Bridging the Gap or Widening the Divide: A Call for Capacity-Building in Artificial Intelligence for Healthcare in the Philippines

Kurt Lenard T Gutierrez, P. M. Viacrusis
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Abstract

The emerging field of generative artificial intelligence (GAI) and some of its well-known technologies: ChatGPT, Google Bard and Claude, have gained substantial popularity due to their enormous potential in healthcare applications, as seen in medically fine-tuned models such as Med-PaLM and ChatDoctor. While these advancements are impressive, the dependence of AI development on data volume and quality raises questions about the generalizability of these models. Regions with lower medical research output risk bias and misrepresentation in AI-generated content, especially when used to assist clinical practice. Upon testing of a prompt concerning the isoniazid dosing of Filipinos versus other ethnic and racial groups, responses from GPT-4, GPT-3, Bard and Claude resulted in 3 out of 4 outputs showing convincing but false content, with extended prompting illustrating how response hallucination happens in GAI models. To address this, model refinement techniques such as fine-tuning and prompt ensembles are suggested; however, refining AI models for local contextualization requires data availability, data quality and quality assurance frameworks. Clinicians and researchers in the Philippines and other underrepresented regions are called to initiate capacity-building efforts to prepare for AI in healthcare. Early efforts from all stakeholders are needed to prevent the exacerbation of health inequities, especially in the new clinical frontiers brought about by GAI. Keywords: Artificial Intelligence, Bias, ChatGPT, Healthcare, Philippines
缩小差距还是扩大鸿沟?呼吁菲律宾开展人工智能医疗保健能力建设
新兴的生成式人工智能(GAI)领域及其一些著名的技术:正如 Med-PaLM 和 ChatDoctor 等医学微调模型所示,ChatGPT、Google Bard 和 Claude 因其在医疗保健应用中的巨大潜力而大受欢迎。虽然这些进步令人印象深刻,但人工智能的发展对数据量和质量的依赖性也引发了对这些模型通用性的质疑。医学研究成果较少的地区有可能在人工智能生成的内容中出现偏差和错误表述,尤其是在用于辅助临床实践时。在测试有关菲律宾人与其他民族和种族群体的异烟肼剂量的提示时,GPT-4、GPT-3、Bard 和 Claude 的回答导致 4 项输出中有 3 项显示出令人信服但虚假的内容,扩展提示说明了 GAI 模型是如何产生幻觉的。为解决这一问题,建议采用微调和提示组合等模型完善技术;然而,针对本地情况完善人工智能模型需要数据可用性、数据质量和质量保证框架。我们呼吁菲律宾和其他代表性不足地区的临床医生和研究人员启动能力建设工作,为医疗保健领域的人工智能做好准备。所有利益相关者都需要尽早做出努力,以防止医疗不平等的加剧,尤其是在全球人工智能带来的新临床领域。关键词人工智能 偏差 ChatGPT 医疗保健 菲律宾
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