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Istasy P, Lee WS, Iansavichene A, Upshur R, Gyawali B, Burkell J, Sadikovic B, Lazo-Langner A, Chin-Yee B. The Impact of Artificial Intelligence on Health Equity in Oncology: Scoping Review. J Med Internet Res 2022; 24:e39748. [PMID: 36005841 PMCID: PMC9667381 DOI: 10.2196/39748] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 08/11/2022] [Accepted: 08/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The field of oncology is at the forefront of advances in artificial intelligence (AI) in health care, providing an opportunity to examine the early integration of these technologies in clinical research and patient care. Hope that AI will revolutionize health care delivery and improve clinical outcomes has been accompanied by concerns about the impact of these technologies on health equity. OBJECTIVE We aimed to conduct a scoping review of the literature to address the question, "What are the current and potential impacts of AI technologies on health equity in oncology?" METHODS Following PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines for scoping reviews, we systematically searched MEDLINE and Embase electronic databases from January 2000 to August 2021 for records engaging with key concepts of AI, health equity, and oncology. We included all English-language articles that engaged with the 3 key concepts. Articles were analyzed qualitatively for themes pertaining to the influence of AI on health equity in oncology. RESULTS Of the 14,011 records, 133 (0.95%) identified from our review were included. We identified 3 general themes in the literature: the use of AI to reduce health care disparities (58/133, 43.6%), concerns surrounding AI technologies and bias (16/133, 12.1%), and the use of AI to examine biological and social determinants of health (55/133, 41.4%). A total of 3% (4/133) of articles focused on many of these themes. CONCLUSIONS Our scoping review revealed 3 main themes on the impact of AI on health equity in oncology, which relate to AI's ability to help address health disparities, its potential to mitigate or exacerbate bias, and its capability to help elucidate determinants of health. Gaps in the literature included a lack of discussion of ethical challenges with the application of AI technologies in low- and middle-income countries, lack of discussion of problems of bias in AI algorithms, and a lack of justification for the use of AI technologies over traditional statistical methods to address specific research questions in oncology. Our review highlights a need to address these gaps to ensure a more equitable integration of AI in cancer research and clinical practice. The limitations of our study include its exploratory nature, its focus on oncology as opposed to all health care sectors, and its analysis of solely English-language articles.
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Affiliation(s)
- Paul Istasy
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Rotman Institute of Philosophy, Western University, London, ON, Canada
| | - Wen Shen Lee
- Department of Pathology & Laboratory Medicine, Schulich School of Medicine, Western University, London, ON, Canada
| | | | - Ross Upshur
- Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - Bishal Gyawali
- Division of Cancer Care and Epidemiology, Department of Oncology, Queen's University, Kingston, ON, Canada
- Division of Cancer Care and Epidemiology, Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Jacquelyn Burkell
- Faculty of Information and Media Studies, Western University, London, ON, Canada
| | - Bekim Sadikovic
- Department of Pathology & Laboratory Medicine, Schulich School of Medicine, Western University, London, ON, Canada
| | - Alejandro Lazo-Langner
- Division of Hematology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Benjamin Chin-Yee
- Rotman Institute of Philosophy, Western University, London, ON, Canada
- Division of Hematology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Division of Hematology, Department of Medicine, London Health Sciences Centre, London, ON, Canada
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Chang P, Chen S, Chang X, Zhu J, Tang Q, Ma L. EXTL3 could serve as a potential biomarker of prognosis and immunotherapy for prostate cancer and its potential mechanisms. Eur J Med Res 2022; 27:115. [PMID: 35818069 PMCID: PMC9275153 DOI: 10.1186/s40001-022-00740-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 06/25/2022] [Indexed: 12/12/2022] Open
Abstract
Background Exostosin like glycosyltransferase 3 (EXTL3) had been reported to be associated with immune deficiency and play prognostic roles in various cancers. However, little is known about the associations between EXTL3 and prostate cancer (PCa). Hence, this article was designed to clarify their associations. Methods All original data were downloaded from The Cancer Genome Atlas (TCGA) database. Gene set enrichment analysis (GSEA) and CellMiner database was utilized, respectively, to identify EXTL3-related signaling pathways and drugs. We explored the relationships between EXTL3 expression and immunity to further evaluate the involvement of EXTL3 in response to immunotherapies. LncRNA/RBP/EXTL3 mRNA networks were also identified for its potential mechanism. Results Compared with normal prostate samples, EXTL3 was poorly expressed in PCa samples not only in mRNA expression levels, but also in protein expression levels, with worse overall survival (P < 0.05) and this gene could be an independent prognostic biomarker for PCa (both P < 0.05). EXTL3 was revealed to be markedly linked with seven signaling pathways in PCa by GSEA, including calcium, chemokine, ERBB, JAK STAT, MAPK, WNT, oxidative phosphorylation pathways. EXTL3 expression was also revealed to be significantly associated with MSI, immune cells, immune checkpoint molecules, tumor microenvironment and immune cells infiltration. We further predicted immune responses of EXTL3 gene to immunotherapies by TIDE database and the IMvigor210 cohort. A total of six LncRNA/RBP/EXTL3 mRNA networks were eventually identified for its potential mechanisms. Conclusions EXTL3 could serve as a potential biomarker of prognosis and immunotherapy for PCa and six LncRNA/RBP/EXTL3 mRNA networks were also identified for its potential mechanisms.
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Affiliation(s)
- Pingan Chang
- Nantong University, Nantong, 226001, Jiangsu, China.,Department of Urology, The Affiliated Dongtai Hospital of Nantong University, No.2 Fukang West Road, Yancheng, 224200, Jiangsu, China
| | - Shenglan Chen
- Department of Anesthesiology, The Affiliated Dongtai Hospital of Nantong University, Yancheng, 224200, Jiangsu, China
| | - Xiumei Chang
- Department of Urology, The Affiliated Dongtai Hospital of Nantong University, No.2 Fukang West Road, Yancheng, 224200, Jiangsu, China
| | - Jiaxi Zhu
- Nantong University, Nantong, 226001, Jiangsu, China
| | - Qingsheng Tang
- Department of Urology, The Affiliated Dongtai Hospital of Nantong University, No.2 Fukang West Road, Yancheng, 224200, Jiangsu, China.
| | - Limin Ma
- Department of Urology, Affiliated Hospital of Nantong University, No. 20 West Temple Road, Nantong, 226001, Jiangsu, China.
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A Staging Auxiliary Diagnosis Model for Nonsmall Cell Lung Cancer Based on the Intelligent Medical System. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2021; 2021:6654946. [PMID: 33628327 PMCID: PMC7886591 DOI: 10.1155/2021/6654946] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/15/2021] [Accepted: 01/30/2021] [Indexed: 11/17/2022]
Abstract
At present, human health is threatened by many diseases, and lung cancer is one of the most dangerous tumors that threaten human life. In most developing countries, due to the large population and lack of medical resources, it is difficult for doctors to meet patients' needs for medical treatment only by relying on the manual diagnosis. Based on massive medical information, the intelligent decision-making system has played a great role in assisting doctors in analyzing patients' conditions, improving the accuracy of clinical diagnosis, and reducing the workload of medical staff. This article is based on the data of 8,920 nonsmall cell lung cancer patients collected by different medical systems in three hospitals in China. Based on the intelligent medical system, on the basis of the intelligent medical system, this paper constructs a nonsmall cell lung cancer staging auxiliary diagnosis model based on convolutional neural network (CNNSAD). CNNSAD converts patient medical records into word sequences, uses convolutional neural networks to extract semantic features from patient medical records, and combines dynamic sampling and transfer learning technology to construct a balanced data set. The experimental results show that the model is superior to other methods in terms of accuracy, recall, and precision. When the number of samples reaches 3000, the accuracy of the system will reach over 80%, which can effectively realize the auxiliary diagnosis of nonsmall cell lung cancer and combine dynamic sampling and migration learning techniques to train nonsmall cell lung cancer staging auxiliary diagnosis models, which can effectively achieve the auxiliary diagnosis of nonsmall cell lung cancer. The simulation results show that the model is better than the other methods in the experiment in terms of accuracy, recall, and precision.
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