024; 31:e12651. [PMID: 38940314 DOI: 10.1111/nin.12651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 06/11/2024] [Accepted: 06/17/2024] [Indexed: 06/29/2024]
Abstract
This article uses critical discourse analysis to investigate artificial intelligence (AI) generated images of aged care nurses and considers how perspectives and perceptions impact upon the recruitment and retention of nurses. The article demonstrates a recontextualization of aged care nursing, giving rise to hidden ideologies including harmful stereotypes which allow for discrimination and exploitation. It is argued that this may imply that nurses require fewer clinical skills in aged care, diminishing the value of working in this area. AI relies on existing data sets, and thus represent existing stereotypes and biases. The discourse analysis has highlighted key issues which may further impact upon nursing recruitment and retention, and advocates for stronger ethical consideration, including the use of experts in data validation, for the way that aged care services and nurses are depicted and thus valued.
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Affiliation(s)
- Amy-Louise Byrne
- School of Nursing, Midwifery, and Social Sciences, CQUniversity, Brisbane, Queensland, Australia
| | - Jennifer Mulvogue
- School of Nursing, Midwifery, and Social Sciences, CQUniversity, Brisbane, Queensland, Australia
| | - Siju Adhikari
- School of Nursing, Midwifery, and Social Sciences, CQUniversity, Brisbane, Queensland, Australia
| | - Ellie Cutmore
- School of Nursing, Midwifery, and Social Sciences, CQUniversity, Brisbane, Queensland, Australia
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2
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Parchmann N, Hansen D, Orzechowski M, Steger F. An ethical assessment of professional opinions on concerns, chances, and limitations of the implementation of an artificial intelligence-based technology into the geriatric patient treatment and continuity of care. GeroScience 2024:10.1007/s11357-024-01229-6. [PMID: 38834930 DOI: 10.1007/s11357-024-01229-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 05/27/2024] [Indexed: 06/06/2024] Open
Abstract
With the introduction of an artificial intelligence-based dashboard into the clinic, the project SURGE-Ahead responds to the importance of improving perioperative geriatric patient treatment and continuity of care. The use of artificial intelligence to process and analyze data automatically, aims at an evidence-based evaluation of the patient's health condition and recommending treatment options. However, its development and introduction raise ethical questions. To ascertain professional perspectives on the clinical use of the dashboard, we have conducted 19 semi-structured qualitative interviews with head physicians, computer scientists, jurists, and ethicists. The application of a qualitative content analysis and thematic analysis enabled the detection of main ethical concerns, chances, and limitations. These ethical considerations were categorized: changes of the patient-physician relationship and the current social reality are expected, causing de-skilling and an active participation of the artificial intelligence. The interviewees anticipated a redistribution of human resources, time, knowledge, and experiences as well as expenses and financing. Concerns of privacy, accuracy, transparency, and explainability were stated, and an insufficient data basis, an intensifying of existing inequalities and systematic discrimination considering a fair access emphasized. Concluding, the patient-physician relationship, social reality, redistribution of resources, fair access, as well as data-related aspects of the artificial intelligence-based system could conflict with the ethical principles of autonomy, non-maleficence, beneficence, and social justice. To respond to these ethical concerns, a responsible use of the dashboard and a critical verification of therapy suggestions is mandatory, and the application limited by questions at the end of life and taking life-changing decisions.
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Affiliation(s)
- Nina Parchmann
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Oberberghof 7, 89081, Ulm, Baden-Wuerttemberg, Germany.
| | - David Hansen
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Oberberghof 7, 89081, Ulm, Baden-Wuerttemberg, Germany
| | - Marcin Orzechowski
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Oberberghof 7, 89081, Ulm, Baden-Wuerttemberg, Germany
| | - Florian Steger
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Oberberghof 7, 89081, Ulm, Baden-Wuerttemberg, Germany
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Capraro V, Lentsch A, Acemoglu D, Akgun S, Akhmedova A, Bilancini E, Bonnefon JF, Brañas-Garza P, Butera L, Douglas KM, Everett JAC, Gigerenzer G, Greenhow C, Hashimoto DA, Holt-Lunstad J, Jetten J, Johnson S, Kunz WH, Longoni C, Lunn P, Natale S, Paluch S, Rahwan I, Selwyn N, Singh V, Suri S, Sutcliffe J, Tomlinson J, van der Linden S, Van Lange PAM, Wall F, Van Bavel JJ, Viale R. The impact of generative artificial intelligence on socioeconomic inequalities and policy making. PNAS NEXUS 2024; 3:pgae191. [PMID: 38864006 PMCID: PMC11165650 DOI: 10.1093/pnasnexus/pgae191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/03/2024] [Indexed: 06/13/2024]
Abstract
Generative artificial intelligence (AI) has the potential to both exacerbate and ameliorate existing socioeconomic inequalities. In this article, we provide a state-of-the-art interdisciplinary overview of the potential impacts of generative AI on (mis)information and three information-intensive domains: work, education, and healthcare. Our goal is to highlight how generative AI could worsen existing inequalities while illuminating how AI may help mitigate pervasive social problems. In the information domain, generative AI can democratize content creation and access but may dramatically expand the production and proliferation of misinformation. In the workplace, it can boost productivity and create new jobs, but the benefits will likely be distributed unevenly. In education, it offers personalized learning, but may widen the digital divide. In healthcare, it might improve diagnostics and accessibility, but could deepen pre-existing inequalities. In each section, we cover a specific topic, evaluate existing research, identify critical gaps, and recommend research directions, including explicit trade-offs that complicate the derivation of a priori hypotheses. We conclude with a section highlighting the role of policymaking to maximize generative AI's potential to reduce inequalities while mitigating its harmful effects. We discuss strengths and weaknesses of existing policy frameworks in the European Union, the United States, and the United Kingdom, observing that each fails to fully confront the socioeconomic challenges we have identified. We propose several concrete policies that could promote shared prosperity through the advancement of generative AI. This article emphasizes the need for interdisciplinary collaborations to understand and address the complex challenges of generative AI.
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Affiliation(s)
- Valerio Capraro
- Department of Psychology, University of Milan-Bicocca, Milan 20126, Italy
| | | | - Daron Acemoglu
- Institute Professor and Department of Economics, MIT, Cambridge, MA 02142, USA
| | - Selin Akgun
- College of Education, Michigan State University, East Lansing, MI 48824, USA
| | - Aisel Akhmedova
- College of Education, Michigan State University, East Lansing, MI 48824, USA
| | | | | | - Pablo Brañas-Garza
- Loyola Behavioral Lab, Loyola Andalucia University, Córdoba 41740, Spain
| | - Luigi Butera
- Department of Economics, Copenhagen Business School, Frederiksberg 2000, Denmark
| | - Karen M Douglas
- School of Psychology, University of Kent, Canterbury CT27NP, UK
| | - Jim A C Everett
- School of Psychology, University of Kent, Canterbury CT27NP, UK
| | - Gerd Gigerenzer
- Max Planck Institute for Human Development, Berlin 14195, Germany
| | - Christine Greenhow
- College of Education, Michigan State University, East Lansing, MI 48824, USA
| | - Daniel A Hashimoto
- Department of Psychology, University of Milan-Bicocca, Milan 20126, Italy
- Department of Computer and Information Science, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA 19104-6309, USA
| | - Julianne Holt-Lunstad
- Department of Psychology and Neuroscience, Brigham Young University, Provo, UT 84602, USA
| | - Jolanda Jetten
- School of Psychology, University of Queensland, St Lucia, QLD 4067, Australia
| | - Simon Johnson
- School of Management, MIT Sloan School of Management, Cambridge, MA 02142, USA
| | - Werner H Kunz
- Department of Marketing, University of Massachusetts Boston, Boston, MA 02125, USA
| | - Chiara Longoni
- Department of Marketing, Bocconi University, Milan 20136, Italy
| | - Pete Lunn
- Behavioural Research Unit, Economic & Social Research Institute, Dublin D02 K138, Ireland
| | - Simone Natale
- Department of Humanities, University of Turin, Turin 10125, Italy
| | - Stefanie Paluch
- Department of Service and Technology Marketing, Aarhus University, Aarhus 8000, Denmark
| | - Iyad Rahwan
- Center for Humans and Machines, Max Planck Institute for Human Development, Berlin 14195, Germany
| | - Neil Selwyn
- Faculty of Education, Monash University, Clayton VIC 3168, Australia
| | - Vivek Singh
- Penn Computer Assisted Surgery and Outcomes Laboratory, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | | | - Jennifer Sutcliffe
- College of Education, Michigan State University, East Lansing, MI 48824, USA
| | - Joe Tomlinson
- York Law School, University of York, York YO105DD, UK
| | | | - Paul A M Van Lange
- Department of Experimental and Applied Psychology, Vrije Universiteit, Amsterdam 1081HV, The Netherlands
| | - Friederike Wall
- Department of Management Control and Strategic Management, University of Klagenfurt, Klagenfurt am Wörthersee 9020, Austria
| | - Jay J Van Bavel
- Department of Psychology & Center for Neural Science, New York University, New York, NY 10012, USA
- Norwegian School of Economics, Bergen 5045, Norway
| | - Riccardo Viale
- CISEPS, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan 20126, Italy
- Herbert Simon Society, Turin 10122, Italy
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Dimitri P, Savage MO. Artificial intelligence in paediatric endocrinology: conflict or cooperation. J Pediatr Endocrinol Metab 2024; 37:209-221. [PMID: 38183676 DOI: 10.1515/jpem-2023-0554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 12/18/2023] [Indexed: 01/08/2024]
Abstract
Artificial intelligence (AI) in medicine is transforming healthcare by automating system tasks, assisting in diagnostics, predicting patient outcomes and personalising patient care, founded on the ability to analyse vast datasets. In paediatric endocrinology, AI has been developed for diabetes, for insulin dose adjustment, detection of hypoglycaemia and retinopathy screening; bone age assessment and thyroid nodule screening; the identification of growth disorders; the diagnosis of precocious puberty; and the use of facial recognition algorithms in conditions such as Cushing syndrome, acromegaly, congenital adrenal hyperplasia and Turner syndrome. AI can also predict those most at risk from childhood obesity by stratifying future interventions to modify lifestyle. AI will facilitate personalised healthcare by integrating data from 'omics' analysis, lifestyle tracking, medical history, laboratory and imaging, therapy response and treatment adherence from multiple sources. As data acquisition and processing becomes fundamental, data privacy and protecting children's health data is crucial. Minimising algorithmic bias generated by AI analysis for rare conditions seen in paediatric endocrinology is an important determinant of AI validity in clinical practice. AI cannot create the patient-doctor relationship or assess the wider holistic determinants of care. Children have individual needs and vulnerabilities and are considered in the context of family relationships and dynamics. Importantly, whilst AI provides value through augmenting efficiency and accuracy, it must not be used to replace clinical skills.
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Affiliation(s)
- Paul Dimitri
- Department of Paediatric Endocrinology, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Martin O Savage
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK
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Ito N, Kadomatsu S, Fujisawa M, Fukaguchi K, Ishizawa R, Kanda N, Kasugai D, Nakajima M, Goto T, Tsugawa Y. The Accuracy and Potential Racial and Ethnic Biases of GPT-4 in the Diagnosis and Triage of Health Conditions: Evaluation Study. JMIR MEDICAL EDUCATION 2023; 9:e47532. [PMID: 37917120 PMCID: PMC10654908 DOI: 10.2196/47532] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/07/2023] [Accepted: 09/05/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Whether GPT-4, the conversational artificial intelligence, can accurately diagnose and triage health conditions and whether it presents racial and ethnic biases in its decisions remain unclear. OBJECTIVE We aim to assess the accuracy of GPT-4 in the diagnosis and triage of health conditions and whether its performance varies by patient race and ethnicity. METHODS We compared the performance of GPT-4 and physicians, using 45 typical clinical vignettes, each with a correct diagnosis and triage level, in February and March 2023. For each of the 45 clinical vignettes, GPT-4 and 3 board-certified physicians provided the most likely primary diagnosis and triage level (emergency, nonemergency, or self-care). Independent reviewers evaluated the diagnoses as "correct" or "incorrect." Physician diagnosis was defined as the consensus of the 3 physicians. We evaluated whether the performance of GPT-4 varies by patient race and ethnicity, by adding the information on patient race and ethnicity to the clinical vignettes. RESULTS The accuracy of diagnosis was comparable between GPT-4 and physicians (the percentage of correct diagnosis was 97.8% (44/45; 95% CI 88.2%-99.9%) for GPT-4 and 91.1% (41/45; 95% CI 78.8%-97.5%) for physicians; P=.38). GPT-4 provided appropriate reasoning for 97.8% (44/45) of the vignettes. The appropriateness of triage was comparable between GPT-4 and physicians (GPT-4: 30/45, 66.7%; 95% CI 51.0%-80.0%; physicians: 30/45, 66.7%; 95% CI 51.0%-80.0%; P=.99). The performance of GPT-4 in diagnosing health conditions did not vary among different races and ethnicities (Black, White, Asian, and Hispanic), with an accuracy of 100% (95% CI 78.2%-100%). P values, compared to the GPT-4 output without incorporating race and ethnicity information, were all .99. The accuracy of triage was not significantly different even if patients' race and ethnicity information was added. The accuracy of triage was 62.2% (95% CI 46.5%-76.2%; P=.50) for Black patients; 66.7% (95% CI 51.0%-80.0%; P=.99) for White patients; 66.7% (95% CI 51.0%-80.0%; P=.99) for Asian patients, and 62.2% (95% CI 46.5%-76.2%; P=.69) for Hispanic patients. P values were calculated by comparing the outputs with and without conditioning on race and ethnicity. CONCLUSIONS GPT-4's ability to diagnose and triage typical clinical vignettes was comparable to that of board-certified physicians. The performance of GPT-4 did not vary by patient race and ethnicity. These findings should be informative for health systems looking to introduce conversational artificial intelligence to improve the efficiency of patient diagnosis and triage.
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Affiliation(s)
- Naoki Ito
- TXP Medical Co Ltd, Tokyo, Japan
- Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sakina Kadomatsu
- TXP Medical Co Ltd, Tokyo, Japan
- Faculty of Medicine, International University of Health and Welfare, Chiba, Japan
| | - Mineto Fujisawa
- TXP Medical Co Ltd, Tokyo, Japan
- Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kiyomitsu Fukaguchi
- TXP Medical Co Ltd, Tokyo, Japan
- Department of Emergency Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Ryo Ishizawa
- TXP Medical Co Ltd, Tokyo, Japan
- Department of Emergency and Critical Care Medicine, Tokyo Medical Center National Hospital Organization, Tokyo, Japan
| | - Naoki Kanda
- TXP Medical Co Ltd, Tokyo, Japan
- Division of General Internal Medicine, Jichi Medical University Hospital, Tochigi, Japan
| | - Daisuke Kasugai
- TXP Medical Co Ltd, Tokyo, Japan
- Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Mikio Nakajima
- TXP Medical Co Ltd, Tokyo, Japan
- Emergency Life-Saving Technique Academy of Tokyo Foundation for Ambulance Service Development, Tokyo, Japan
| | | | - Yusuke Tsugawa
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, The University of California, Los Angeles, Los Angeles, CA, United States
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, United States
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Bernstein J. CORR Insights®: Can Artificial Intelligence Improve the Readability of Patient Education Materials? Clin Orthop Relat Res 2023; 481:2268-2270. [PMID: 37192346 PMCID: PMC10566765 DOI: 10.1097/corr.0000000000002702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 04/25/2023] [Indexed: 05/18/2023]
Affiliation(s)
- Joseph Bernstein
- Clinical Professor of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
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Vodanović M, Subašić M, Milošević D, Savić Pavičin I. Artificial Intelligence in Medicine and Dentistry. Acta Stomatol Croat 2023; 57:70-84. [PMID: 37288152 PMCID: PMC10243707 DOI: 10.15644/asc57/1/8] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/01/2023] [Indexed: 09/14/2023] Open
Abstract
INTRODUCTION Artificial intelligence has been applied in various fields throughout history, but its integration into daily life is more recent. The first applications of AI were primarily in academia and government research institutions, but as technology has advanced, AI has also been applied in industry, commerce, medicine and dentistry. OBJECTIVE Considering that the possibilities of applying artificial intelligence are developing rapidly and that this field is one of the areas with the greatest increase in the number of newly published articles, the aim of this paper was to provide an overview of the literature and to give an insight into the possibilities of applying artificial intelligence in medicine and dentistry. In addition, the aim was to discuss its advantages and disadvantages. CONCLUSION The possibilities of applying artificial intelligence to medicine and dentistry are just being discovered. Artificial intelligence will greatly contribute to developments in medicine and dentistry, as it is a tool that enables development and progress, especially in terms of personalized healthcare that will lead to much better treatment outcomes.
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Affiliation(s)
- Marin Vodanović
- Department of Dental Anthropology, School of Dental Medicine, University of Zagreb, Croatia
- University Hospital Centre Zagreb, Croatia
| | - Marko Subašić
- Faculty of Electrical Engineering and Computing, University of Zagreb, Croatia
| | - Denis Milošević
- Faculty of Electrical Engineering and Computing, University of Zagreb, Croatia
| | - Ivana Savić Pavičin
- Department of Dental Anthropology, School of Dental Medicine, University of Zagreb, Croatia
- University Hospital Centre Zagreb, Croatia
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Mainz JT, Sønderholm J, Uhrenfeldt R. Artificial intelligence and the secret ballot. AI & SOCIETY 2022. [DOI: 10.1007/s00146-022-01551-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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