Is it alright to use artificial intelligence in digital health? A systematic literature review on ethical considerations

Factors influencing digital health competence among healthcare professionals: A cross-sectional study

BACKGROUND

Improving healthcare professionals' digital health competence is critical to providing safer care. However, there is still a lack of empirical studies exploring the factors influencing healthcare professionals' digital health competence, even though significant investments have been made to advance digitalisation of healthcare globally.

AIM

This study aimed to identify the key characteristics influencing healthcare professionals' digital health competence.

METHODS

Cross-sectional data was collected from 252 healthcare professionals using two instruments measuring the digital health competences and the associated educational and organisational factors in 2024 via an online and paper-based survey. Univariate and binary logistic regression analyses were performed to identify the key characteristics influencing digital health competence.

RESULTS

Higher levels of education, working in a hospital, more professional experience, and increased use of digital solutions at work or during free time were associated with higher digital health competence. Higher qualifications were linked to greater digital health competence across several factors, with postgraduate degrees increasing health-related counselling competence and undergraduate degrees enhancing work-related attitudes and evaluating digital solutions. Professionals with university qualifications and those working in hospital settings showed higher ICT competence, while more years of professional experience increased ethical competence in using digital solutions.

CONCLUSIONS

Digital health competence development should prioritise healthcare professionals with lower educational levels. Additionally, such initiatives should include supporting those who work in non-hospital settings, have less professional experience, and use digital solutions less frequently at work or in their free time. Professional experience increases ethical competence in using digital solutions. Continuous professional development interventions and organisational policies should consider these factors to improve healthcare professionals' digital health competences.

Decoding AI ethics from Users' lens in education: A systematic review

In recent years, Artificial Intelligence (AI) has witnessed remarkable expansion, greatly benefiting the education sector. Nonetheless, this advancement brings forth several ethical dilemmas. The existing research on these ethical concerns within the educational framework is notably scarce, particularly when viewed from a user's standpoint. This research systematically reviewed 17 empirical articles from January 2018 to June 2023, sourced from peer-reviewed journals and conferences, to outlined existing ethical framework in Artificial Intelligence in Education (AIED), identify related concerns from user's perspectives, and construct Ethics Guideline for AIED. The finding revealed that certain ethical aspects, including the ethics of learning analytics and the ethics of algorithms in AIED, are often neglected in the existing ethical frameworks, principles, and standards for AIED. Based on the blank between existing ethical frameworks and ethic concerns from user's perspectives, the research proposes more inclusive and thoughtfully Ethics Guideline for AIED. The study also provides actionable recommendations for multiple stakeholders, emphasizing the need for guidelines that address user-centered concerns. In addition, How this Ethics Guideline for AIED could be developed is discussed, along with outlining potential avenues for future research.

Artificial intelligence - the emperor's new clothes?

There is a massive hype of artificial intelligence (AI) allegedly revolutionizing medicine. However, algorithms have been at the core of medicine for centuries and have been implemented in technologies such as computed tomography and magnetic resonance imaging machines for decades. They have given decision support in electrocardiogram machines without much attention. So, what is new with AI? To withstand the massive hype of AI, we should learn from the little child in H.C. Andersen's fairytale "The emperor's new clothes" revealing the collective figment of the emperor having new clothes. While AI certainly accelerates algorithmic medicine, we must learn from history and avoid implementing AI because it allegedly is new - we must implement it because we can demonstrate that it is useful.

Examining how Ethics in Relation to Health Technology is Described in the Research Literature: Scoping Review

BACKGROUND

Given the increased use of technology in health care, both in extent and application, the importance of understanding the ethical implications of new health technologies increases. Profound insight into the possible ethical implications of new health technologies enhances the research and development of such technologies and the likelihood of eventual successful implementation in clinical practice.

OBJECTIVE

This study aimed to gain an understanding of how and if researchers focused on health technologies describe the actual or possible ethical aspects of their research findings.

METHODS

An established framework for scoping reviews was used to guide the methodology. Studies published in PubMed over the last 10 years were included if they study or refer to ethics in relation to health technology as defined by established frameworks. In total, 14,532 articles were screened, 692 were retained for full-text evaluation, and 227 were included for data extraction.

RESULTS

In total, 250 (80.9%, N=309) studies were conducted in North America and Europe; literature review studies were dominant. Most studies (52.9%, 120/227) had no direct reference to any of the 4 basic ethical principles: beneficence, nonmaleficence, autonomy, and justice. In cases where studies referenced ethical theory, consequentialism dominated.

CONCLUSIONS

When research about technology and ethics is published, the predominant focus is on its intent rather than its actual effect on patients. This lack of insight is problematic considering the vast advancement of technology in which ethics cannot keep up with understanding and offer insights on addressing ethical issues. This finding has implications for practice, research, and education.

Determinants of the implementation of an artificial intelligence-supported device for the screening of diabetic retinopathy in primary care - a qualitative study

Diabetic retinopathy is a microvascular complication of diabetes mellitus that is usually asymptomatic in the early stages. Therefore, its timely detection and treatment are essential. First pilot projects exist to establish a smartphone-based and AI-supported screening of DR in primary care. This study explored health professionals' perceptions of potential barriers and enablers of using a screening such as this in primary care to understand the mechanisms that could influence implementation into routine clinical practice. Semi-structured telephone interviews were conducted and analysed with the help of qualitative analysis of Mayring. The following main influencing factors to implementation have been identified: personal attitude, organisation, time, financial factors, education, support, technical requirement, influence on profession and patient welfare. Most determinants could be relocated in the behaviour change wheel, a validated implementation model. Further research on the patients' perspective and a ranking of the determinants found is needed.