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AI-based healthcare: a new dawn or apartheid revisited?

ABSTRACT: The Bubonic Plague outbreak that wormed its way through San Francisco's Chinatown in 1900 tells a story of prejudice guiding health policy, resulting in enormous suffering for much of its Chinese population. This article seeks to discuss the potential for hidden "prejudice" should Artificial Intelligence (AI) gain a dominant foothold in healthcare systems. Using a toy model, this piece explores potential future outcomes, should AI continue to develop without bound. Where potential dangers may lurk will be discussed, so that the full benefits AI has to offer can be reaped whilst avoiding the pitfalls. The model is produced using the computer programming language MATLAB and offers visual representations of potential outcomes. Interwoven with these potential outcomes are numerous historical models for problems caused by prejudice and recent issues in AI systems, from police prediction and facial recognition software to recruitment tools. Therefore, this research's novel angle, of using historical precedents to model and discuss potential futures, offers a unique contribution.

Supplementary information

The online version contains supplementary material available at 10.1007/s00146-020-01120-w.

SUBMITTER: Parfett A

PROVIDER: S-EPMC7754701 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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AI-based healthcare: a new dawn or apartheid revisited?

Parfett Alice A Townley Stuart S Allerfeldt Kristofer K

AI & society 20201222 3

The Bubonic Plague outbreak that wormed its way through San Francisco's Chinatown in 1900 tells a story of prejudice guiding health policy, resulting in enormous suffering for much of its Chinese population. This article seeks to discuss the potential for hidden "prejudice" should Artificial Intelligence (AI) gain a dominant foothold in healthcare systems. Using a toy model, this piece explores potential future outcomes, should AI continue to develop without bound. Where potential dangers may lu ...[more]

PMID: 33362363

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Project description:During their development and progression tumors acquire numerous mutations that, when translated into proteins give rise to neoantigens that can be recognized by T cells. Initially, neoantigens were not recognized as preferred targets for cancer immunotherapy due to their enormous diversity and the therefore limited options to develop "one fits all" pharmacologic solutions. In recent years, the experience obtained in clinical trials demonstrating a predictive role of neoantigens in checkpoint inhibition has changed our view on the clinical potential of neoantigens in cancer immunotherapy. Technological advances such as sequencing of whole cancer genomes, the development of reliable algorithms for epitope prediction, and an increasing number of immunotherapeutic options now facilitate the development of personalized tumor therapies directly targeting a patient's neoantigenic burden. Preclinical studies in mice that support the excellent therapeutic potential of neoantigen-directed immunotherapies have provided blueprints on how this methodology can be translated into clinical applications in humans. Consistently, very recent clinical studies on personalized vaccinations targeting in silico predicted neoepitopes shed a first light on the therapeutic potential of personalized, neoantigen-directed immunotherapies. In our review, we discuss the various subtypes of tumor antigens with a focus on neoantigens and their potential in cancer immunotherapy. We will describe the current methods and techniques of detection as well as the structural requirements for neoantigens that are needed for their recognition by T cells and for tumor destruction. To assess the clinical potential of neoantigens, we will discuss their occurrence and functional relevance in spontaneous and hereditary cancers and their prognostic and predictive value. We will present in detail the existing immunotherapeutic options that exploit the neoantigen burden of tumors encompassing both preclinical efforts that provided convincing technological proof-of-concept and the current clinical studies confirming the potential of neoantigen-directed immunotherapies.

Dataset Information

AI-based healthcare: a new dawn or apartheid revisited?

Supplementary information

Publications

AI-based healthcare: a new dawn or apartheid revisited?

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