医疗保健中的生成式人工智能:关于应用、整合和治理的实施科学转化路径。

IF 8.8 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Sandeep Reddy
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引用次数: 0

摘要

背景:人工智能(AI),尤其是生成式人工智能,已成为医疗保健领域的一种变革性工具,具有彻底改变临床决策和改善健康结果的潜力。生成式人工智能能够生成文本和图像等新数据,有望加强患者护理、彻底改变疾病诊断和扩大治疗选择。然而,人们对生成式人工智能在医疗保健领域的效用和影响仍然知之甚少,对其伦理和医疗法律影响、与医疗保健服务提供的整合以及劳动力利用等方面存在担忧。此外,在医疗保健服务中实施和整合生成式人工智能还没有明确的途径:本文旨在全面概述生成式人工智能在医疗保健领域的应用,重点关注该技术在医疗保健领域的实用性及其转化应用,强调在临床医学中采用生成式人工智能时需要仔细规划、执行和管理预期。主要考虑因素包括数据隐私、安全性和临床医生专业知识的不可替代作用等。技术接受模型(TAM)和非采用、放弃、推广、普及和可持续性(NASSS)模型等框架被认为是促进负责任整合的方法。这些框架可以预测并主动解决采用障碍,促进利益相关者的参与,并以负责任的方式使护理系统过渡到利用生成式人工智能的潜力:通过自动化系统、强化临床决策和专业知识民主化,以及诊断支持工具提供及时、个性化的建议,生成式人工智能有可能改变医疗保健。生成式人工智能在计费、诊断、治疗和研究方面的应用也能使医疗服务更加高效、公平和有效。然而,要整合生成式人工智能,就必须制定细致的变革管理和风险缓解战略。仅靠技术能力无法在一夜之间改变复杂的医疗生态系统;相反,以实施科学为基础的结构化采用计划势在必行:本文有力地论证了,如果以负责任的方式引入人工智能,将为医疗保健带来巨大的进步。以实施科学为基础的战略性采用、渐进式部署以及围绕机遇与限制的平衡信息传递,有助于促进安全、合乎道德的生成式人工智能整合。应根据临床优先事项进行广泛的实际试点和迭代,以推动发展。通过以人类福祉而非技术新颖性为中心的有意识治理,人工智能生成技术可以提高医疗服务的可及性、可负担性和质量。随着这些模式的不断快速发展,围绕其优缺点进行持续的重新评估和透明的沟通对于恢复信任、实现积极的潜力,以及最重要的是改善患者的治疗效果仍然至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Generative AI in healthcare: an implementation science informed translational path on application, integration and governance.

Background: Artificial intelligence (AI), particularly generative AI, has emerged as a transformative tool in healthcare, with the potential to revolutionize clinical decision-making and improve health outcomes. Generative AI, capable of generating new data such as text and images, holds promise in enhancing patient care, revolutionizing disease diagnosis and expanding treatment options. However, the utility and impact of generative AI in healthcare remain poorly understood, with concerns around ethical and medico-legal implications, integration into healthcare service delivery and workforce utilisation. Also, there is not a clear pathway to implement and integrate generative AI in healthcare delivery.

Methods: This article aims to provide a comprehensive overview of the use of generative AI in healthcare, focusing on the utility of the technology in healthcare and its translational application highlighting the need for careful planning, execution and management of expectations in adopting generative AI in clinical medicine. Key considerations include factors such as data privacy, security and the irreplaceable role of clinicians' expertise. Frameworks like the technology acceptance model (TAM) and the Non-Adoption, Abandonment, Scale-up, Spread and Sustainability (NASSS) model are considered to promote responsible integration. These frameworks allow anticipating and proactively addressing barriers to adoption, facilitating stakeholder participation and responsibly transitioning care systems to harness generative AI's potential.

Results: Generative AI has the potential to transform healthcare through automated systems, enhanced clinical decision-making and democratization of expertise with diagnostic support tools providing timely, personalized suggestions. Generative AI applications across billing, diagnosis, treatment and research can also make healthcare delivery more efficient, equitable and effective. However, integration of generative AI necessitates meticulous change management and risk mitigation strategies. Technological capabilities alone cannot shift complex care ecosystems overnight; rather, structured adoption programs grounded in implementation science are imperative.

Conclusions: It is strongly argued in this article that generative AI can usher in tremendous healthcare progress, if introduced responsibly. Strategic adoption based on implementation science, incremental deployment and balanced messaging around opportunities versus limitations helps promote safe, ethical generative AI integration. Extensive real-world piloting and iteration aligned to clinical priorities should drive development. With conscientious governance centred on human wellbeing over technological novelty, generative AI can enhance accessibility, affordability and quality of care. As these models continue advancing rapidly, ongoing reassessment and transparent communication around their strengths and weaknesses remain vital to restoring trust, realizing positive potential and, most importantly, improving patient outcomes.

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来源期刊
Implementation Science
Implementation Science 医学-卫生保健
CiteScore
14.30
自引率
11.10%
发文量
78
审稿时长
4-8 weeks
期刊介绍: Implementation Science is a leading journal committed to disseminating evidence on methods for integrating research findings into routine healthcare practice and policy. It offers a multidisciplinary platform for studying implementation strategies, encompassing their development, outcomes, economics, processes, and associated factors. The journal prioritizes rigorous studies and innovative, theory-based approaches, covering implementation science across various healthcare services and settings.
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