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Arora A, Alderman JE, Palmer J, Ganapathi S, Laws E, McCradden MD, Oakden-Rayner L, Pfohl SR, Ghassemi M, McKay F, Treanor D, Rostamzadeh N, Mateen B, Gath J, Adebajo AO, Kuku S, Matin R, Heller K, Sapey E, Sebire NJ, Cole-Lewis H, Calvert M, Denniston A, Liu X. The value of standards for health datasets in artificial intelligence-based applications. Nat Med 2023; 29:2929-2938. [PMID: 37884627 PMCID: PMC10667100 DOI: 10.1038/s41591-023-02608-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023]
Abstract
Artificial intelligence as a medical device is increasingly being applied to healthcare for diagnosis, risk stratification and resource allocation. However, a growing body of evidence has highlighted the risk of algorithmic bias, which may perpetuate existing health inequity. This problem arises in part because of systemic inequalities in dataset curation, unequal opportunity to participate in research and inequalities of access. This study aims to explore existing standards, frameworks and best practices for ensuring adequate data diversity in health datasets. Exploring the body of existing literature and expert views is an important step towards the development of consensus-based guidelines. The study comprises two parts: a systematic review of existing standards, frameworks and best practices for healthcare datasets; and a survey and thematic analysis of stakeholder views of bias, health equity and best practices for artificial intelligence as a medical device. We found that the need for dataset diversity was well described in literature, and experts generally favored the development of a robust set of guidelines, but there were mixed views about how these could be implemented practically. The outputs of this study will be used to inform the development of standards for transparency of data diversity in health datasets (the STANDING Together initiative).
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Affiliation(s)
- Anmol Arora
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Joseph E Alderman
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- National Institute for Health and Care Research Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
| | - Joanne Palmer
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- National Institute for Health and Care Research Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
| | | | - Elinor Laws
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- National Institute for Health and Care Research Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
| | - Melissa D McCradden
- Department of Bioethics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Genetics and Genome Biology, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Lauren Oakden-Rayner
- The Australian Institute for Machine Learning, University of Adelaide, Adelaide, South Australia, Australia
| | | | - Marzyeh Ghassemi
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
- Institute for Medical Engineering & Science, Massachusetts Institute of Technology, Cambridge, MA, USA
- Vector Institute, Toronto, Ontario, Canada
| | - Francis McKay
- The Ethox Centre and the Wellcome Centre for Ethics and Humanities, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Darren Treanor
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
- University of Leeds, Leeds, UK
- Department of Clinical Pathology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden
| | | | - Bilal Mateen
- Institute for Health Informatics, University College London, London, UK
- Wellcome Trust, London, UK
| | - Jacqui Gath
- Patient and Public Involvement and Engagement (PPIE) Group, STANDING Together, Birmingham, UK
| | - Adewole O Adebajo
- Patient and Public Involvement and Engagement (PPIE) Group, STANDING Together, Birmingham, UK
| | | | - Rubeta Matin
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | - Elizabeth Sapey
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- National Institute for Health and Care Research Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
- PIONEER, HDR UK Hub in Acute Care, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Neil J Sebire
- National Institute for Health and Care Research, Great Ormond Street Hospital Biomedical Research Centre, London, UK
- Great Ormond Street Institute of Child Health, University Hospital London, London, UK
| | | | - Melanie Calvert
- National Institute for Health and Care Research Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research Applied Research Collaboration West Midlands, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research Birmingham-Oxford Blood and Transplant Research Unit in Precision Transplant and Cellular Therapeutics, University of Birmingham, Birmingham, UK
- DEMAND Hub, University of Birmingham, Birmingham, UK
- UK SPINE, University of Birmingham, Birmingham, UK
| | - Alastair Denniston
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- National Institute for Health and Care Research Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research Biomedical Research Centre, Moorfields Eye Hospital/University College London, London, UK
| | - Xiaoxuan Liu
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
- National Institute for Health and Care Research Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK.
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Ganapathi S, Duggal S. Exploring the experiences and views of doctors working with Artificial Intelligence in English healthcare; a qualitative study. PLoS One 2023; 18:e0282415. [PMID: 36862694 PMCID: PMC9980725 DOI: 10.1371/journal.pone.0282415] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/14/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND The National Health Service (NHS) aspires to be a world leader of Artificial Intelligence (AI) in healthcare, however, there are several barriers facing translation and implementation. A key enabler of AI within the NHS is the education and engagement of doctors, however evidence suggests that there is an overall lack of awareness of and engagement with AI. RESEARCH AIM This qualitative study explores the experiences and views of doctor developers working with AI within the NHS exploring; their role within medical AI discourse, their views on the implementation of AI more widely and how they consider the engagement of doctors with AI technologies may increase in the future. METHODS This study involved eleven semi-structured, one-to-one interviews conducted with doctors working with AI in English healthcare. Data was subjected to thematic analysis. RESULTS The findings demonstrate that there is an unstructured pathway for doctors to enter the field of AI. The doctors described the various challenges they had experienced during their career, with many arising from the differing demands of operating in a commercial and technological environment. The perceived awareness and engagement among frontline doctors was low, with two prominent barriers being the hype surrounding AI and a lack of protected time. The engagement of doctors is vital for both the development and adoption of AI. CONCLUSIONS AI offers big potential within the medical field but is still in its infancy. For the NHS to leverage the benefits of AI, it must educate and empower current and future doctors. This can be achieved through; informative education within the medical undergraduate curriculum, protecting time for current doctors to develop understanding and providing flexible opportunities for NHS doctors to explore this field.
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Affiliation(s)
- Shaswath Ganapathi
- University of Birmingham Medical School, Birmingham, United Kingdom
- * E-mail:
| | - Sandhya Duggal
- University of Birmingham Medical School, Birmingham, United Kingdom
- The Strategy Unit, Midlands Lancashire Commissioning Support Unit, Leyland, United Kingdom
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Ganapathi S, Palmer J, Alderman JE, Calvert M, Espinoza C, Gath J, Ghassemi M, Heller K, Mckay F, Karthikesalingam A, Kuku S, Mackintosh M, Manohar S, Mateen BA, Matin R, McCradden M, Oakden-Rayner L, Ordish J, Pearson R, Pfohl SR, Rostamzadeh N, Sapey E, Sebire N, Sounderajah V, Summers C, Treanor D, Denniston AK, Liu X. Tackling bias in AI health datasets through the STANDING Together initiative. Nat Med 2022; 28:2232-2233. [PMID: 36163296 DOI: 10.1038/s41591-022-01987-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Shaswath Ganapathi
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Jo Palmer
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Joseph E Alderman
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Melanie Calvert
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK.,Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK.,NIHR Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK.,NIHR Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, UK.,NIHR Applied Research Collaborative West Midlands University of Birmingham, Birmingham, UK
| | | | - Jacqui Gath
- Patient Partner, Birmingham, UK.,Patient Partner, Sheffield, UK
| | - Marzyeh Ghassemi
- Department of Electrical Engineering and Computer Science; Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | - Francis Mckay
- The Ethox Centre and the Wellcome Centre for Ethics and Humanities, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Stephanie Kuku
- Institute of Women's Health, University College London, London, UK.,Hardian Health, London, UK
| | | | | | - Bilal A Mateen
- Institute of Health Informatics, University College London, London, UK.,The Wellcome Trust, London, UK
| | - Rubeta Matin
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Melissa McCradden
- Department of Bioethics, Hospital for Sick Children, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Lauren Oakden-Rayner
- Australian Institute for Machine Learning, University of Adelaide, Adelaide, South Australia, Australia
| | - Johan Ordish
- Medicines and Healthcare Products Regulatory Agency, London, UK
| | - Russell Pearson
- Medicines and Healthcare Products Regulatory Agency, London, UK
| | | | | | - Elizabeth Sapey
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Neil Sebire
- Health Data Research, London, UK.,Great Ormond Street Hospital for Children, London, UK
| | - Viknesh Sounderajah
- Institute of Global Health Innovation, Imperial College London, London, UK.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - Charlotte Summers
- Wolfson Lung Injury Unit, Heart and Lung Research Institute, University of Cambridge, Cambrdige, UK.,Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Darren Treanor
- Leeds Teaching Hospitals NHS Trust, Leeds, UK.,University of Leeds, Leeds, UK.,Department of Clinical Pathology, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Alastair K Denniston
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.,Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK.,NIHR Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK.,Health Data Research, London, UK
| | - Xiaoxuan Liu
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. .,Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. .,Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK.
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