Artificial Intelligence (AI) appears to be ubiquitous presently. One may already be familiar with apps like ChatGPT, a chatbot that aids in writing essays, or AI image generators like Midjourney that produces realistic visuals based on user instructions. However, it may come as a surprise that AI is now also employed in Irish healthcare facilities to assist healthcare practitioners in delivering patient care services.
Like every game-changing technology, AI’s expanded deployment correlates with credible worries and dilemmas about its application from an ethical, legal, and moral perspective. All facets of life may be influenced by AI, especially when it concerns our well-being and private health information.
Dr Conor Judge, an advisor nephrologist at Saolta University Health Care Group (which operates six hospitals across seven sites in Ireland’s west and northwest) and a distinguished lecturer of applied clinical data analytics at the University of Galway, spoke about the likely effect of AI on Ireland’s healthcare provisions at the annual general meeting of the Irish Medical Organisation held in Kerry.
Dr. Judge posits that AI utilisation in healthcare should be approached in the same manner as medications, implying that they need to undergo rigorous testing in large phase trials.
The University of Galway pioneered Ireland’s first Institute for Clinical Trials last year, focusing on patient impact and benefit. The Institute assures that it will render transformative benefits by ensuring patients have prompt access to novel medicines and treatments.
At the Institute’s inauguration, Prof Martin O’Donnell, dean of the college of medicine, nursing and health sciences at the University of Galway, acknowledged that the institute would strengthen their significant prowess in clinical trials. It will also expedite the translation of medical breakthroughs to clinical appraisal, and ultimately enhance population health, exploiting the academic robustness of the university and it’s healthcare ally, Saolta University Healthcare Group.
Dr Conor Judge, a consultant nephrologist, has voiced the ambitious objective of using tailored approaches to hypertension treatment to fill the prevalent treatment gap and drastically cut down the worldwide impact of complications related to hypertension. His commentary was in relation to the use of Artificial Intelligence Clinical Decision Support Systems.
It was announced by Dr Judge that there are plans underway for the new institute to investigate advancements in randomised clinical trials. This will involve the trialling of novel medicinal products, medical appliances, and AI-based approaches. He indicated one of the key aims is to generate a team comprised of academic and industrial investigators devoted to assessing digital health interventions, in an effort to bolster areas like healthcare AI.
Recently, Dr Judge obtained funds from the Health Research Board to delve into how AI could be harnessed to enhance both the management and treatment of hypertension, also referred to as high blood pressure. High blood pressure, frequently dubbed a silent killer, afflicts over 1.4 billion people globally and greatly increases the risk of heart attacks and strokes.
At present, individuals with high blood pressure might need to frequently visit their GP for optimal illness management, a process that is time-demanding for both parties. This is where AI could be deployed through Clinical Decision Support Systems to aid in hypertension treatment.
In order to train a computer programme to make similar decisions to a hypertension specialist, the research project will analyse two wide-ranging clinical trials on hypertension treatment. Subsequently, safety mechanisms will be incorporated in the AI programme to ensure trustworthy advice, particularly in uncharted medical terrain. The aim of the AI tool would be to facilitate GPs to give the most fitting treatment for a patient’s hypertension more efficiently.
In addition, the project will administer in-depth surveys to both clinicians and patients to understand their attitudes towards AI-led treatment. The last stage entails a meticulous examination of the efficacy of the AI programme in prescribing hypertension treatment in real-life situations.
Dr Judge notes that this primary objective of personalised treatment for hypertension aims to not only bridge current treatment gaps but also significantly alleviate the global repercussion of complications associated with hypertension. The insights gained from the project could serve as a framework for future applications of AI in managing other critical health issues, marking an important leap towards incorporating AI into ordinary clinical practice.
Dr Judge acknowledged the work of the HSE National Intelligence Group’s work in the field of medical imaging, as there are already some AI-enabled interventions in use in Irish hospitals.
In the realm of stroke management, an assisted decision-making tool is currently operational. Thrombectomy, a life-saving procedure involving the mechanical removal of a brain clot, is one potential treatment for patients who’ve suffered a stroke. Determining patient suitability for this treatment requires a radiologist to scrutinize the patient’s brain CT scans to come up with a score known as the ASPECTS score.
Dr Judge expounded on the time-intensive nature of this task and highlighted the role of an AI tool developed by Brainomix to streamline the process. It’s the Brainomix 360 stroke platform that uses AI technology to provide radiologists with instantaneous readings of brain scans. The tool swiftly computes the ASPECTS score, thereby hastening the decision-making process over the most suitable treatment and enhancing efficiency. This is crucial in scenarios where time is of the essence for enhancing patient outcomes.
Despite the assistance of AI tools, Dr Judge underscored that final treatment decisions always rest on the clinician’s judgment, albeit AI could bolster their decision-making process.
The inherent humanity or art of medicine, particularly the doctor-patient relationship, has remained unvaried throughout the evolution of medicine, from the inception of vaccines and anaesthesia, organ transplants, to contemporary medical treatments. Dr Judge contends that AI doesn’t pose a threat to the doctor-patient relationship, but rather offers potential benefits.
Dr Judge points out that doctors frequently grapple with administrative tasks, involving gathering data from numerous different systems, each requiring separate logins. With that, they have limited time to discuss treatment decisions with the patients. However, with systems that amalgamate all information in one location, physicians could have more time for patient interactions, explaining treatments, and answering questions. This, Dr Judge believes, could greatly enhance the doctor-patient relationship.
Dr. Judge is optimistic about the capacity of Artificial Intelligence (AI) to revolutionise healthcare, albeit with the proper safeguards ensured. His viewpoint is that patients ought to insist on AI initiatives being put through stringent testing, comparable to that done for medicines. He argued that we do not expect patients to use drugs that have not undergone randomised clinical trials, so the same must hold true for AI interventions.
While he holds a largely positive outlook on it, he emphasised the necessity of doing it right. If not implemented correctly, AI holds the potential to negatively alter the field. It has to be coordinated with the appropriate protective measures in place – a principle that harks back to the original medical ethos of ‘do no harm’. Despite the challenges, he maintains a largely positive sentiment about AI, and believes in its transformational potential.