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Gundlack J, Negash S, Thiel C, Buch C, Schildmann J, Unverzagt S, Mikolajczyk R, Frese T. Artificial Intelligence in Medical Care - Patients' Perceptions on Caregiving Relationships and Ethics: A Qualitative Study. Health Expect 2025; 28:e70216. [PMID: 40094179 PMCID: PMC11911933 DOI: 10.1111/hex.70216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2024] [Revised: 02/07/2025] [Accepted: 02/25/2025] [Indexed: 03/19/2025] Open
Abstract
INTRODUCTION Artificial intelligence (AI) offers several opportunities to enhance medical care, but practical application is limited. Consideration of patient needs is essential for the successful implementation of AI-based systems. Few studies have explored patients' perceptions, especially in Germany, resulting in insufficient exploration of perspectives of outpatients, older patients and patients with chronic diseases. We aimed to explore how patients perceive AI in medical care, focusing on relationships to physicians and ethical aspects. METHODS We conducted a qualitative study with six semi-structured focus groups from June 2022 to March 2023. We analysed data using a content analysis approach by systemising the textual material via a coding system. Participants were mostly recruited from outpatient settings in the regions of Halle and Erlangen, Germany. They were enrolled primarily through convenience sampling supplemented by purposive sampling. RESULTS Patients (N = 35; 13 females, 22 males) with a median age of 50 years participated. Participants were mixed in socioeconomic status and affinity for new technology. Most had chronic diseases. Perceived main advantages of AI were its efficient and flawless functioning, its ability to process and provide large data volume, and increased patient safety. Major perceived disadvantages were impersonality, potential data security issues, and fear of errors based on medical staff relying too much on AI. A dominant theme was that human interaction, personal conversation, and understanding of emotions cannot be replaced by AI. Participants emphasised the need to involve everyone in the informing process about AI. Most considered physicians as responsible for decisions resulting from AI applications. Transparency of data use and data protection were other important points. CONCLUSIONS Patients could generally imagine AI as support in medical care if its usage is focused on patient well-being and the human relationship is maintained. Including patients' needs in the development of AI and adequate communication about AI systems are essential for successful implementation in practice. PATIENT OR PUBLIC CONTRIBUTION Patients' perceptions as participants in this study were crucial. Further, patients assessed the presentation and comprehensibility of the research material during a pretest, and recommended adaptations were implemented. After each FG, space was provided for requesting modifications and discussion.
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Affiliation(s)
- Jana Gundlack
- Institute of General Practice & Family Medicine, Interdisciplinary Center of Health SciencesMedical Faculty of the Martin Luther University Halle‐WittenbergHalle (Saale)Germany
| | - Sarah Negash
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health SciencesMedical Faculty of the Martin Luther University Halle‐WittenbergHalle (Saale)Germany
| | - Carolin Thiel
- Institute of General Practice & Family Medicine, Interdisciplinary Center of Health SciencesMedical Faculty of the Martin Luther University Halle‐WittenbergHalle (Saale)Germany
- SRH University of Applied Health SciencesHeidelbergGermany
| | - Charlotte Buch
- Institute for History and Ethics of Medicine, Interdisciplinary Center for Health SciencesMedical Faculty of the Martin Luther University Halle‐WittenbergHalle (Saale)Germany
| | - Jan Schildmann
- Institute for History and Ethics of Medicine, Interdisciplinary Center for Health SciencesMedical Faculty of the Martin Luther University Halle‐WittenbergHalle (Saale)Germany
| | - Susanne Unverzagt
- Institute of General Practice & Family Medicine, Interdisciplinary Center of Health SciencesMedical Faculty of the Martin Luther University Halle‐WittenbergHalle (Saale)Germany
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health SciencesMedical Faculty of the Martin Luther University Halle‐WittenbergHalle (Saale)Germany
| | - Thomas Frese
- Institute of General Practice & Family Medicine, Interdisciplinary Center of Health SciencesMedical Faculty of the Martin Luther University Halle‐WittenbergHalle (Saale)Germany
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Li W, Shi HY, Chen XL, Lan JZ, Rehman AU, Ge MW, Shen LT, Hu FH, Jia YJ, Li XM, Chen HL. Application of artificial intelligence in medical education: A meta-ethnographic synthesis. MEDICAL TEACHER 2024:1-14. [PMID: 39480998 DOI: 10.1080/0142159x.2024.2418936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Accepted: 10/16/2024] [Indexed: 11/02/2024]
Abstract
With the advancement of Artificial Intelligence (AI), it has had a profound impact on medical education. Understanding the advantages and issues of AI in medical education, providing guidance for educators, and overcoming challenges in the implementation process is particularly important. The objective of this study is to explore the current state of AI applications in medical education. A systematic search was conducted across databases such as PsycINFO, CINAHL, Scopus, PubMed, and Web of Science to identify relevant studies. The Critical Appraisal Skills Programme (CASP) was employed for the quality assessment of these studies, followed by thematic synthesis to analyze the themes from the included research. Ultimately, 21 studies were identified, establishing four themes: (1) Shaping the Future: Current Trends in AI within Medical Education; (2) Advancing Medical Instruction: The Transformative Power of AI; (3) Navigating the Ethical Landscape of AI in Medical Education; (4) Fostering Synergy: Integrating Artificial Intelligence in Medical Curriculum. Artificial intelligence's role in medical education, while not yet extensive, is impactful and promising. Despite challenges, including ethical concerns over privacy, responsibility, and humanistic care, future efforts should focus on integrating AI through targeted courses to improve educational quality.
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Affiliation(s)
- Wei Li
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China
| | - Hai-Yan Shi
- Nantong University Affiliated Rugao Hospital, Rugao People's Hospital, Nantong, Jiangsu, China
| | - Xiao-Ling Chen
- Department of Respiratory Medicine, Dongtai People's Hospital, Yancheng, Jiangsu, China
| | - Jian-Zeng Lan
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China
| | - Attiq-Ur Rehman
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China
- Gulfreen Nursing College Avicenna Hospital Bedian, Lahore, Pakistan
| | - Meng-Wei Ge
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China
| | - Lu-Ting Shen
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China
| | - Fei-Hong Hu
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China
| | - Yi-Jie Jia
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China
| | - Xiao-Min Li
- Nantong First People's Hospital, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Hong-Lin Chen
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China
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Fazakarley CA, Breen M, Thompson B, Leeson P, Williamson V. Beliefs, experiences and concerns of using artificial intelligence in healthcare: A qualitative synthesis. Digit Health 2024; 10:20552076241230075. [PMID: 38347935 PMCID: PMC10860471 DOI: 10.1177/20552076241230075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/15/2024] Open
Abstract
Objective Artificial intelligence (AI) is a developing field in the context of healthcare. As this technology continues to be implemented in patient care, there is a growing need to understand the thoughts and experiences of stakeholders in this area to ensure that future AI development and implementation is successful. The aim of this study was to conduct a literature search of qualitative studies exploring the opinions of stakeholders such as clinicians, patients, and technology experts in order to establish the most common themes and ideas that have been presented in this research. Methods A literature search was conducted of existing qualitative research on stakeholder beliefs about the use of AI use in healthcare. Twenty-one papers were selected and analysed resulting in the development of four key themes relating to patient care, patient-doctor relationships, lack of education and resources, and the need for regulations. Results Overall, patients and healthcare workers are open to the use of AI in care and appear positive about potential benefits. However, concerns were raised relating to the lack of empathy in interactions of AI tools, and potential risks that may arise from the data collection needed for AI use and development. Stakeholders in the healthcare, technology, and business sectors all stressed that there was a lack of appropriate education, funding, and guidelines surrounding AI, and these concerns needed to be addressed to ensure future implementation is safe and suitable for patient care. Conclusion Ultimately, the results found in this study highlighted that there was a need for communication between stakeholder in order for these concerns to be addressed, mitigate potential risks, and maximise benefits for patients and clinicians alike. The results also identified a need for further qualitative research in this area to further understand stakeholder experiences as AI use continues to develop.
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Affiliation(s)
| | | | | | - Paul Leeson
- RDM Division of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Victoria Williamson
- King's Centre for Military Health Research, King's College London, London, UK
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Vo V, Chen G, Aquino YSJ, Carter SM, Do QN, Woode ME. Multi-stakeholder preferences for the use of artificial intelligence in healthcare: A systematic review and thematic analysis. Soc Sci Med 2023; 338:116357. [PMID: 37949020 DOI: 10.1016/j.socscimed.2023.116357] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/04/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION Despite the proliferation of Artificial Intelligence (AI) technology over the last decade, clinician, patient, and public perceptions of its use in healthcare raise a number of ethical, legal and social questions. We systematically review the literature on attitudes towards the use of AI in healthcare from patients, the general public and health professionals' perspectives to understand these issues from multiple perspectives. METHODOLOGY A search for original research articles using qualitative, quantitative, and mixed methods published between 1 Jan 2001 to 24 Aug 2021 was conducted on six bibliographic databases. Data were extracted and classified into different themes representing views on: (i) knowledge and familiarity of AI, (ii) AI benefits, risks, and challenges, (iii) AI acceptability, (iv) AI development, (v) AI implementation, (vi) AI regulations, and (vii) Human - AI relationship. RESULTS The final search identified 7,490 different records of which 105 publications were selected based on predefined inclusion/exclusion criteria. While the majority of patients, the general public and health professionals generally had a positive attitude towards the use of AI in healthcare, all groups indicated some perceived risks and challenges. Commonly perceived risks included data privacy; reduced professional autonomy; algorithmic bias; healthcare inequities; and greater burnout to acquire AI-related skills. While patients had mixed opinions on whether healthcare workers suffer from job loss due to the use of AI, health professionals strongly indicated that AI would not be able to completely replace them in their professions. Both groups shared similar doubts about AI's ability to deliver empathic care. The need for AI validation, transparency, explainability, and patient and clinical involvement in the development of AI was emphasised. To help successfully implement AI in health care, most participants envisioned that an investment in training and education campaigns was necessary, especially for health professionals. Lack of familiarity, lack of trust, and regulatory uncertainties were identified as factors hindering AI implementation. Regarding AI regulations, key themes included data access and data privacy. While the general public and patients exhibited a willingness to share anonymised data for AI development, there remained concerns about sharing data with insurance or technology companies. One key domain under this theme was the question of who should be held accountable in the case of adverse events arising from using AI. CONCLUSIONS While overall positivity persists in attitudes and preferences toward AI use in healthcare, some prevalent problems require more attention. There is a need to go beyond addressing algorithm-related issues to look at the translation of legislation and guidelines into practice to ensure fairness, accountability, transparency, and ethics in AI.
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Affiliation(s)
- Vinh Vo
- Centre for Health Economics, Monash University, Australia.
| | - Gang Chen
- Centre for Health Economics, Monash University, Australia
| | - Yves Saint James Aquino
- Australian Centre for Health Engagement, Evidence and Values, School of Health and Soceity, University of Wollongong, Australia
| | - Stacy M Carter
- Australian Centre for Health Engagement, Evidence and Values, School of Health and Soceity, University of Wollongong, Australia
| | - Quynh Nga Do
- Department of Economics, Monash University, Australia
| | - Maame Esi Woode
- Centre for Health Economics, Monash University, Australia; Monash Data Futures Research Institute, Australia
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Mumtaz H, Saqib M, Jabeen S, Muneeb M, Mughal W, Sohail H, Safdar M, Mehmood Q, Khan MA, Ismail SM. Exploring alternative approaches to precision medicine through genomics and artificial intelligence - a systematic review. Front Med (Lausanne) 2023; 10:1227168. [PMID: 37849490 PMCID: PMC10577305 DOI: 10.3389/fmed.2023.1227168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/20/2023] [Indexed: 10/19/2023] Open
Abstract
The core idea behind precision medicine is to pinpoint the subpopulations that differ from one another in terms of disease risk, drug responsiveness, and treatment outcomes due to differences in biology and other traits. Biomarkers are found through genomic sequencing. Multi-dimensional clinical and biological data are created using these biomarkers. Better analytic methods are needed for these multidimensional data, which can be accomplished by using artificial intelligence (AI). An updated review of 80 latest original publications is presented on four main fronts-preventive medicine, medication development, treatment outcomes, and diagnostic medicine-All these studies effectively illustrated the significance of AI in precision medicine. Artificial intelligence (AI) has revolutionized precision medicine by swiftly analyzing vast amounts of data to provide tailored treatments and predictive diagnostics. Through machine learning algorithms and high-resolution imaging, AI assists in precise diagnoses and early disease detection. AI's ability to decode complex biological factors aids in identifying novel therapeutic targets, allowing personalized interventions and optimizing treatment outcomes. Furthermore, AI accelerates drug discovery by navigating chemical structures and predicting drug-target interactions, expediting the development of life-saving medications. With its unrivaled capacity to comprehend and interpret data, AI stands as an invaluable tool in the pursuit of enhanced patient care and improved health outcomes. It's evident that AI can open a new horizon for precision medicine by translating complex data into actionable information. To get better results in this regard and to fully exploit the great potential of AI, further research is required on this pressing subject.
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Affiliation(s)
| | | | | | - Muhammad Muneeb
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Wajiha Mughal
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Hassan Sohail
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Myra Safdar
- Armed Forces Institute of Cardiology and National Institute of Heart Diseases (AFIC-NIHD), Rawalpindi, Pakistan
| | - Qasim Mehmood
- Department of Medicine, King Edward Medical University, Lahore, Pakistan
| | - Muhammad Ahsan Khan
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
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Koshmaganbetova G, Zhamaliyeva L, Abenova N, Dilmagambetova G, Zhylkybekova A, Tanbetova Z, Akhmetzhanova M, Tautanova A. Residents’ Perception of the Educational Program “Family Medicine” in Kazakhstan: A Focus Group Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Целью данного исследования было: восприятие обучения, мнение резидентов, обучающихся по программе «Семейная медицина», и определение потребности резидентов программы «Семейная медицина».
Методы . В этом качественном исследовании были проведены четыре полуторачасовых фокус-группы с 24 ординаторами, обучаемыми по программе резидентуры по семейной медицине Западно-Казахстанского университета, и результаты были проанализированы с использованием тематического анализа.
Результаты. Анализ появления пяти тем и 14 вопросов подтем, которые были классифицированы по областям для обсуждения в фокус-группах: восприятие особенности ФМ, Мотивация доходов, Преимущества и внешний вид категории товаров, Жалобы и проблемы, пожелания по просмотру программ, идеальное значение имеют.
Выводы. Это исследование выявления наличия жителей, которые ранее не учитывались в достаточной мере. Компетенции и содержание программы будут изменены в соответствии с назначением резидентов.
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Sony M, Antony J, McDermott O. The Impact of Healthcare 4.0 on the Healthcare Service Quality: A Systematic Literature Review. Hosp Top 2022; 101:288-304. [PMID: 35324390 DOI: 10.1080/00185868.2022.2048220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Healthcare 4.0 is inspired by Industry 4.0 and its application has resulted in a paradigmatic shift in the field of healthcare. However, the impact of this digital revolution in the healthcare system on healthcare service quality is not known. The purpose of this study is to examine the impact of healthcare 4.0 on healthcare service quality. This study used the systematic literature review methodology suggested by Transfield et al. to critically examine 67 articles. The impact of healthcare 4.0 is analyzed in-depth in terms of the interpersonal, technical, environmental, and administrative aspect of healthcare service quality. This study will be useful to hospitals and other stakeholders to understand the impact of healthcare 4.0 on the service quality of health systems. Besides, this study critically analyses the existing literature and identifies research areas in this field and hence will be beneficial to researchers. Though there are few literature reviews in healthcare 4.0, this is the first study to examine the impact of Healthcare 4.0 on healthcare service quality.
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Affiliation(s)
- Michael Sony
- WITS Business School, University of Witwatersrand, Johannesburg, South Africa
| | - Jiju Antony
- Industrial and Systems Engineering, Khalifa University, Abu Dhabi, UAE
| | - Olivia McDermott
- College of Engineering and Science, National University of Ireland, Gallway, Ireland
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