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Alberto IRI, Alberto NRI, Altinel Y, Blacker S, Binotti WW, Celi LA, Chua T, Fiske A, Griffin M, Karaca G, Mokolo N, Naawu DKN, Patscheider J, Petushkov A, Quion JM, Senteio C, Taisbak S, Tırnova İ, Tokashiki H, Velasquez A, Yaghy A, Yap K. A scientometric analysis of fairness in health AI literature. PLOS Glob Public Health 2024; 4:e0002513. [PMID: 38241250 PMCID: PMC10798451 DOI: 10.1371/journal.pgph.0002513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 12/07/2023] [Indexed: 01/21/2024]
Abstract
Artificial intelligence (AI) and machine learning are central components of today's medical environment. The fairness of AI, i.e. the ability of AI to be free from bias, has repeatedly come into question. This study investigates the diversity of members of academia whose scholarship poses questions about the fairness of AI. The articles that combine the topics of fairness, artificial intelligence, and medicine were selected from Pubmed, Google Scholar, and Embase using keywords. Eligibility and data extraction from the articles were done manually and cross-checked by another author for accuracy. Articles were selected for further analysis, cleaned, and organized in Microsoft Excel; spatial diagrams were generated using Public Tableau. Additional graphs were generated using Matplotlib and Seaborn. Linear and logistic regressions were conducted using Python to measure the relationship between funding status, number of citations, and the gender demographics of the authorship team. We identified 375 eligible publications, including research and review articles concerning AI and fairness in healthcare. Analysis of the bibliographic data revealed that there is an overrepresentation of authors that are white, male, and are from high-income countries, especially in the roles of first and last author. Additionally, analysis showed that papers whose authors are based in higher-income countries were more likely to be cited more often and published in higher impact journals. These findings highlight the lack of diversity among the authors in the AI fairness community whose work gains the largest readership, potentially compromising the very impartiality that the AI fairness community is working towards.
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Affiliation(s)
| | | | - Yuksel Altinel
- Bagcilar Research and Training Hospital, General Surgery Department, University of Health Sciences, Istanbul, Turkey
| | - Sarah Blacker
- Department of Social Science, York University, Toronto, Ontario, Canada
| | - William Warr Binotti
- New England Eye Center, Tufts Medical Center, Boston, Massachusetts, United States of America
| | - Leo Anthony Celi
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Tiffany Chua
- University of San Francisco, San Francisco, California, United States of America
| | - Amelia Fiske
- Institute for History and Ethics in Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - Molly Griffin
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Gulce Karaca
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Nkiruka Mokolo
- Meharry Medical College School of Medicine, Nashville, Tennessee, United States of America
| | - David Kojo N Naawu
- Meharry Medical College School of Medicine, Nashville, Tennessee, United States of America
| | | | - Anton Petushkov
- University of Michigan, Ann Arbor, Michigan, United States of America
| | - Justin Michael Quion
- University of the East Ramon Magsaysay Memorial Medical Center Inc, Quezon City, Philippines
| | - Charles Senteio
- Department of Library and Information Science, Rutgers University School of Communication and Information, New Brunswick, New Jersey, United States of America
| | | | - İsmail Tırnova
- Department of General Surgery, Baskent University School of Medicine, Istanbul, Turkey
| | - Harumi Tokashiki
- Department of Medicine, Carney Hospital, Boston, Massachusetts, United States of America
| | - Adrian Velasquez
- Department of Medicine, Carney Hospital, Boston, Massachusetts, United States of America
- Warren Alpert School of Medicine at Brown University, Providence, Rhode Island, United States of America
| | - Antonio Yaghy
- New England Eye Center, Boston, Massachusetts, United States of America
| | - Keagan Yap
- Harvard College, Cambridge, Massachusetts, United States of America
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Alberto IRI, Alberto NRI, Marcelo AB. Call to action for global and national actors for open health data. PLOS Digit Health 2023; 2:e0000320. [PMID: 37552658 PMCID: PMC10409293 DOI: 10.1371/journal.pdig.0000320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Affiliation(s)
| | | | - Alvin B. Marcelo
- Medical Informatics Unit, College of Medicine, University of the Philippines, Manila, Metro Manila, Philippines
- Department of Surgery, Philippine General Hospital, Manila, Metro Manila, Philippines
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Yaghy A, Alberto NRI, Alberto IRI, Bermea RS, Ristovska L, Yaghy M, Hoyek S, Patel NA, Celi LA. The potential use of non-fungible tokens (NFTs) in healthcare and medical research. PLOS Digit Health 2023; 2:e0000312. [PMID: 37498836 PMCID: PMC10374113 DOI: 10.1371/journal.pdig.0000312] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Non-fungible tokens (NFTs) are cryptographic assets recorded on the blockchain that can certify authenticity and ownership, and they can be used to monetize health data, optimize the process of receiving a hematopoietic stem cell transplant, and improve the distribution of solid organs for transplantation. Blockchain technology, including NFTs, provides equitable access to wealth, increases transparency, eliminates personal or institutional biases of intermediaries, reduces inefficiencies, and ensures accountability. Blockchain architecture is ideal for ensuring security and privacy while granting individuals jurisdiction over their own information, making it a unique solution to the current limitations of existing health information systems. NFTs can be used to give patients the option to monetize their health data and provide valuable data to researchers. Wearable technology companies can also give their customers the option to monetize their data while providing data necessary to improve their products. Additionally, the process of receiving a hematopoietic stem cell transplant and the distribution of solid organs for transplantation could benefit from the integration of NFTs into the allocation process. However, there are limitations to the technology, including high energy consumption and the need for regulatory guidance. Further research is necessary to fully understand the potential of NFTs in healthcare and how it can be integrated with existing health information technology. Overall, NFTs have the potential to revolutionize the healthcare sector, providing benefits such as improved access to health information and increased efficiency in the distribution of organs for transplantation.
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Affiliation(s)
- Antonio Yaghy
- New England Eye Center, Tufts University Medical Center, Boston, Massachusetts, United States of America
| | | | | | - Rene S. Bermea
- Division of Pulmonary & Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Ljubica Ristovska
- Harvard University, Faculty of Arts and Sciences, Department of Economics, Cambridge, Massachusetts, United States of America
| | - Maria Yaghy
- Centre Hospitalier Universitaire Timone Enfants, Marseille, France
| | - Sandra Hoyek
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Nimesh A. Patel
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Ophthalmology, Boston Children’s Hospital, Boston, Massachusetts, United States of America
| | - Leo Anthony Celi
- Laboratory for Computational Physiology, MIT Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- Information Systems, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
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Alberto IRI, Alberto NRI, Ghosh AK, Jain B, Jayakumar S, Martinez-Martin N, McCague N, Moukheiber D, Moukheiber L, Moukheiber M, Moukheiber S, Yaghy A, Zhang A, Celi LA. The impact of commercial health datasets on medical research and health-care algorithms. Lancet Digit Health 2023; 5:e288-e294. [PMID: 37100543 PMCID: PMC10155113 DOI: 10.1016/s2589-7500(23)00025-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/26/2022] [Accepted: 02/03/2023] [Indexed: 04/28/2023]
Abstract
As the health-care industry emerges into a new era of digital health driven by cloud data storage, distributed computing, and machine learning, health-care data have become a premium commodity with value for private and public entities. Current frameworks of health data collection and distribution, whether from industry, academia, or government institutions, are imperfect and do not allow researchers to leverage the full potential of downstream analytical efforts. In this Health Policy paper, we review the current landscape of commercial health data vendors, with special emphasis on the sources of their data, challenges associated with data reproducibility and generalisability, and ethical considerations for data vending. We argue for sustainable approaches to curating open-source health data to enable global populations to be included in the biomedical research community. However, to fully implement these approaches, key stakeholders should come together to make health-care datasets increasingly accessible, inclusive, and representative, while balancing the privacy and rights of individuals whose data are being collected.
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Affiliation(s)
| | | | - Arnab K Ghosh
- Department of Medicine, Weill Cornell Medical College, Cornell University, New York, NY, USA
| | - Bhav Jain
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | | | - Ned McCague
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA; Markforged, Watertown, MA, USA
| | - Dana Moukheiber
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Lama Moukheiber
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Mira Moukheiber
- The Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Sulaiman Moukheiber
- Department of Computer Science, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Antonio Yaghy
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA; New England Eye Center, Tufts University Medical Center, Boston, MA, USA
| | - Andrew Zhang
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
| | - Leo Anthony Celi
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, USA.
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Suanes PN, Alberto NRI, Alberto IRI, Swami N, Eala MAB, Tangco ED, Dee EC. Lung cancer screening in the Philippines: the need for guidelines based on the local context and the imperative for improved access to screening. Lancet Reg Health West Pac 2023; 32:100704. [PMID: 36866270 PMCID: PMC9971506 DOI: 10.1016/j.lanwpc.2023.100704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/04/2023] [Accepted: 01/17/2023] [Indexed: 02/18/2023]
Affiliation(s)
| | | | | | - Nishwant Swami
- University of Massachusetts Medical School, Worcester, MA, USA
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michelle Ann B. Eala
- College of Medicine, University of the Philippines, Manila, Philippines
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA
| | - Enrico D. Tangco
- Department of Radiation Oncology, The Medical City, Pasig City, Philippines
| | - Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Alberto NRI, Alberto IRI, Puyat CVM, Antonio MAR, Ho FDV, Dee EC, Mahal BA, Eala MAB. Disparities in access to cancer diagnostics in ASEAN member countries. Lancet Reg Health West Pac 2023; 32:100667. [PMID: 36785859 PMCID: PMC9918780 DOI: 10.1016/j.lanwpc.2022.100667] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/30/2022] [Indexed: 01/09/2023]
Abstract
Diagnostics, including laboratory tests, medical and nuclear imaging, and molecular testing, are essential in the diagnosis and management of cancer to optimize clinical outcomes. With the continuous rise in cancer mortality and morbidity in the Association of Southeast Asian Nations (ASEAN), there exists a critical need to evaluate the accessibility of cancer diagnostics in the region so as to direct multifaceted interventions that will address regional inequities and inadequacies in cancer care. This paper identifies existing gaps in service delivery, health workforce, health information systems, leadership and governance, and financing and how these contribute to disparities in access to cancer diagnostics in ASEAN member countries. Intersectoral health policies that will strengthen coordinated laboratory services, upscale infrastructure development, encourage health workforce production, and enable proper appropriation of funding are necessary to effectively reduce the regional cancer burden.
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Affiliation(s)
| | | | | | | | | | - Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Brandon A. Mahal
- Department of Radiation Oncology, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Michelle Ann B. Eala
- College of Medicine, University of the Philippines, Manila, Philippines,Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA,Corresponding author.
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Arevalo MVPN, Robredo JPG, Valenzuela S, Ho FDV, Alberto NRI, Alberto IRI, Bernardo MNG, Manlongat KD, Garcia AMU, Galvez Tan JZ, Dee EC, Eala MAB. The role of traditional, complementary, and alternative medicine in cancer care in the Philippines. Chin Clin Oncol 2022; 11:49. [PMID: 36632981 DOI: 10.21037/cco-22-91] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 12/20/2022] [Indexed: 01/01/2023]
Affiliation(s)
| | | | - Sary Valenzuela
- University of the East Ramon Magsaysay Memorial Medical Center, Inc., Quezon City, Philippines
| | | | | | | | | | | | - Ann Meredith U Garcia
- Section of Medical Oncology, Dagupan Doctors Villaflor Memorial Hospital, Dagupan City, Philippines
| | | | - Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Michelle Ann B Eala
- College of Medicine, University of the Philippines, Manila, Philippines; Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA
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Suanes PN, Alberto NRI, Alberto IRI, Eala MAB. Gambling disorder. Lancet Psychiatry 2022; 9:429-430. [PMID: 35569497 DOI: 10.1016/s2215-0366(22)00105-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 11/20/2022]
Affiliation(s)
- Patricia N Suanes
- College of Medicine, University of the Philippines, Manila 1000, Philippines
| | | | | | - Michelle Ann B Eala
- College of Medicine, University of the Philippines, Manila 1000, Philippines.
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Bernardo MNG, Alberto IRI, Alberto NRI, Eala MAB, Roa CC. The way forward for drug-resistant tuberculosis in the Philippines. The Lancet Infectious Diseases 2022; 22:760. [PMID: 35643095 PMCID: PMC9132560 DOI: 10.1016/s1473-3099(22)00285-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 11/30/2022]
Affiliation(s)
| | - Isabelle Rose I Alberto
- College of Medicine, Philippine General Hospital, University of the Philippines, Manila 1000, Philippines
| | - Nicole Rose I Alberto
- College of Medicine, Philippine General Hospital, University of the Philippines, Manila 1000, Philippines
| | - Michelle Ann B Eala
- College of Medicine, Philippine General Hospital, University of the Philippines, Manila 1000, Philippines
| | - Camilo C Roa
- Department of Physiology, Philippine General Hospital, University of the Philippines, Manila 1000, Philippines.
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Alberto IRI, Alberto NRI, Eala MAB, Mata MKM, Yao JS. Inequities in alcohol-related harm in the Philippines. Lancet Gastroenterol Hepatol 2022; 7:387-388. [PMID: 35397240 DOI: 10.1016/s2468-1253(22)00053-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 02/16/2022] [Indexed: 06/14/2023]
Affiliation(s)
| | | | | | - Maria Katrina M Mata
- Department of Internal Medicine, Philippine General Hospital, Manila, Philippines
| | - Jasper Seth Yao
- Department of Internal Medicine, Albert Einstein Medical Center, Philadelphia, PA 19141, USA.
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Affiliation(s)
| | | | | | - Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Johanna Patricia A Cañal
- Department of Radiology, College of Medicine, University of the Philippines, Manila, Philippines
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Baticulon RE, Sy JJ, Alberto NRI, Baron MBC, Mabulay REC, Rizada LGT, Tiu CJS, Clarion CA, Reyes JCB. Barriers to Online Learning in the Time of COVID-19: A National Survey of Medical Students in the Philippines. Med Sci Educ 2021; 31:615-626. [PMID: 33649712 PMCID: PMC7904236 DOI: 10.1007/s40670-021-01231-z] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 05/14/2023]
Abstract
INTRODUCTION In March 2020, the coronavirus disease 2019 (COVID-19) pandemic forced medical schools in the Philippines to stop face-to-face learning activities and abruptly shift to an online curriculum. This study aimed to identify barriers to online learning from the perspective of medical students in a developing country. METHODS The authors sent out an electronic survey to medical students in the Philippines from 11 to 24 May 2020. Using a combination of multiple-choice, Likert scale, and open-ended questions, the following data were obtained: demographics, medical school information, access to technological resources, study habits, living conditions, self-assessment of capacity for and perceived barriers to online learning, and proposed interventions. Descriptive statistics were calculated. Responses were compared between student subgroups using nonparametric tests. RESULTS Among 3670 medical students, 93% owned a smartphone and 83% had a laptop or desktop computer. To access online resources, 79% had a postpaid internet subscription while 19% used prepaid mobile data. Under prevailing conditions, only 1505 students (41%) considered themselves physically and mentally capable of engaging in online learning. Barriers were classified under five categories: technological, individual, domestic, institutional, and community barriers. DISCUSSION Medical students in the Philippines confronted several interrelated barriers as they tried to adapt to online learning. Most frequently encountered were difficulty adjusting learning styles, having to perform responsibilities at home, and poor communication between educators and learners. By implementing student-centered interventions, medical schools and educators play a significant role in addressing these challenges during the COVID-19 pandemic and beyond. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-021-01231-z.
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Affiliation(s)
- Ronnie E. Baticulon
- Department of Anatomy, University of the Philippines College of Medicine, Manila, Philippines
- Division of Neurosurgery, Department of Neurosciences, Philippine General Hospital, Manila, Philippines
| | - Jinno Jenkin Sy
- University of the Philippines College of Medicine, Manila, Philippines
| | | | | | | | | | | | - Charlie A. Clarion
- Section of Pulmonary Medicine, Department of Internal Medicine, Philippine General Hospital, University of the Philippines, Manila, Philippines
| | - John Carlo B. Reyes
- National Institutes of Health, University of the Philippines Manila, Manila, Philippines
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