Artificial Intelligence in Low- and Middle-Income Countries: Innovating Global Health Radiology.

Journal: Radiology
PMID: 33021895

Abstract

Scarce or absent radiology resources impede adoption of artificial intelligence (AI) for medical imaging by resource-poor health institutions. They face limitations in local equipment, personnel expertise, infrastructure, data-rights frameworks, and public policies. The trustworthiness of AI for medical decision making in global health and low-resource settings is hampered by insufficient data diversity, nontransparent AI algorithms, and resource-poor health institutions' limited participation in AI production and validation. RAD-AID's three-pronged integrated strategy for AI adoption in resource-poor health institutions is presented, which includes clinical radiology education, infrastructure implementation, and phased AI introduction. This strategy derives from RAD-AID's more-than-a-decade experience as a nonprofit organization developing radiology in resource-poor health institutions, both in the United States and in low- and middle-income countries. The three components synergistically provide the foundation to address health care disparities. Local radiology personnel expertise is augmented through comprehensive education. Software, hardware, and radiologic and networking infrastructure enables radiology workflows incorporating AI. These educational and infrastructure developments occur while RAD-AID delivers phased introduction, testing, and scaling of AI via global health collaborations.

Authors

  • Daniel J Mollura
    Center for Infectious Disease Imaging (CIDI), Radiology and Imaging Science Department, National Institutes of Health (NIH), Bethesda, MD 20892, United States.
  • Melissa P Culp
    From RAD-AID International, 8004 Ellingson Dr, Chevy Chase, MD 20815 (D.J.M., M.P.C., E.P., G.B., J.R.S., V.L.M., A.E., A.S., F.D.); Department of Radiology and Medical Imaging, Denver Health and Hospital Authority, Denver, Colo (E.P.); Departments of Radiology and Global Health, University of Washington, Seattle, Wash (J.R.S.); Fred Hutchinson Cancer Research Center, Seattle, Wash (J.R.S.); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (V.L.M.); Department of Radiology, University of Pennsylvania Health System, Philadelphia, Pa (A.E.); and Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (F.D.).
  • Erica Pollack
    From RAD-AID International, 8004 Ellingson Dr, Chevy Chase, MD 20815 (D.J.M., M.P.C., E.P., G.B., J.R.S., V.L.M., A.E., A.S., F.D.); Department of Radiology and Medical Imaging, Denver Health and Hospital Authority, Denver, Colo (E.P.); Departments of Radiology and Global Health, University of Washington, Seattle, Wash (J.R.S.); Fred Hutchinson Cancer Research Center, Seattle, Wash (J.R.S.); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (V.L.M.); Department of Radiology, University of Pennsylvania Health System, Philadelphia, Pa (A.E.); and Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (F.D.).
  • Gillian Battino
    From RAD-AID International, 8004 Ellingson Dr, Chevy Chase, MD 20815 (D.J.M., M.P.C., E.P., G.B., J.R.S., V.L.M., A.E., A.S., F.D.); Department of Radiology and Medical Imaging, Denver Health and Hospital Authority, Denver, Colo (E.P.); Departments of Radiology and Global Health, University of Washington, Seattle, Wash (J.R.S.); Fred Hutchinson Cancer Research Center, Seattle, Wash (J.R.S.); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (V.L.M.); Department of Radiology, University of Pennsylvania Health System, Philadelphia, Pa (A.E.); and Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (F.D.).
  • John R Scheel
    From RAD-AID International, 8004 Ellingson Dr, Chevy Chase, MD 20815 (D.J.M., M.P.C., E.P., G.B., J.R.S., V.L.M., A.E., A.S., F.D.); Department of Radiology and Medical Imaging, Denver Health and Hospital Authority, Denver, Colo (E.P.); Departments of Radiology and Global Health, University of Washington, Seattle, Wash (J.R.S.); Fred Hutchinson Cancer Research Center, Seattle, Wash (J.R.S.); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (V.L.M.); Department of Radiology, University of Pennsylvania Health System, Philadelphia, Pa (A.E.); and Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (F.D.).
  • Victoria L Mango
    Memorial Sloan Kettering Cancer Center, Breast and Imaging Center, 300 E 66th St, Ste 715, New York, NY 10065.
  • Ameena Elahi
    From RAD-AID International, 8004 Ellingson Dr, Chevy Chase, MD 20815 (D.J.M., M.P.C., E.P., G.B., J.R.S., V.L.M., A.E., A.S., F.D.); Department of Radiology and Medical Imaging, Denver Health and Hospital Authority, Denver, Colo (E.P.); Departments of Radiology and Global Health, University of Washington, Seattle, Wash (J.R.S.); Fred Hutchinson Cancer Research Center, Seattle, Wash (J.R.S.); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (V.L.M.); Department of Radiology, University of Pennsylvania Health System, Philadelphia, Pa (A.E.); and Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (F.D.).
  • Alan Schweitzer
    From RAD-AID International, 8004 Ellingson Dr, Chevy Chase, MD 20815 (D.J.M., M.P.C., E.P., G.B., J.R.S., V.L.M., A.E., A.S., F.D.); Department of Radiology and Medical Imaging, Denver Health and Hospital Authority, Denver, Colo (E.P.); Departments of Radiology and Global Health, University of Washington, Seattle, Wash (J.R.S.); Fred Hutchinson Cancer Research Center, Seattle, Wash (J.R.S.); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (V.L.M.); Department of Radiology, University of Pennsylvania Health System, Philadelphia, Pa (A.E.); and Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Md (F.D.).
  • Farouk Dako
    Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.

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