通过透明度和问责制,防止在医疗保健中不受限制和监控的AI实验
Donnella S Comeau1,2, Danielle S Bitterman3,4, Leo Anthony Celi5,6
1Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. dscomeau@bidmc.harvard.edu.
NPJ digital medicine
|January 18, 2025
概括
电子健康记录中的大型语言模型 (LLM) 提供了好处,但也带来了风险,如未经同意的数据使用和偏见. 患者安全需要道德实践和监督,以防止AI在医疗保健中的危害.
科学领域:
- 医疗信息学 医疗信息学
- 医疗保健中的人工智能
- 生物伦理学生物伦理学
背景情况:
- 电子健康记录 (EHR) 越来越多地结合了先进的AI,包括大型语言模型 (LLM).
- 在医疗保健提供和管理方面,LLM具有显著的潜在益处.
- 然而,它们的整合引入了复杂的伦理,法律和运营挑战.
研究的目的:
- 识别和分析与将LLMs整合到EHRs相关的伦理,法律和运营方面的担忧.
- 突出风险,如未经同意的数据使用,不充分的治理和对人工智能相关不当行为的问责制.
- 提出保护患者,特别是弱势群体的策略.
主要方法:
- 在医疗保健环境中对当前的LLM应用进行文献审查和伦理分析.
- 检查潜在的偏差 (例如,曲,反循环偏差) 和数据重复使用风险.
- 评估现有和拟议的AI在医学中的治理框架.
主要成果:
- 在EHR中集成LLM带来了未经同意的数据使用风险,缺乏明确的治理,以及在分配不当行为责任方面面临的挑战.
- 潜在的偏差放大 (sycophancy,反循环) 和数据重复使用没有适当的监督可以加剧错误.
- 在没有适当的保障措施的情况下,脆弱的患者群体面临更高的风险.
结论:
- 强有力的伦理准则和治理对于在EHR中安全有效地部署LLM至关重要.
- 临床医生必须积极倡导以患者为中心的教育和道德的人工智能实践.
- 实施强有力的监督机制对于减轻风险和防止患者受到伤害至关重要.
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