Quinlan D. Buchlak, a final-year Medicine student and PhD candidate at The University of Notre Dame’s School of Medicine, Sydney, is the lead author on an article titled ‘Ethical thinking machines in surgery and the requirement for clinical leadership’, which was published by The American Journal of Surgery this month.
“I feel lucky and grateful to be a small part of Notre Dame’s research team,” says Quinlan, who worked on this article alongside the neurosurgical team from the Neurosciences Institute at Virginia Mason Medical Center in Seattle, USA, and Notre Dame’s Deputy Vice Chancellor, Professor Christine Bennett AO – formerly Dean of the School of Medicine, Sydney.
Quinlan has been successfully collaborating with the team at the Neurosciences Institute for six years and this article is part of a broader body of work that looks at applying artificial intelligence (AI) to surgery to improve patient safety. “Our international collaboration, with people based in Australia, Canada and the USA, is interested in improving patient safety and facilitating the development of personalised medicine by exploring and applying cutting edge technologies,” says Quinlan.
The team’s latest publication in the American Journal of Surgery discusses the need for clinical leadership to facilitate the effective application of ethical machine learning systems to surgery.
“Machine learning is a branch of AI that is capable of effectively predicting many useful outcomes using large volumes of data. In surgery, it can be used to improve safety by predicting the likelihood of an adverse postoperative outcome before the surgery takes place. This helps patients and clinicians to choose the safest treatment option and, correspondingly, improves health outcomes,” explains Quinlan.
However, applying this kind of technology in healthcare in a way that is safe and ethical requires careful attention to a range of issues across development, implementation and evaluation.
“Healthcare is one of the sectors that has not yet utilised data as effectively as it could,” says Professor Bennett. “Doctors of the future will be looking to AI to help interpret data in a way that we can't do now, so really understanding how best to apply sophisticated data analytics was the thinking that went into this paper.”
While harnessing data using AI could help predict outcomes for patients in care, Professor Bennett points out that, as with all human endeavour, there are conscious and unconscious biases. “When we make the assumptions that build the algorithms and maths behind interpreting data and predicting outcomes, we need strong ethical governance and careful consideration of what biases may exist,” she says. “In healthcare, when you're caring for people’s lives, it’s important to have a very high standard of governance of data and ethical consideration of how it's applied, as well as evidence that outcomes are going to deliver benefit to the patient.”
Quinlan, who is currently completing his PhD on machine learning in brain and spine surgery, says he looks forward to contributing to a safer healthcare future by continuing to research the ethical application of machine learning technologies, and believes clinicians need to prepare now for a more automated future that aligns with the best interests of patients. “It is a great privilege to have the opportunity to deeply explore these inspiring and engaging ideas. Notre Dame is well positioned to play a thought-leadership role in the salient domain of AI ethics,” he says.
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