{"title":"Ethical issues when using digital biomarkers and artificial intelligence for the early detection of dementia.","authors":"Elizabeth Ford, Richard Milne, Keegan Curlewis","doi":"10.1002/widm.1492","DOIUrl":null,"url":null,"abstract":"<p><p>Dementia poses a growing challenge for health services but remains stigmatized and under-recognized. Digital technologies to aid the earlier detection of dementia are approaching market. These include traditional cognitive screening tools presented on mobile devices, smartphone native applications, passive data collection from wearable, in-home and in-car sensors, as well as machine learning techniques applied to clinic and imaging data. It has been suggested that earlier detection and diagnosis may help patients plan for their future, achieve a better quality of life, and access clinical trials and possible future disease modifying treatments. In this review, we explore whether digital tools for the early detection of dementia can or should be deployed, by assessing them against the principles of ethical screening programs. We conclude that while the importance of dementia as a health problem is unquestionable, significant challenges remain. There is no available treatment which improves the prognosis of diagnosed disease. Progression from early-stage disease to dementia is neither given nor currently predictable. Available technologies are generally not both minimally invasive and highly accurate. Digital deployment risks exacerbating health inequalities due to biased training data and inequity in digital access. Finally, the acceptability of early dementia detection is not established, and resources would be needed to ensure follow-up and support for those flagged by any new system. We conclude that early dementia detection deployed at scale via digital technologies does not meet standards for a screening program and we offer recommendations for moving toward an ethical mode of implementation. This article is categorized under:Application Areas > Health CareCommercial, Legal, and Ethical Issues > Ethical ConsiderationsTechnologies > Artificial Intelligence.</p>","PeriodicalId":48970,"journal":{"name":"Wiley Interdisciplinary Reviews-Data Mining and Knowledge Discovery","volume":null,"pages":null},"PeriodicalIF":6.4000,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10909482/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Wiley Interdisciplinary Reviews-Data Mining and Knowledge Discovery","FirstCategoryId":"94","ListUrlMain":"https://doi.org/10.1002/widm.1492","RegionNum":2,"RegionCategory":"计算机科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/2/19 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"COMPUTER SCIENCE, ARTIFICIAL INTELLIGENCE","Score":null,"Total":0}
引用次数: 0
Abstract
Dementia poses a growing challenge for health services but remains stigmatized and under-recognized. Digital technologies to aid the earlier detection of dementia are approaching market. These include traditional cognitive screening tools presented on mobile devices, smartphone native applications, passive data collection from wearable, in-home and in-car sensors, as well as machine learning techniques applied to clinic and imaging data. It has been suggested that earlier detection and diagnosis may help patients plan for their future, achieve a better quality of life, and access clinical trials and possible future disease modifying treatments. In this review, we explore whether digital tools for the early detection of dementia can or should be deployed, by assessing them against the principles of ethical screening programs. We conclude that while the importance of dementia as a health problem is unquestionable, significant challenges remain. There is no available treatment which improves the prognosis of diagnosed disease. Progression from early-stage disease to dementia is neither given nor currently predictable. Available technologies are generally not both minimally invasive and highly accurate. Digital deployment risks exacerbating health inequalities due to biased training data and inequity in digital access. Finally, the acceptability of early dementia detection is not established, and resources would be needed to ensure follow-up and support for those flagged by any new system. We conclude that early dementia detection deployed at scale via digital technologies does not meet standards for a screening program and we offer recommendations for moving toward an ethical mode of implementation. This article is categorized under:Application Areas > Health CareCommercial, Legal, and Ethical Issues > Ethical ConsiderationsTechnologies > Artificial Intelligence.
期刊介绍:
The goals of Wiley Interdisciplinary Reviews-Data Mining and Knowledge Discovery (WIREs DMKD) are multifaceted. Firstly, the journal aims to provide a comprehensive overview of the current state of data mining and knowledge discovery by featuring ongoing reviews authored by leading researchers. Secondly, it seeks to highlight the interdisciplinary nature of the field by presenting articles from diverse perspectives, covering various application areas such as technology, business, healthcare, education, government, society, and culture. Thirdly, WIREs DMKD endeavors to keep pace with the rapid advancements in data mining and knowledge discovery through regular content updates. Lastly, the journal strives to promote active engagement in the field by presenting its accomplishments and challenges in an accessible manner to a broad audience. The content of WIREs DMKD is intended to benefit upper-level undergraduate and postgraduate students, teaching and research professors in academic programs, as well as scientists and research managers in industry.