Transcript

Module 1 – Unit 1 : AI in Health Care

{00:00 – 00:28}

Welcome to this unit on Artificial Intelligence in Health Care.

By the end of this unit, you will be able to outline the use of artificial intelligence – or AI – in health care.

The use of AI in medicine raises notions of AI replacing clinicians and human decision-making.

However, the prevailing view is that AI is increasingly improving diagnosis and clinical care.

{00:28 – 01:55}

AI can support diagnosis in several ways, including radiology and medical imaging.

These applications are relatively novel and AI is not yet routinely used in clinical decision-making.

AI is currently being evaluated for use in:

• Radiological diagnosis in oncology – such as abdominal and pelvic imaging, colonoscopy and
mammography;
• Non-radiological application, such as dermatology and pathology;
• Diagnosis of diabetic retinopathy;
• Ophthalmology;
• And for RNA and DNA sequencing to guide immunotherapy.

low- and-middle-income countries, for example, AI may be used to:

• Improve detection of tuberculosis in a support system for interpreting staining images;

• Or scan X-rays for signs of tuberculosis, COVID-19 or other conditions.

However, few of these systems have been evaluated in prospective clinical trials.
As AI improves, it could allow medical providers to make faster, more accurate diagnoses.

For example, for the prompt detection of conditions such as:

• Stroke, pneumonia and breast cancer by imaging;

• Coronary heart disease by echocardiography;
• Or detection of cervical cancer.

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Module 1 – Unit 1 : AI in Health Care
{01:55 – 03:18}

AI could be used to support low-income settings, where there are chronic shortages of health care
services and skilled workers, by:

• Providing assistance in diagnosis and assessment;

• And thereby reducing workload on health care workers.

AI also has the potential to predict illness or major health events before they occur.

AI systems can support prevention research through analysing large amounts of data to identify patterns
which can enable the prediction of probable trends.

For example:

• AI could be adapted to assess the relative risk of disease, which could help prevent lifestyle
diseases such as cardiovascular disease and diabetes;

• It could be used to identify individuals with tuberculosis in low- and-middle-income countries,

who are not reached by the health system and therefore do not know their status;

• Predictive analysis could avert other causes of unnecessary morbidity and mortality in low- and-
middle-income countries, such as birth asphyxia.

Questions about the role of AI in health include:

• Whether the performance of AI can be generalized and regulated to implementation in practice;

• Whether AI trained for use in one context can be used accurately and safely in a different
geographical region or context, mitigating any risk of bias.

{03:18 – 04:18}

Let’s now look at applications of AI in clinical care. Clinicians could use AI to:

• Identify patients at risk and vulnerable groups;

• Aid difficult treatment decisions;
• Catch clinical errors.

In low- and-middle-income countries, for example, AI could be used in the management of antiretroviral
therapy by predicting resistance to HIV drugs. This could help physicians optimize diagnosis, prognosis
and treatment.

However, clinical experience and knowledge about patients is essential.

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Module 1 – Unit 1 : AI in Health Care
AI will not be a substitute for clinical due diligence for the foreseeable future.

If it did, clinicians might engage in “automation bias”, where the system is trusted based on perceived
accuracy and objectivity, without considering whether an AI technology meets their needs or those of
the patient.

{04:18 – 06:06}

The wider use of AI in medicine also has technological challenges.

Many prototypes have been developed and performed well in field tests, but they often cannot be
translated, commercialized or deployed.
AI task automation could give doctors more time to:

• Listen to patients;
• Address their fears and concerns;
• Ask about unrelated social factors.

However, it could also lead to an economically-driven approach to health care, resulting in patient
inequities.

For example, using AI for task automation may lead to a reduction in the number of staff required –
negating the potential increase in doctor/patient time or reducing human-contact services in some
areas.

As the use of AI increases, health care workers will also have to adapt their clinical practice. Doctors will
have to update their competence to:

• Understand how AI functions;

• Communicate risks;
• Make predictions and discuss trade-offs with patients;
• Express their ethical and legal concerns about AI technology.

Additional obstacles for health administration are:

• The ongoing changes in information technology management, whereby systems become

obsolete;
• The challenge of training staff to use new technologies;
• The lack of digital infrastructure, in resource-poor countries, which limit use of such
technologies.

You have now completed Unit 1 of Module 1: Applications of Artificial Intelligence for Health.

In the next unit, we will look at emerging trends in the use of AI for health.

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Module 1 – Unit 1 : AI in Health Care