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Trying to unite AI and physician decision-making

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Three Stanford University School of Medicine researchers write in a JAMA opinion essay that healthcare must learn how to  bring two separate cultures—technology and physicians—together as artificial intelligence takes hold in the sector.

Abraham Verghese, M.D., Nigam H. Shah, Ph.D., and Robert A. Harrington, M.D., write that folks should study the electronic medical records saga, which shows that bad things (perhaps most notably physician burnout)  happen when such innovations are implemented with little input from physicians.

“The lessons learned with the EMR should serve as a guide as artificial intelligence and machine learning are developed to help process and creatively use the vast amounts of data being generated in the healthcare system,” the researchers wrote.

They note that while computers can predict certain outcomes with higher accuracy than can physicians,  doctors and other clinicians must interpret computerized data and actually decide on action.

A benefit of computerization is that it offsets clinicians ‘ tendency to make excessively optimistic predictions about patients’ outcomes. Predictive models using vast amount of data can do better. But  human intelligence is needed  to put cases into broader clinical, personal and societal context.

“The missing piece in the dialectic around artificial intelligence and machine learning in health care is understanding the key step of separating prediction from action and recommendation. Such separation of prediction from action and recommendation requires a change in how clinicians think about using models developed using machine learning,” the three write.

The authors conclude:

“As with the EMR, there are legitimate concerns that artificial intelligence applications might jeopardize critical social interactions between colleagues and with the patient, affecting the lived experiences of both groups. But concerns about physician ‘unemployment; and ‘de-skilling’ are overblown. In the same manner that automated blood pressure measurement and automated blood cell counts freed clinicians from some tasks, artificial intelligence could bring back meaning and purpose in the practice of medicine while providing new levels of efficiency and accuracy. Physicians must proactively guide, oversee, and monitor the adoption of artificial intelligence as a partner in patient care.

“In the care of the sick, there is a key function played by physicians, referred to by Tinsley Harrison as the ‘priestly function of the physician.’ Human intelligence working with artificial intelligence—a well-informed, empathetic clinician armed with good predictive tools and unburdened from clerical drudgery—can bring physicians closer to fulfilling {the} maxim that the secret of care is in ‘caring for the patient.”’

To read the JAMA piece, please hit this link.

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