Artificial Intelligence in Medicine: Special Report from the Journal of the American Medical Association

The great British physicist Stephen Hawking famously warned that Artificial Intelligence (AI) could spell the end of the human race. On the other hand, he also acknowledged that AI is already benefitting humans through applications in medicine and many other fields.

The American Medical Association is a powerhouse in setting and promoting standards of excellence in the science and application of clinical research. It publishes the Journal of the American Medical Association (JAMA), internationally recognized as a leading authority in all aspects of medicine. Thus, it comes as no surprise that JAMA has published a summit report on AI in medicine, “AI, Health, and Health Care Today and Tomorrow”.

It opens by noting that AI applications have already penetrated many areas related to health, patient services, and physician employment:

• Clinical tools used for medical alerts or screening
• Resources used by individuals, such as mobile health apps and ChatGPT
• Software to improve the business side of medicine, e.g. scheduling, billing, etc.
• Health records/documentation
• Clinical applications to assist with diagnosis and treatment planning.

In fact, under the leadership of Dr. Dan Sperling, the Sperling Prostate Center was an early adopter of AI to assist in the efficiency and accuracy of interpreting MRI imaging for prostate cancer. His Medical Group offers patient blogs dedicated to understanding the role of AI in medicine, among other areas..

Key points in the JAMA Summit Report

Whether we like it or not, AI is here to stay. However, judging its impact in the medical world is difficult because, as the report states, “evaluations are extremely challenging or not required, in part because many are outside the US Food and Drug Administration’s regulatory oversight.” Existing standards are mostly aimed at safety or how well institutional users comply with various guidelines, but fail to assess whether outcomes are improved or not.

Therefore, the Summit Report identifies four key points for AI deployment that will safely and equitably improve health outcomes.

1. Collaboration among all stakeholders with regard to developing AI tools. Stakeholders include “developers, regulators, and health care systems” partnering in evaluating and deploying AI tools.
2. With regard to generating methods to evaluate and monitor the impact of AI tools, health care systems themselves should be allowed to “conduct or participate in rapid, efficient, and robust evaluations of effectiveness.”
3. There needs to be a “nationally representative data infrastructure and learning environment” so that knowledge about the effects of AI products across different settings can be generally accessed by all.
4. Successfully driving these changes requires incentives to create and implement them, “using market forces and policy levers.”

Harnessing and supervising AI

There is no doubt that the introduction of sophisticated AI systems that can basically teach themselves has tremendous promise to improve healthcare and its delivery. However, as Stephen Hawking cautions, if not properly harnessed and supervised there is also potential for harm—probably more out of ignorance than malice—but still something to be concerned about. How to assure constructive outcomes is challenging.

As the report points out, “In contrast to drugs or more traditional medical devices, there is little consensus or structure to ensure robust, safe, transparent, and standardized evaluation, regulation, implementation, and monitoring of new AI tools and technologies.”

JAMA’s Summit Report is a timely all to action. Coordinating efforts to integrate accurate and ethical AI tools “will depend heavily on the creation of an ecosystem capable of rapid, efficient, robust, and generalizable knowledge about the consequences of these tools on health.”

It is the hope of all of us at the Sperling Prostate Center and Sperling Medical Group that the progress made by AI developers and end users is informed not only by science and technology, but also by wisdom, ethics, and a spirit of informed teamwork. We’re all in this together, and we all stand to benefit.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.