Artificial Intelligence: an opportunity for a more humane medicine?

Jordi Varela
Editor

Changing doctors for robots is a recurring theme in science fiction, but the appearance of devices with digital assistance, such as Alexa or Siri, and the promotion of self-care through smartphones, admitted The Lancet in an editorial, now seems a plausible reality. On the other hand, Harvard Medical School Professor Warner Slack said that if a doctor can be replaced by a computer, then this doctor deserves to be replaced by a computer. In this context, Eric Topol in "Deep Medicine" brings light to this debate with the defence of an open thesis: "artificial intelligence (AI), instead of replacing doctors, should become an aid for them to recover lost humanism."

The fallibility of scientists

Nature has echoed the professional debate about the intrinsic quality of scientists’ work, in a dynamics of self-criticism comparable to what is taking place, in similar terms, in the clinical world. Scientists are also fallible, says the article writer and therefore, should enhance the mechanisms of self-criticism, rather than enrol in self-deception.

John Ioannidis, Meta-Research Innovation Center at Stanford, says scientists should work harder to understand the biases of their human fallibility if they want to overcome the crisis of confidence generated by the poor reproducibility of research results. And to illustrate his words, Ioannidis offers three examples: a) from a selection of one hundred psychology studies, only the results of just over a third of the work could be replicated, b) a group of Amgen researchers only succeeded in reproducing 6 of the results of 53 reference studies in the field of oncology and haematology, and c) the Ioannidis team itself was able to replicate completely only 2 of the 18 gene expression studies based on microarrays (DNA chips).

Right Care: definition, gray areas and reversals

One of the Right Care Alliance initiatives, led by Vikas Saini and Shannon Brownlee from the Lown Institute in Boston, has been the compiling of 4 reports that are analyzing the misuse, by excess and by default, of health resources from a global perspective.

What does the Lown Institute mean by "right care"?

Before defining the concept of "right care", we must take note of Donald Berwick's definition of quality in the introductory article of the series. The author believes that the quality of care, as we understand it, is too focused on the guarantee of procedures and, despite being correct, the question now is: what do the inappropriate clinical processes mean for people’s health? Berwick states that quality should be understood as the provision of services that respond to people's real needs. So, practically, appropriatness has been filtered in the realm of quality.