Algor-ethics: charting the ethical path for AI in critical care.

Journal: Journal of clinical monitoring and computing
PMID: 38573370

Abstract

The integration of Clinical Decision Support Systems (CDSS) based on artificial intelligence (AI) in healthcare is groundbreaking evolution with enormous potential, but its development and ethical implementation, presents unique challenges, particularly in critical care, where physicians often deal with life-threating conditions requiring rapid actions and patients unable to participate in the decisional process. Moreover, development of AI-based CDSS is complex and should address different sources of bias, including data acquisition, health disparities, domain shifts during clinical use, and cognitive biases in decision-making. In this scenario algor-ethics is mandatory and emphasizes the integration of 'Human-in-the-Loop' and 'Algorithmic Stewardship' principles, and the benefits of advanced data engineering. The establishment of Clinical AI Departments (CAID) is necessary to lead AI innovation in healthcare, ensuring ethical integrity and human-centered development in this rapidly evolving field.

Authors

  • Jonathan Montomoli
    Department of Anesthesia and Intensive Care, Infermi Hospital, Romagna Local Health Authority, Rimini, Italy.
  • Maria Maddalena Bitondo
    Department of Anesthesia and Intensive Care, Infermi Hospital, Romagna Local Health Authority, Viale Settembrini 2, Rimini, 47923, Italy.
  • Marco Cascella
    Department of Medicine, Surgery and Dentistry, University of Salerno, 84081, Baronissi, Italy.
  • Emanuele Rezoagli
    Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
  • Luca Romeo
    Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy. Electronic address: l.romeo@univpm.it.
  • Valentina Bellini
    Anesthesiology, Critical Care and Pain Medicine Division, Department of Medicine and Surgery, University of Parma, Viale Gramsci 14, 43126, Parma, Italy.
  • Federico Semeraro
    European Resuscitation Council, Belgium, Niel; Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy. Electronic address: federico.semeraro@erc.edu.
  • Emiliano Gamberini
    M. Bufalini Hospital, Cesena, Italy.
  • Emanuele Frontoni
  • Vanni Agnoletti
    Bufalini Hospital, AUSL Romagna, Cesena, Italy.
  • Mattia Altini
    Hospital Care Sector, Emilia-Romagna Region, Via Aldo Moro, 21, Bologna, 40127, Italy.
  • Paolo Benanti
    Pontifical Gregorian University, Rome, Italy.
  • Elena Giovanna Bignami
    Anesthesiology, Critical Care and Pain Medicine Division, Department of Medicine and Surgery, University of Parma, Parma, Italy.

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