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Can Assoc Radiol J ; 70(4): 329-334, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31585825


This is a condensed summary of an international multisociety statement on ethics of artificial intelligence (AI) in radiology produced by the ACR, European Society of Radiology, RSNA, Society for Imaging Informatics in Medicine, European Society of Medical Imaging Informatics, Canadian Association of Radiologists, and American Association of Physicists in Medicine. AI has great potential to increase efficiency and accuracy throughout radiology, but it also carries inherent pitfalls and biases. Widespread use of AI-based intelligent and autonomous systems in radiology can increase the risk of systemic errors with high consequence and highlights complex ethical and societal issues. Currently, there is little experience using AI for patient care in diverse clinical settings. Extensive research is needed to understand how to best deploy AI in clinical practice. This statement highlights our consensus that ethical use of AI in radiology should promote well-being, minimize harm, and ensure that the benefits and harms are distributed among stakeholders in a just manner. We believe AI should respect human rights and freedoms, including dignity and privacy. It should be designed for maximum transparency and dependability. Ultimate responsibility and accountability for AI remains with its human designers and operators for the foreseeable future. The radiology community should start now to develop codes of ethics and practice for AI that promote any use that helps patients and the common good and should block use of radiology data and algorithms for financial gain without those two attributes.

Inteligência Artificial/ética , Radiologia/ética , Canadá , Consenso , Europa (Continente) , Humanos , Radiologistas/ética , Sociedades Médicas , Estados Unidos
Can Assoc Radiol J ; 70(2): 107-118, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30962048


Artificial intelligence (AI) software that analyzes medical images is becoming increasingly prevalent. Unlike earlier generations of AI software, which relied on expert knowledge to identify imaging features, machine learning approaches automatically learn to recognize these features. However, the promise of accurate personalized medicine can only be fulfilled with access to large quantities of medical data from patients. This data could be used for purposes such as predicting disease, diagnosis, treatment optimization, and prognostication. Radiology is positioned to lead development and implementation of AI algorithms and to manage the associated ethical and legal challenges. This white paper from the Canadian Association of Radiologists provides a framework for study of the legal and ethical issues related to AI in medical imaging, related to patient data (privacy, confidentiality, ownership, and sharing); algorithms (levels of autonomy, liability, and jurisprudence); practice (best practices and current legal framework); and finally, opportunities in AI from the perspective of a universal health care system.

Inteligência Artificial/ética , Inteligência Artificial/legislação & jurisprudência , Radiologia/ética , Radiologia/legislação & jurisprudência , Canadá , Humanos , Guias de Prática Clínica como Assunto , Radiologistas/ética , Radiologistas/legislação & jurisprudência , Sociedades Médicas
Radiol Med ; 124(8): 714-720, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30900132


AIMS AND OBJECTIVES: This study aimed to analyse the key factors that influence the overimaging using X-ray such as self-referral, defensive medicine and duplicate imaging studies and to emphasize the ethical problem that derives from it. MATERIALS AND METHODS: In this study, we focused on the more frequent sources of overdiagnosis such as the total-body CT, proposed in the form of screening in both public and private sector, the choice of the most sensitive test for each pathology such as pulmonary embolism, ultrasound investigations mostly of the thyroid and of the prostate and MR examinations, especially of the musculoskeletal system. RESULTS: The direct follow of overdiagnosis and overimaging is the increase in the risk of contrast media infusion, radiant damage, and costs in the worldwide healthcare system. The theme of the costs of overdiagnosis is strongly related to inappropriate or poorly appropriate imaging examination. CONCLUSIONS: We underline the ethical imperatives of trust and right conduct, because the major ethical problems in radiology emerge in the justification of medical exposures of patients in the practice. A close cooperation and collaboration across all the physicians responsible for patient care in requiring imaging examination is also important, balancing possible ionizing radiation disadvantages and patient benefits in terms of care.

Medicina Defensiva/ética , Sobremedicalização , Autorreferência Médica/ética , Proteção Radiológica , Radiologia/ética , Temas Bioéticos , Meios de Contraste/administração & dosagem , Meios de Contraste/efeitos adversos , Humanos , Imagem por Ressonância Magnética/ética , Imagem por Ressonância Magnética/estatística & dados numéricos , Masculino , Sobremedicalização/economia , Próstata/diagnóstico por imagem , Exposição à Radiação/efeitos adversos , Exposição à Radiação/ética , Radiologia/economia , Sensibilidade e Especificidade , Glândula Tireoide/diagnóstico por imagem , Imagem Corporal Total/ética , Imagem Corporal Total/métodos
Diagn Interv Imaging ; 99(11): 727-742, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30470627


The rapid development of information technology and data processing capabilities has led to the creation of new tools known as artificial intelligence (AI). Medical applications of AI are emerging, and the French radiology community felt it was therefore timely to issue a position paper on AI as part of its role as a leader in the development of digital projects. Essential information about the application of AI to radiology includes a description of the available algorithms with a glossary; a review of the issues raised by healthcare data, notably those pertaining to imaging (imaging data and co-variables, metadata); a look at research and innovation; an overview of current and future applications; a discussion of AI education; and a scrutiny of ethical issues. In addition to the principles set forth at the Asilomar Conference on Beneficial AI, the French radiology community has developed ten principles aimed at governing the use and development of AI tools in a manner that will create a concerted approach centered on benefits to patients, while also ensuring good integration within clinical workflows. High-quality care in radiology and opportunities for managing large datasets are two avenues relevant to the development of a precision, personalized, and participative radiology practice characterized by improved predictive and preventive capabilities.

Inteligência Artificial , Diagnóstico por Imagem , Radiologia/métodos , Inteligência Artificial/ética , Diagnóstico por Imagem/métodos , Previsões , Humanos , Radiologia/educação , Radiologia/ética , Pesquisa , Terminologia como Assunto
Rev. chil. radiol ; 24(1): 2-4, mar. 2018.
Artigo em Espanhol | LILACS | ID: biblio-959566


Resumen: La práctica médica debe estar siempre enmarcada en un ejercicio profesional moralmente aceptable, que procure la promoción y respeto de los principios éticos fundamentales de la medicina, manteniendo el beneficio del paciente como objetivo principal. Al igual que otras especialidades, en el ejercicio de la radiología, se debe cuidar el marco ético profesional que obliga a velar por el respeto de la dignidad e intimidad de las personas y todo lo relacionado con la confidencialidad del acto médico. En el ejercicio de la radiología, al igual en que otros actos médicos, se tiene acceso a información sensible y privada de los pacientes, lo que obliga a hacer un correcto uso de ella, resguardando las normas de privacidad y secreto profesional. Se debe enseñar y sensibilizar a los alumnos y al personal que asiste en el cuidado de los pacientes, para asegurar un comportamiento acorde a las normas éticas que rigen la práctica radiológica.

Abstract: An ethical and professional medical behavior, which promotes and respects the ethical principles of medicine, is a goal that should always be pursued in medical practice. In radiology, as in other medical specialties, this includes respect for patients' dignity, intimacy and confidentiality. The possibility of accessing patients' private information compels radiologists to make a correct usage of this information, in order to respect professional secrecy and privacy codes that rule medical practice. Radiologists must teach and raise awareness among their students and co-workers in health care institutions of the importance of ethical behavior in their daily practice.

Humanos , Relações Médico-Paciente/ética , Radiologia/ética , Confidencialidade/ética , Ética Médica , Ética Profissional
Bioethics ; 31(9): 648-656, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28975656


The introduction of novel diagnostic techniques in clinical domains such as genomics and radiology has led to a rich ethical debate on how to handle unsolicited findings that result from these innovations. Yet while unsolicited findings arise in both genomics and radiology, most of the relevant literature to date has tended to focus on only one of these domains. In this article, we synthesize and critically assess similarities and differences between "scanning the body" and "sequencing the genome" from an ethical perspective. After briefly describing the novel diagnostic contexts leading to unsolicited findings, we synthesize and reflect on six core ethical issues that relate to both specialties: terminology; benefits and risks; autonomy; disclosure of unsolicited findings to children; uncertainty; and filters and routine screening. We identify ethical rationales that pertain to both fields and may contribute to more ethically sound policies. Considerations of preserving public trust and ensuring that people perceive healthcare policies as fair also support the need for a combined debate.

Temas Bioéticos , Testes Genéticos/ética , Genômica/ética , Achados Incidentais , Radiografia/ética , Radiologia/ética , Sequenciamento Completo do Genoma/ética , Revelação/ética , Genoma Humano , Humanos , Consentimento Livre e Esclarecido/ética , Incerteza
Acta bioeth ; 23(2): 245-251, jul. 2017.
Artigo em Espanhol | LILACS | ID: biblio-886025


Resumen: Las exploraciones radiológicas médico-legales incluyen exposiciones médicas a radiaciones que se realizan por orden judicial a una persona que no está enferma. El técnico o tecnólogo médico en radiología tiene el deber de minimizar las dosis a pacientes y a la población en su conjunto; por ello, realizar este tipo de exploraciones entra en conflicto con las máximas de la protección radiológica y de su código ético. Presentamos un estudio de revisión donde se analiza si estas prácticas médicas son contrarias a la ética profesional del técnico en radiología.

Abstract: The medico-legal, radiological examinations include those medical exposures to radiation conducted by court order a person who is not sick. The radiologic technologist has a duty to minimize the dose to patients and the population as a whole, therefore, make this type of exploration conflicts with the maximum of Radiation Protection and its ethical code. We present a review study where we analyze whether these medical practices are contrary to professional ethics of the Radiologic technologist.

Resumo: As explorações radiológicas médico-legais incluem aquelas exposições médicas a radiações que se realizam por ordem judicial a uma pessoa que não está doente. O técnico ou tecnólogo médico em radiologia tem o dever de minimizar a dose para os pacientes e a população como um todo; portanto, realizar este tipo de exploração entra em conflito com os princípios da proteção radiológica e de seu código de ética. Apresentamos um estudo de revisão no qual analisamos se estas práticas médicas são contrárias à ética profissional do técnico em radiologia.

Humanos , Radiologia/ética , Radiologistas/ética , Medicina Legal/ética , Ética Profissional
AJR Am J Roentgenol ; 209(3): 640-642, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28590809


OBJECTIVE: The purpose of this study is to assess medical ethics knowledge among trainees and practicing radiologists through an online survey that included questions about the American College of Radiology Code of Ethics and the American Medical Association Code of Medical Ethics. CONCLUSION: Most survey respondents reported that they had never read the American Medical Association Code of Medical Ethics or the American College of Radiology Code of Ethics (77.2% and 67.4% of respondents, respectively). With regard to ethics education during medical school and residency, 57.3% and 70.0% of respondents, respectively, found such education to be insufficient. Medical ethics training should be highlighted during residency, at specialty society meetings, and in journals and online resources for radiologists.

Ética Médica/educação , Radiologistas , Radiologia/ética , Códigos de Ética , Humanos , Inquéritos e Questionários , Estados Unidos
Curr Probl Diagn Radiol ; 46(3): 173-176, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28185690


In the last century, rapidly advancing technological innovations have become essential components of modern healthcare, increasing the frequency and necessity of interactions between physicians and industry. These interactions have the potential to bias objectivity and should be approached carefully. A recent JACR article by Harvey et al, highlighted 2014 CMS data, which reported that only 4% of radiologists had interactions with industry, coming in second lowest amongst all 19 reported specialties. However, when managed appropriately, physician-industry relationships can mutually benefit patients, research, payers, providers, hospitals and the medical industry. In order to maintain relevance in the evolving healthcare landscape, it is imperative that radiologists establish, maintain, and expand relationships with industry. To help providers work within the ethical safety of institutional guidelines, while still promoting innovation, we propose a methodical approach with 7 key components to consider when developing appropriate physician-industry relationships or evaluating new products.

Indústrias/ética , Relações Interinstitucionais , Relações Interprofissionais/ética , Padrões de Prática Médica/ética , Radiologia/ética , Códigos de Ética , Conflito de Interesses , Comportamento Cooperativo , Tomada de Decisões/ética , Difusão de Inovações , Doações/ética , Humanos