Clinician voices on ethics of LLM integration in healthcare: a thematic analysis of ethical concerns and implications

IF 3.3 3区医学 Q2 MEDICAL INFORMATICS

BMC Medical Informatics and Decision Making Pub Date : 2024-09-09 DOI:10.1186/s12911-024-02656-3

Tala Mirzaei, Leila Amini, Pouyan Esmaeilzadeh

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引用次数: 0

Abstract

This study aimed to explain and categorize key ethical concerns about integrating large language models (LLMs) in healthcare, drawing particularly from the perspectives of clinicians in online discussions. We analyzed 3049 posts and comments extracted from a self-identified clinician subreddit using unsupervised machine learning via Latent Dirichlet Allocation and a structured qualitative analysis methodology. Analysis uncovered 14 salient themes of ethical implications, which we further consolidated into 4 overarching domains reflecting ethical issues around various clinical applications of LLM in healthcare, LLM coding, algorithm, and data governance, LLM’s role in health equity and the distribution of public health services, and the relationship between users (human) and LLM systems (machine). Mapping themes to ethical frameworks in literature illustrated multifaceted issues covering transparent LLM decisions, fairness, privacy, access disparities, user experiences, and reliability. This study emphasizes the need for ongoing ethical review from stakeholders to ensure responsible innovation and advocates for tailored governance to enhance LLM use in healthcare, aiming to improve clinical outcomes ethically and effectively.

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临床医生对将法律硕士纳入医疗保健的伦理问题的看法：对伦理问题和影响的专题分析

本研究旨在解释和归类在医疗保健领域整合大型语言模型（LLMs）的关键伦理问题，特别是借鉴临床医生在在线讨论中的观点。我们通过 Latent Dirichlet Allocation 无监督机器学习和结构化定性分析方法，分析了从一个自称临床医生的 subreddit 中提取的 3049 篇帖子和评论。通过分析，我们发现了 14 个具有伦理意义的突出主题，并将这些主题进一步整合为 4 个总体领域，分别反映了 LLM 在医疗保健领域的各种临床应用、LLM 编码、算法和数据管理、LLM 在健康公平和公共卫生服务分配中的作用以及用户（人类）与 LLM 系统（机器）之间的关系等方面的伦理问题。将主题与文献中的伦理框架进行映射，可以发现多方面的问题，包括透明的 LLM 决策、公平性、隐私、访问差异、用户体验和可靠性。本研究强调了利益相关者持续进行伦理审查的必要性，以确保负责任的创新，并倡导有针对性的治理，以加强 LLM 在医疗保健领域的应用，从而以合乎伦理的方式有效改善临床结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Medical Informatics and Decision Making 医学-医学：信息

CiteScore

7.20

自引率

5.70%

发文量

297

审稿时长

1 months

期刊介绍： BMC Medical Informatics and Decision Making is an open access journal publishing original peer-reviewed research articles in relation to the design, development, implementation, use, and evaluation of health information technologies and decision-making for human health.