Special Issue: Emerging Trends of AI in Healthcare and Medicine

Introduction: “Democratizing” artificial intelligence (AI) in medicine and healthcare is a vague term that encompasses various meanings, issues, and visions. This article maps the ways this term is used in discourses on AI in medicine and healthcare and uses this map for a normative reflection on how to direct AI in medicine and healthcare towards desirable futures. Methods: We searched peer-reviewed articles from Scopus, Google Scholar, and PubMed along with grey literature using search terms “democrat*”, “artificial intelligence” and “machine learning”. We approached both as documents and analyzed them qualitatively, asking: What is the object of democratization? What should be democratized, and why? Who is the demos who is said to benefit from democratization? And what kind of theories of democracy are (tacitly) tied to specific uses of the term? Results: We identified four clusters of visions of democratizing AI in healthcare and medicine: 1) democratizing medicine and healthcare through AI, 2) multiplying the producers and users of AI, 3) enabling access to and oversight of data, and 4) making AI an object of democratic governance. Discussion: The envisioned democratization in most visions mainly focuses on patients as consumers and relies on or limits itself to free market-solutions. Democratization in this context requires defining and envisioning a set of social goods, and deliberative processes and modes of participation to ensure that those affected by AI in healthcare have a say on its development and use.

A study on the regulation of artificial intelligence (AI) in healthcare, includes a brief overview of the current state of use of AI in healthcare and its potential benefits and risks. The article summarizes the current regulations that exist for AI in healthcare, including any relevant laws, guidelines, and best practices, including information on regulatory bodies such as the FDA and HIPAA. The ethical considerations arising from the use of AI in healthcare, such as patient confidentiality and data security, bias in algorithms, and transparency in decision making, are given. Examples of AI in healthcare are given that illustrate the challenges and opportunities provided by the technology, including both successful and unsuccessful implementations. Future developments in AI and healthcare are described, including emerging technologies and trends, and predictions of how rules might evolve in response to these developments. Summarize and provide recommendations for addressing regulatory challenges related to AI in healthcare.

The successful implementation of artificial intelligence (AI) in health care depends on its acceptance by key stakeholders, particularly patients, who are the primary beneficiaries of AI-driven outcomes. To survey hospital patients to investigate their trust, concerns, and preferences toward the use of AI in health care and diagnostics and to assess the sociodemographic factors associated with patient attitudes. This cross-sectional study developed and implemented an anonymous quantitative survey between February 1 and November 1, 2023, using a nonprobability sample at 74 hospitals in 43 countries. Participants included hospital patients 18 years of age or older who agreed with voluntary participation in the survey presented in 1 of 26 languages. Information sheets and paper surveys handed out by hospital staff and posted in conspicuous hospital locations. The primary outcome was participant responses to a 26-item instrument containing a general data section (8 items) and 3 dimensions (trust in AI, AI and diagnosis, preferences and concerns toward AI) with 6 items each. Subgroup analyses used cumulative link mixed and binary mixed-effects models. In total, 13 806 patients participated, including 8951 (64.8%) in the Global North and 4855 (35.2%) in the Global South. Their median (IQR) age was 48 (34-62) years, and 6973 (50.5%) were male. The survey results indicated a predominantly favorable general view of AI in health care, with 57.6% of respondents (7775 of 13 502) expressing a positive attitude. However, attitudes exhibited notable variation based on demographic characteristics, health status, and technological literacy. Female respondents (3511 of 6318 [55.6%]) exhibited fewer positive attitudes toward AI use in medicine than male respondents (4057 of 6864 [59.1%]), and participants with poorer health status exhibited fewer positive attitudes toward AI use in medicine (eg, 58 of 199 [29.2%] with rather negative views) than patients with very good health (eg, 134 of 2538 [5.3%] with rather negative views). Conversely, higher levels of AI knowledge and frequent use of technology devices were associated with more positive attitudes. Notably, fewer than half of the participants expressed positive attitudes regarding all items pertaining to trust in AI. The lowest level of trust was observed for the accuracy of AI in providing information regarding treatment responses (5637 of 13 480 respondents [41.8%] trusted AI). Patients preferred explainable AI (8816 of 12 563 [70.2%]) and physician-led decision-making (9222 of 12 652 [72.9%]), even if it meant slightly compromised accuracy. In this cross-sectional study of patient attitudes toward AI use in health care across 6 continents, findings indicated that tailored AI implementation strategies should take patient demographics, health status, and preferences for explainable AI and physician oversight into account.

Recent developments in the application of artificial intelligence (AI) in health care promise to solve many of the existing global problems in improving human health care and managing global legal challenges. In addition to machine learning techniques, artificial intelligence is currently being applied in health care in other forms, such as robotic systems. However, the artificial intelligence currently used in health care is not fully autonomous, given that health care professionals make the final decision. Therefore, the most prevalent legal issues relating to the application of artificial intelligence are patient safety, impact on patient-physician relationship, physician’s responsibility, the right to privacy, data protection, intellectual property protection, lack of proper regulation, algorithmic transparency and governance of artificial intelligence empowered health care. Hence, the aim of this research is to point out the possible legal consequences and challenges of regulation and control in the application of artificial intelligence in health care. The results of this paper confirm the potential of artificial intelligence to noticeably improve patient care and advance medical research, but the shortcomings of its implementation relate to a complex legal and ethical issue that remains to be resolved. In this regard, it is necessary to achieve a broad social consensus regarding the application of artificial intelligence in health care, and adopt legal frameworks that determine the conditions for its application.

The integration of artificial intelligence (AI) in healthcare has the potential to revolutionize the industry by improving patient outcomes and increasing efficiency. However, the rapid development and implementation of AI technologies raise complex legal issues and challenges. This article explores the key legal aspects of AI integration in healthcare, including data privacy and security, liability and accountability, intellectual property, and regulatory compliance. It examines relevant international and national legal instruments, regulations, and guidelines, as well as industry-specific standards that apply to AI in healthcare. The study also analyzes case studies and practical applications to highlight legal challenges and resolutions, lessons learned, and best practices. The discussion addresses the implications of the results, comparing the legal landscape for AI in healthcare to other industries and countries and highlighting potential future legal developments and challenges. The conclusion summarizes key findings, offers recommendations for integrating AI in healthcare systems while addressing legal concerns, and proposes future directions for legal research and policy development in the context of AI and healthcare. This comprehensive analysis aims to inform healthcare providers, AI developers, and policymakers on the legal landscape surrounding AI in healthcare, providing valuable insights to navigate this complex domain and harness the potential of AI to transform healthcare delivery.

The rapid development of artificial intelligence (AI) in healthcare has exposed the unmet need for growing a multidisciplinary workforce that can collaborate effectively in the learning health systems. Maximizing the synergy among multiple teams is critical for Collaborative AI in Healthcare. We have developed a series of data, tools, and educational resources for cultivating the next generation of multidisciplinary workforce for Collaborative AI in Healthcare. We built bulk-natural language processing pipelines to extract structured information from clinical notes and stored them in common data models. We developed multimodal AI/machine learning (ML) tools and tutorials to enrich the toolbox of the multidisciplinary workforce to analyze multimodal healthcare data. We have created a fertile ground to cross-pollinate clinicians and AI scientists and train the next generation of AI health workforce to collaborate effectively. Our work has democratized access to unstructured health information, AI/ML tools and resources for healthcare, and collaborative education resources. From 2017 to 2022, this has enabled studies in multiple clinical specialties resulting in 68 peer-reviewed publications. In 2022, our cross-discipline efforts converged and institutionalized into the Center for Collaborative AI in Healthcare. Our Collaborative AI in Healthcare initiatives has created valuable educational and practical resources. They have enabled more clinicians, scientists, and hospital administrators to successfully apply AI methods in their daily research and practice, develop closer collaborations, and advanced the institution-level learning health system.

The development of Artificial Intelligence (AI) in healthcare has had a significant impact on healthcare. AI in healthcare can provide more accurate diagnoses and interventions for patients. AI can predict, diagnose, and treat diseases, facilitate the maximum use of healthcare resources by integrating medical information, increase efficiency, and reduce overcrowding of healthcare resources. However, the application of AI in healthcare also faces challenges such as accountability, algorithmic security, and data privacy. This paper discusses the application of AI in healthcare and explores the challenges faced by AI, in-cluding accountability traceability, algorithmic safety, data security, and ethical issues, and makes targeted recommendations. This study provides an in-depth exploration of the application of AI in healthcare, helping to improve the accuracy and efficiency of AI ap-plications in healthcare, as well as providing necessary guidance and references for opti-mizing and enhancing AI technologies.

This chapter addresses the current and future challenges of implementing artificial intelligence (AI) in brain and mental health by exploring international regulations of healthcare and AI, and how human rights play a role in these regulations. First, a broad perspective of human rights in AI and human rights in healthcare is reviewed, then regulations of AI in healthcare are discussed, and finally applications of human rights in AI and brain and mental health regulations are considered. The foremost challenge in the blending and development of regulations of AI in healthcare is that currently both AI and healthcare lack accepted international-level regulation. It can be argued that human rights and human rights law are for the most part internationally accepted, and we can use these rights as guidelines for global regulations. However, as philosophical and ethical environments vary across nations, subsequent policies reflect varying conceptions and fulfillments of human rights. Like human rights, the recognized definitions of “AI” and “health” can vary across international borders and even vary within the professions themselves. One of the biggest challenges in the future of AI in brain and mental health will be applying human rights in a practical manner. Initially, the thought of applying human rights in the development of AI in healthcare seems straightforward. In order to develop better AI, better healthcare and, thus, better AI in healthcare, one must simply respect the human rights that are granted by various declarations, covenants, and constitutions. This is so seemingly straightforward that one would think this has already been the case in these developing fields. However, as we explore this notion of applying human rights, we find agreement, disagreement, and variability on a global scale. It is these variabilities that may well hamper the ethical development of AI in brain and mental health internationally.

The purpose of this research is to identify and evaluate the technical, ethical and regulatory challenges related to the use of Artificial Intelligence (AI) in healthcare. The potential applications of AI in healthcare seem limitless and vary in their nature and scope, ranging from privacy, research, informed consent, patient autonomy, accountability, health equity, fairness, AI-based diagnostic algorithms to care management through automation for specific manual activities to reduce paperwork and human error. The main challenges faced by states in regulating the use of AI in healthcare were identified, especially the legal voids and complexities for adequate regulation and better transparency. A few recommendations were made to protect health data, mitigate risks and regulate more efficiently the use of AI in healthcare through international cooperation and the adoption of harmonized standards under the World Health Organization (WHO) in line with its constitutional mandate to regulate digital and public health. European Union (EU) law can serve as a model and guidance for the WHO for a reform of the International Health Regulations (IHR).

The adoption of artificial intelligence (AI) in healthcare is rapidly expanding, transforming areas such as diagnostics, drug discovery, and patient monitoring. Despite these advances, public perceptions of AI in healthcare, particularly in Canada, remain underexplored. This study investigates the relationship between Canadians' knowledge, comfort, and trust in AI, focusing on key sociodemographic factors like age, gender, education, and income. Using data from the 2021 Canadian Digital Health Survey of 12,052 respondents, we employed ordinal logistic and multivariate polynomial regression analyses to uncover trends and disparities. Findings reveal that women and older adults consistently report lower levels of knowledge and comfort with AI, with middle-aged women expressing the most significant discomfort. Comfort levels are closely tied to concerns over data privacy, especially regarding the use of identifiable personal health data. Healthcare professionals exhibited heightened discomfort with AI, indicating potential issues with trust in AI’s reliability and ethical governance. Our results underscore that increasing knowledge alone does not necessarily lead to greater comfort with AI in healthcare. Addressing public concerns through robust data governance, transparency, and inclusive AI design is essential to fostering trust and successful integration of AI in healthcare systems.

BackgroundThe successful integration of artificial intelligence (AI) in healthcare depends on the global perspectives of all stakeholders. This study aims to answer the research question: What are the attitudes of medical, dental, and veterinary students towards AI in education and practice, and what are the regional differences in these perceptions?MethodsAn anonymous online survey was developed based on a literature review and expert panel discussions. The survey assessed students' AI knowledge, attitudes towards AI in healthcare, current state of AI education, and preferences for AI teaching. It consisted of 16 multiple-choice items, eight demographic queries, and one free-field comment section. Medical, dental, and veterinary students from various countries were invited to participate via faculty newsletters and courses. The survey measured technological literacy, AI knowledge, current state of AI education, preferences for AI teaching, and attitudes towards AI in healthcare using Likert scales. Data were analyzed using descriptive statistics, Mann–Whitney U-test, Kruskal–Wallis test, and Dunn-Bonferroni post hoc test.ResultsThe survey included 4313 medical, 205 dentistry, and 78 veterinary students from 192 faculties and 48 countries. Most participants were from Europe (51.1%), followed by North/South America (23.3%) and Asia (21.3%). Students reported positive attitudes towards AI in healthcare (median: 4, IQR: 3–4) and a desire for more AI teaching (median: 4, IQR: 4–5). However, they had limited AI knowledge (median: 2, IQR: 2–2), lack of AI courses (76.3%), and felt unprepared to use AI in their careers (median: 2, IQR: 1–3). Subgroup analyses revealed significant differences between the Global North and South (r = 0.025 to 0.185, all P < .001) and across continents (r = 0.301 to 0.531, all P < .001), with generally small effect sizes.ConclusionsThis large-scale international survey highlights medical, dental, and veterinary students' positive perceptions of AI in healthcare, their strong desire for AI education, and the current lack of AI teaching in medical curricula worldwide. The study identifies a need for integrating AI education into medical curricula, considering regional differences in perceptions and educational needs.Trial registrationNot applicable (no clinical trial).

The convergence of healthcare with the Internet of Things (IoT) and Artificial Intelligence (AI) is reshaping medical practice with promising enhanced data-driven insights, automated decision-making, and remote patient monitoring. It has the transformative potential of these technologies to revolutionize diagnosis, treatment, and patient care. This study aims to explore the integration of IoT and AI in healthcare, outlining their applications, benefits, challenges, and potential risks. By synthesizing existing literature, this study aims to provide insights into the current landscape of AI, IoT, and AIoT in healthcare, identify areas for future research and development, and establish a framework for the effective use of AI in health. A comprehensive literature review included indexed databases such as PubMed/Medline, Scopus, and Google Scholar. Key search terms related to IoT, AI, healthcare, and medicine were employed to identify relevant studies. Papers were screened based on their relevance to the specified themes, and eventually, a selected number of papers were methodically chosen for this review. The integration of IoT and AI in healthcare offers significant advancements, including remote patient monitoring, personalized medicine, and operational efficiency. Wearable sensors, cloud-based data storage, and AI-driven algorithms enable real-time data collection, disease diagnosis, and treatment planning. However, challenges such as data privacy, algorithmic bias, and regulatory compliance must be addressed to ensure responsible deployment of these technologies. Integrating IoT and AI in healthcare holds immense promise for improving patient outcomes and optimizing healthcare delivery. Despite challenges such as data privacy concerns and algorithmic biases, the transformative potential of these technologies cannot be overstated. Clear governance frameworks, transparent AI decision-making processes, and ethical considerations are essential to mitigate risks and harness the full benefits of IoT and AI in healthcare.

Objectives The use of artificial intelligence (AI) in healthcare is a growing field of research and clinical application. The views of the general public, ie future healthcare users, need to be surveyed and interpreted so that researchers and the public have a shared understanding of the appropriate use of AI. Currently, there is only limited data on the public’s views. Methods An anonymous, quantitative questionnaire was administered as part of a public exhibition on AI. The questionnaire was based on previously validated questions designed to assess respondents’ views on the use of AI in healthcare. Brief demographic data were also collected. Results The population surveyed was more diverse and younger than the general UK population (65% white, 45% aged 18-29). Respondents were largely comfortable with the application of AI in healthcare: 80% felt positively about its use, 56% thought it would be safe. 70% did not feel that it would replace doctors, and most would not be happy for AI to make decisions without considering their feelings. Conclusions Our study shows that the population we surveyed, particularly young future healthcare users, are comfortable with the use of AI in healthcare, but do not see it as a replacement for doctors. Advances in knowledge This paper highlights views from the general public on the use of AI in healthcare, which is largely under researched.

The development of artificial intelligence (AI) in healthcare is accelerating rapidly. Beyond the urge for technological optimization, public perceptions and preferences regarding the application of such technologies remain poorly understood. Risk and benefit perceptions of novel technologies are key drivers for successful implementation. Therefore, it is crucial to understand the factors that condition these perceptions. In this study, we draw on the risk perception and human-AI interaction literature to examine how explicit (i.e., deliberate) and implicit (i.e., automatic) comparative trust associations with AI versus physicians, and knowledge about AI, relate to likelihood perceptions of risks and benefits of AI in healthcare and preferences for the integration of AI in healthcare. We use survey data (N=378) to specify a path model. Results reveal that the path for implicit comparative trust associations on relative preferences for AI over physicians is only significant through risk, but not through benefit perceptions. This finding is reversed for AI knowledge. Explicit comparative trust associations relate to AI preference through risk and benefit perceptions. These findings indicate that risk perceptions of AI in healthcare might be driven more strongly by affect-laden factors than benefit perceptions, which in turn might depend more on reflective cognition. Implications of our findings and directions for future research are discussed considering the conceptualization of trust as heuristic and dual-process theories of judgment and decision-making. Regarding the design and implementation of AI-based healthcare technologies, our findings suggest that a holistic integration of public viewpoints is warranted.

There are many benefits to the expanding application of artificial intelligence (AI) in healthcare, which includes everything from surgical robots to treatment recommendation systems, diagnostic tools, and platforms for workflow enhancement. At the same time, it brings up important legal and ethical concerns, especially when things don’t go as planned. A key issue is criminal liability: deciding who should be held responsible if an AI-related problem leads to patient harm, or if the use of AI in healthcare breaks the law or harms the public interest. This area is not well understood. This paper looks into how traditional criminal liability systems might have trouble dealing with AI in healthcare and highlights major issues and difficulties, such as the independence of AI, the lack of transparency in algorithms, and how responsibility is shared among developers, healthcare professionals, organizations, and AI systems themselves. It also suggests ways to improve this, like new governance structures, stronger regulations, and mixed liability systems. The aim is to create a healthcare environment with AI that is accountable, safe, and ethically sound.