肿瘤学中人工智能伦理部署的过程框架

2022-08-16 13:45

在对人工智能毫无保留的热情的背景下，这些不同的担忧挑战了肿瘤人工智能被广泛实施和伦理上可接受的未来。我们建议采用以流程为中心的方法在癌症治疗中部署人工智能，例如合理框架(A4R) 问责制，可以解决这些问题，并实现一个在伦理上部署肿瘤人工智能的未来。

SCI

15 August 2022

A Process Framework for Ethically Deploying Artificial Intelligence in Oncology

(J Clin Oncol, IF: 50.717)

Hantel A, Clancy DD, Kehl KL, Marron JM, Van Allen EM, Abel GA. A Process Framework for Ethically Deploying Artificial Intelligence in Oncology. J Clin Oncol 2022:JCO2201113. DOI: 10.1200/JCO.22.01113.

CORRESPONDING AUTHOR：Andrew Hantel, MD, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215; e-mail: andrew_hantel@dfci.harvard.edu.

Artificial Intelligence (AI) is an emerging technology that uses complex algorithms to arrive at an outcome over a range of circumstances, leveraging the ability of computer systems to perform tasks that would usually require human levels of intelligence. The use of AI in cancer care is rapidly expanding: a May 2022 PubMed search of the term cross-referenced with cancer revealed approximately 26,000 citations, with more than 60% published in the past five years. Ethical considerations for AI in oncology include patient equity, privacy, and autonomy; the roles of human- and machine-based judgment; and the patient-oncologist relationship. Relative to other parts of medicine, the implications of oncology AI are outsized, and some are idiosyncratic. Oncology AI tools apply to not one but two genomes (germline and somatic); can greatly complicate the existing weight of bias, discrimination, and structural racism in cancer care; and can subtly undermine patient and physician autonomy, leading to cancer care that is algorithmic rather than patient-centered. These diverse concerns, in the context of unreserved enthusiasm for AI, challenge a future where oncology AI is both widely implemented and ethically acceptable. We propose that adapting a process-focused approach for deploying AI in cancer care, such as the accountability for reasonableness framework (A4R), can address these concerns and realize a future where oncology AI is ethically deployed.

人工智能(AI)是一项新兴技术，它利用复杂的算法在一系列情况下得出结果，利用计算机系统的能力来执行通常需要人类智能水平的任务。人工智能在癌症治疗中的应用正在迅速扩大：2022年5月，PubMed对与癌症相关的术语的搜索显示了约2.6万次引用，其中60%以上是在过去5年发表的。人工智能在肿瘤学领域的伦理考虑包括患者的公平、隐私和自主权；基于人类和机器判断的角色；还有病人和肿瘤医生的关系。相对于医学的其他部分，肿瘤人工智能的影响是巨大的，有些是特殊的。肿瘤人工智能工具不只适用于一个，而是两个基因组(生殖系和体细胞系)；可极大地复杂化癌症治疗中现有的偏见，歧视和结构性种族主义；而且会潜移默化地削弱病人和医生的自主权，导致癌症治疗以算法为中心，而不是以病人为中心。在对人工智能毫无保留的热情的背景下，这些不同的担忧挑战了肿瘤人工智能被广泛实施和伦理上可接受的未来。我们建议采用以流程为中心的方法在癌症治疗中部署人工智能，例如合理框架(A4R) 问责制，可以解决这些问题，并实现一个在伦理上部署肿瘤人工智能的未来。