Artificial intelligence, ChatGPT, and other large language models for social determinants of health: Current state and future directions.

Journal: Cell reports. Medicine
Published Date:

Abstract

This perspective highlights the importance of addressing social determinants of health (SDOH) in patient health outcomes and health inequity, a global problem exacerbated by the COVID-19 pandemic. We provide a broad discussion on current developments in digital health and artificial intelligence (AI), including large language models (LLMs), as transformative tools in addressing SDOH factors, offering new capabilities for disease surveillance and patient care. Simultaneously, we bring attention to challenges, such as data standardization, infrastructure limitations, digital literacy, and algorithmic bias, that could hinder equitable access to AI benefits. For LLMs, we highlight potential unique challenges and risks including environmental impact, unfair labor practices, inadvertent disinformation or "hallucinations," proliferation of bias, and infringement of copyrights. We propose the need for a multitiered approach to digital inclusion as an SDOH and the development of ethical and responsible AI practice frameworks globally and provide suggestions on bridging the gap from development to implementation of equitable AI technologies.

Authors

  • Jasmine Chiat Ling Ong
    Duke-NUS Medical School, Singapore, Singapore.
  • Benjamin Jun Jie Seng
    MOHH Holdings (Singapore) Pte., Ltd., Singapore, Singapore; SingHealth Duke-NUS Family Medicine Academic Clinical Programme, Singapore, Singapore.
  • Jeren Zheng Feng Law
    Department of Pharmacy, National University of Singapore, Singapore, Singapore.
  • Lian Leng Low
    Programme in Health Services and Systems Research, Duke-National University of Singapore Medical School, Singapore.
  • Andrea Lay Hoon Kwa
    Division of Pharmacy, Singapore General Hospital, Singapore, Singapore; SingHealth Duke-NUS Medicine Academic Clinical Programme, Singapore, Singapore; Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore.
  • Kathleen M Giacomini
    Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, 94158, California, USA.
  • Daniel Shu Wei Ting
    Singapore National Eye Center, Singapore Eye Research Institute Singapore Health Service Singapore Singapore.