Artificial intelligence has the potential to deliver unprecedented value in healthcare, but the same capital challenges that persist in other areas of healthcare need to be addressed in the world of AI as well. Maia Hightower, PhD, MPH, MBA said in her talk. American Society of Gastrointestinal Endoscopy’s 2024 World Gastroenterology and Artificial Intelligence Summit.
Dr. Hightower, CEO of Equality AI, a healthcare AI quality assurance, risk management, and compliance consulting and software company, said AI has great potential to improve value, quality, cost, and patient and care team experience. I mentioned that there is. However, he added, “80% of AI projects in healthcare fail.”
Dr. Hightower noted that one of the persistent barriers to bringing AI into healthcare settings is AI bias and health inequalities, noting that “bias occurs throughout the lifecycle of AI.” .
Clinicians involved in using AI need to be aware of points in the process where bias can be introduced, she said. For example, at the data production level, real-world data may not be representative of the target population. Additionally, biases such as labeling errors can be introduced into model development, and model evaluations often exclude subpopulation analysis, she said. Decisions made during model implementation can also result in biased decision-making, she added.
Dr. Hightower shared the results of a study published in Science (2019;366(6464):447-453) that investigated bias in AI algorithms used in population health management. In the algorithm’s original form, black patients were 50% less likely to be referred for treatment than white patients, despite having the same disease. In this study, Ziad Obermeyer, MD, of the University of California, Berkeley, and colleagues modified the algorithm to reduce bias, resulting in 44% of black patients compared with 56% of white patients. resulting in referral for treatment.
AI quality assurance
Potential solutions to the problem of inequity in AI include involving more diverse teams in model creation and improving AI governance by involving patients, clinicians, ethicists, and other stakeholders. can be mentioned. Dr. Hightower said a responsible quality assurance and management platform for AI requires consistent monitoring, auditing, and validation.
Dr. Hightower encouraged clinicians to participate in improving AI wherever possible to increase the relevance and accuracy of models. Additionally, she said, “Clinicians need to monitor AI systems to ensure they are working as intended and providing safe and effective recommendations.” But it’s equally important for clinicians to understand the limitations of AI systems and to openly discuss concerns about them with colleagues, managers, and regulators to provide the best possible patient care. Dr. Hightower said. “AI promises many benefits, but clinicians have a critical role to play in ensuring these systems are used responsibly and safely.”
promise and danger
“AI has the potential to significantly improve equity in gastroenterology by addressing disparities in health care access, early diagnosis, and treatment outcomes among diverse populations,” said the summit joint statement. Chair and ASGE President Dr. Prateek Sharma told Gastroenterology & Endoscopy News.
“We are at a critical juncture, where the right AI tools, when used, can improve access to care in underserved areas, personalize risk assessments, and improve medical decisions. It is a capable AI tool that can have a significant impact on reducing bias, multilingual and cultural leverage in decisions,” said Dr. Sharma, a professor of medicine at the University of Kansas School of Medicine in Kansas City. .
Despite this potential, challenges to the use of AI to improve equity in gastroenterology include algorithmic bias, limited data availability and quality in underserved areas, and digital These include disparities in access to infrastructure, lack of trust in AI, and concerns, Dr. Sharma added. Patient privacy, consent, and data ownership. Gastroenterologists must be committed to addressing these issues.
—Heidi Sprite
Dr. Hightower is the co-founder and CEO of Equality AI. Dr. Sharma is a member of the editorial board of Gastroenterology and Endoscopy News.
This article is from the January 2025 print issue.
