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Singhal A, Neveditsin N, Tanveer H, Mago V. Toward Fairness, Accountability, Transparency, and Ethics in AI for Social Media and Health Care: Scoping Review. JMIR Med Inform 2024; 12:e50048. [PMID: 38568737 PMCID: PMC11024755 DOI: 10.2196/50048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 12/21/2023] [Accepted: 02/15/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND The use of social media for disseminating health care information has become increasingly prevalent, making the expanding role of artificial intelligence (AI) and machine learning in this process both significant and inevitable. This development raises numerous ethical concerns. This study explored the ethical use of AI and machine learning in the context of health care information on social media platforms (SMPs). It critically examined these technologies from the perspectives of fairness, accountability, transparency, and ethics (FATE), emphasizing computational and methodological approaches that ensure their responsible application. OBJECTIVE This study aims to identify, compare, and synthesize existing solutions that address the components of FATE in AI applications in health care on SMPs. Through an in-depth exploration of computational methods, approaches, and evaluation metrics used in various initiatives, we sought to elucidate the current state of the art and identify existing gaps. Furthermore, we assessed the strength of the evidence supporting each identified solution and discussed the implications of our findings for future research and practice. In doing so, we made a unique contribution to the field by highlighting areas that require further exploration and innovation. METHODS Our research methodology involved a comprehensive literature search across PubMed, Web of Science, and Google Scholar. We used strategic searches through specific filters to identify relevant research papers published since 2012 focusing on the intersection and union of different literature sets. The inclusion criteria were centered on studies that primarily addressed FATE in health care discussions on SMPs; those presenting empirical results; and those covering definitions, computational methods, approaches, and evaluation metrics. RESULTS Our findings present a nuanced breakdown of the FATE principles, aligning them where applicable with the American Medical Informatics Association ethical guidelines. By dividing these principles into dedicated sections, we detailed specific computational methods and conceptual approaches tailored to enforcing FATE in AI-driven health care on SMPs. This segmentation facilitated a deeper understanding of the intricate relationship among the FATE principles and highlighted the practical challenges encountered in their application. It underscored the pioneering contributions of our study to the discourse on ethical AI in health care on SMPs, emphasizing the complex interplay and the limitations faced in implementing these principles effectively. CONCLUSIONS Despite the existence of diverse approaches and metrics to address FATE issues in AI for health care on SMPs, challenges persist. The application of these approaches often intersects with additional ethical considerations, occasionally leading to conflicts. Our review highlights the lack of a unified, comprehensive solution for fully and effectively integrating FATE principles in this domain. This gap necessitates careful consideration of the ethical trade-offs involved in deploying existing methods and underscores the need for ongoing research.
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Affiliation(s)
- Aditya Singhal
- Department of Computer Science, Lakehead University, Thunder Bay, ON, Canada
| | - Nikita Neveditsin
- Department of Mathematics and Computing Science, Saint Mary's University, Halifax, NS, Canada
| | - Hasnaat Tanveer
- Faculty of Mathematics, University of Waterloo, Waterloo, ON, Canada
| | - Vijay Mago
- School of Health Policy and Management, York University, Toronto, ON, Canada
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Jalilvand MA, Raeisi AR, Shaarbafchizadeh N. Hospital governance accountability structure: a scoping review. BMC Health Serv Res 2024; 24:47. [PMID: 38200541 PMCID: PMC10777527 DOI: 10.1186/s12913-023-10135-0] [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: 05/23/2023] [Accepted: 10/11/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION Hospitals, as complex organizations with clinical, financial, and social functions, face different barriers to providing high-quality and safe services at reasonable costs. Various initiatives have been carried out in hospital governance to improve quality, safety, and accountability. This research aims to identify the structures and dimensions that make hospital governance accountable. METHODS The research used Arksey and O'Malley's scoping review framework to examine the research literature on hospital governance structure and accountability. The literature review included PubMed, Web of Science, Embase, Scopus ProQuest, Google search engine, and Google Scholar databases from 2010 to 2023. Data were analyzed using the content analysis method. RESULTS Excluding unrelated and duplicate sources, 40 articles and reports were included in the study. The studies were reviewed and analyzed based on organizational type, type of source, year of publication, objectives, and key findings. Accountable governance features were extracted from the selected articles and reports. The four main themes include inclusive governance, commitment to accountability, planning for accountability, and autonomous governance. Thirteen subthemes were extracted from the study literature. CONCLUSION Various initiatives have been implemented regarding the reform of the governance structure of public hospitals in different countries. Many of these reforms aim to improve financial and clinical accountability. The study results could be used to identify the structures and dimensions that make hospital governance accountable.
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Affiliation(s)
- Mohammad Ali Jalilvand
- Student Research Committee, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Reza Raeisi
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Nasrin Shaarbafchizadeh
- Health Services Management, Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
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Benski C, Zambruni M, Stancanelli G, Landinarisoa T, Hantavololona A, Rachel Andrianarisoa V, Manjary PR, Capello C, de Tejada BM, Reich MR, Guyer AL. Lessons Learned From Building a Global Health Partnership on Obstetric Care in Madagascar. GLOBAL HEALTH, SCIENCE AND PRACTICE 2023; 11:e2200521. [PMID: 37903582 PMCID: PMC10615231 DOI: 10.9745/ghsp-d-22-00521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 08/30/2023] [Indexed: 11/01/2023]
Abstract
The authors share experiences of a global health partnership that worked to promote equity through a commitment to shared values and goals, engagement and communication, and mutual trust and respect.
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Affiliation(s)
- Caroline Benski
- Département de la femme, l'enfant et l'adolescent, Hôpitaux Universitaires de Genève, Geneva, Switzerland.
| | - Monica Zambruni
- Département de la femme, l'enfant et l'adolescent, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | | | | | - Abéline Hantavololona
- Service Maternité Sans Risque, Direction de la Santé Familiale, Ministère de la Santé Publique, Antananarivo, Madagascar
| | | | | | | | - Begona Martinez de Tejada
- Département de la femme, l'enfant et l'adolescent, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Michael R Reich
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Christie S, Chahine T, Curry LA, Cherlin E, Linnander EL. The Evolution of Trust Within a Global Health Partnership With the Private Sector: An Inductive Framework. Int J Health Policy Manag 2022; 11:1140-1147. [PMID: 33904694 PMCID: PMC9808177 DOI: 10.34172/ijhpm.2021.14] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 02/12/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Public-private partnerships (PPPs) in global health are increasingly common to support sustainable development and strengthen health systems in low- and middle-income countries. Since the release of the Sustainable Development Goals (SDGs) in 2015 culminating in a discrete goal "to revitalize the global partnership for sustainable development," public health scholars have sought to understand what makes PPPs successful in different contexts. While trust has long been identified as a key component of successful strategic alliances in the private sector, less is known about how trust emerges between public- and private- sector partners, particularly in global health. Therefore, we investigated how trust between partners evolved in the context of Project Last Mile (PLM), a global health partnership that translates the business acumen of The Coca-Cola Company to strengthen public health systems across Africa. METHODS This study draws upon secondary analysis of qualitative data generated as part of the longitudinal, mixed-methods evaluation of PLM across country settings. Seventy-seven interviews with a purposeful sample of key stakeholders were conducted in Mozambique, South Africa and eSwatini between August 2016 and July 2018. Trained qualitative interviewers followed a standard discussion guide, and audio-recorded interviews with participants' consent. In this secondary analysis, we analyzed qualitative data to understand how trust between partners was cultivated across settings. RESULTS We drew upon stakeholder experiences to inform an inductive framework for how trust develops over time. Our analysis revealed five domains that were foundational to building trust: (1) reputational context, (2) team composition, (3) tangible outputs, (4) shared values, and (5) effective communication. CONCLUSION The framework may be useful for private and public sector entities seeking to establish and sustain trust within their global health partnerships.
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Affiliation(s)
- Sarah Christie
- Global Health Leadership Initiative, Yale School of Public Health, New Haven, CT, USA
| | | | - Leslie A. Curry
- Global Health Leadership Initiative, Yale School of Public Health, New Haven, CT, USA
| | - Emily Cherlin
- Global Health Leadership Initiative, Yale School of Public Health, New Haven, CT, USA
| | - Erika L. Linnander
- Global Health Leadership Initiative, Yale School of Public Health, New Haven, CT, USA
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Strasser S, Stauber C, Shrivastava R, Riley P, O’Quin K. Collective insights of public-private partnership impacts and sustainability: A qualitative analysis. PLoS One 2021; 16:e0254495. [PMID: 34283847 PMCID: PMC8291689 DOI: 10.1371/journal.pone.0254495] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 06/29/2021] [Indexed: 11/18/2022] Open
Abstract
The global Coronavirus or COVID-19 pandemic exposed the weakness of healthcare systems including laboratory systems and is a call to action for unprecedented collaboration and partnerships to deal with the global crisis. The United States (U.S.) President’s Emergency Plan for AIDS Relief (PEPFAR) establishes the global HIV/AIDS treatment agenda in alignment with the UNAIDS 90-90-90 treatment targets to achieve epidemic control related to enhanced testing, treatment, and viral suppression. A strategic PEPFAR priority area recognizes that large-scale collective efforts and sharing of resources bear greater potential impact for lasting change than any single organization or entity can achieve alone. An important vehicle utilized within the global public health context is the public-private partnership (PPP) model whereby multiple international organizations forge unified project charters to collectively reach mutually agreed goals. While touted as an ideal mechanism to synthesize resources and maximize gain in numerous applications, little is known from a seasoned stakeholder perspective regarding PPP implementation and sustainability issues. The purpose of this research is to holistically examine perceptions of PPP model sustainability related to inputs and impacts among a collective network of stakeholders experienced with PEPFAR workforce development, laboratory-system strengthening project implementation. Interviews were conducted with frontline stakeholders from public and private sector organizations based in the US and select PEPFAR-supported priority countries. Analysis revealed three dominant themes: PPP impacts, keys of successful collaboration, and logistical challenges and opportunities to enhance sustainability of PPP outcomes in the future.
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Affiliation(s)
- Sheryl Strasser
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, United States of America
- * E-mail:
| | - Christine Stauber
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, United States of America
| | - Ritu Shrivastava
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Patricia Riley
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Karen O’Quin
- Department of Sustainable Development, Region Värmland, Karlstad, Sweden
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Mushi BP, Mwachiro MM, Buckle G, Kaimila BN, Mulima G, Kayamba V, Kelly P, Akoko L, Mmbaga EJ, Selekwa M, Ringo Y, Pritchett N, White RE, Topazian MD, Fleischer DE, Dawsey SM, Van Loon K. Improving Access to Self-Expanding Metal Stents for Patients With Esophageal Cancer in Eastern Africa: A Stepwise Implementation Strategy. JCO Glob Oncol 2021; 7:118-126. [PMID: 33449802 PMCID: PMC8081508 DOI: 10.1200/go.20.00318] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/29/2020] [Accepted: 10/29/2020] [Indexed: 01/25/2023] Open
Abstract
PURPOSE The eastern corridor of Africa is affected by a high burden of esophageal cancer (EC), with > 90% of patients presenting with advanced disease. Self-expanding metal stents (SEMS) have been previously reported as safe and effective for palliation of malignant dysphagia in resource-limited settings; however, access is limited throughout Eastern Africa. METHODS In response to demand for palliative interventions for patients with dysphagia because of EC, the African Esophageal Cancer Consortium (AfrECC) partnered with the Clinton Health Access Initiative to improve access to SEMS in Eastern Africa. We undertook a stepwise implementation approach to (1) identify barriers to SEMS access, (2) conduct a market analysis, (3) select an industry partner, (4) establish regulatory and procurement processes, (5) develop endoscopic training resources, (6) create a medical device registry, and (7) establish principles of accountability. RESULTS Following an evaluation of market demand and potential SEMS manufacturers, Boston Scientific Corporation announced its commitment to launch an access program to provide esophageal SEMS to patients in Tanzania, Kenya, Malawi, and Zambia at a subsidized price. Parallel regulatory and procurement processes were established in each participating country. Endoscopy training courses were designed and conducted, using the Training-of-Trainers model. A device registry was created to centralize data for quality control and to monitor channels of SEMS distribution. Principles of accountability were developed to guide the sustainability of this endeavor. CONCLUSION The AfrECC Stent Access Initiative is an example of a multisector partnership formed to provide an innovative solution to align regional needs with a supply chain for a high-priority medical device.
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Affiliation(s)
- Beatrice P. Mushi
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Geoffrey Buckle
- Global Cancer Program, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (UCSF), San Francisco, CA
| | | | | | | | - Paul Kelly
- University of Zambia School of Medicine, Lusaka, Zambia
| | - Larry Akoko
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Elia J. Mmbaga
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Msiba Selekwa
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Yona Ringo
- Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Natalie Pritchett
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | | | | | | | - Sanford M. Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Katherine Van Loon
- Global Cancer Program, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco (UCSF), San Francisco, CA
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Ravi SJ, Warmbrod KL, Mullen L, Meyer D, Cameron E, Bell J, Bapat P, Paterra M, Machalaba C, Nath I, Gostin LO, James W, George D, Nikkari S, Gozzer E, Tomori O, Makumbi I, Nuzzo JB. The value proposition of the Global Health Security Index. BMJ Glob Health 2020; 5:e003648. [PMID: 33033053 PMCID: PMC7545501 DOI: 10.1136/bmjgh-2020-003648] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 12/20/2022] Open
Abstract
Infectious disease outbreaks pose major threats to human health and security. Countries with robust capacities for preventing, detecting and responding to outbreaks can avert many of the social, political, economic and health system costs of such crises. The Global Health Security Index (GHS Index)-the first comprehensive assessment and benchmarking of health security and related capabilities across 195 countries-recently found that no country is sufficiently prepared for epidemics or pandemics. The GHS Index can help health security stakeholders identify areas of weakness, as well as opportunities to collaborate across sectors, collectively strengthen health systems and achieve shared public health goals. Some scholars have recently offered constructive critiques of the GHS Index's approach to scoring and ranking countries; its weighting of select indicators; its emphasis on transparency; its focus on biosecurity and biosafety capacities; and divergence between select country scores and corresponding COVID-19-associated caseloads, morbidity, and mortality. Here, we (1) describe the practical value of the GHS Index; (2) present potential use cases to help policymakers and practitioners maximise the utility of the tool; (3) discuss the importance of scoring and ranking; (4) describe the robust methodology underpinning country scores and ranks; (5) highlight the GHS Index's emphasis on transparency and (6) articulate caveats for users wishing to use GHS Index data in health security research, policymaking and practice.
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Affiliation(s)
- Sanjana J Ravi
- Johns Hopkins Center for Health Security, Baltimore, Maryland, USA
| | | | - Lucia Mullen
- Johns Hopkins Center for Health Security, Baltimore, Maryland, USA
| | - Diane Meyer
- Johns Hopkins Center for Health Security, Baltimore, Maryland, USA
| | | | | | | | | | | | - Indira Nath
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, India
| | - Lawrence O Gostin
- O'Neill Institute for National and Global Health Law, Georgetown Law, Washington, DC, USA
| | - Wilmot James
- Institute for Social and Economic Research and Policy, Columbia University, New York, New York, USA
| | | | - Simo Nikkari
- Centre for Biothreat Preparedness, Helsinki, Finland
| | | | - Oyewale Tomori
- The Nigerian Academy of Science, Lagos, Nigeria
- College of Veterinary Surgeons of Nigeria, Abuja, Nigeria
| | - Issa Makumbi
- Republic of Uganda Ministry of Health, Kampala, Uganda
| | - Jennifer B Nuzzo
- Johns Hopkins Center for Health Security, Baltimore, Maryland, USA
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Rockers PC, Laing RO, Scott N, Ashigbie P, Lucca EH, Umeh CA, Wirtz VJ. Evaluation of pharmaceutical industry-led access programmes: a standardised framework. BMJ Glob Health 2019; 4:e001659. [PMID: 31423348 PMCID: PMC6688691 DOI: 10.1136/bmjgh-2019-001659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/15/2019] [Accepted: 07/20/2019] [Indexed: 11/17/2022] Open
Abstract
Pharmaceutical industry-led access programmes are increasing in number and scope worldwide. We present a new standardised framework for evaluation of these programmes that includes three components: a taxonomy of 11 access programme strategies; a series of logic models, one for each strategy and a set of measurement indicators. The logic models describe pathways of potential programme impact. Concepts relevant across a broad range of strategies were prioritised for inclusion in logic models to ensure consistency and to facilitate synthesis and learning across programmes. Each concept has at least one corresponding measurement indicator with metadata that includes the definition, details on how it should be measured and recommended data sources. The framework establishes a shared language for the collection and reporting of meaningful industry-led access programme information. Broad adoption by programme developers and implementing partners in the for-profit sector and beyond could facilitate shared learning on effective strategies and best practices.
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Affiliation(s)
- Peter C Rockers
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Richard O Laing
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA.,School of PublicHealth, Faculty of Community and Health Sciences, Universityof Western Cape, Cape Town, South Africa
| | - Nancy Scott
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Paul Ashigbie
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Erin H Lucca
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Chukwuemeka Anthony Umeh
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Veronika J Wirtz
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
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