Artificial intelligence: Who is responsible for the diagnosis?

Abstract

The aim of the paper is to find an answer to the question "Who or what is responsible for the benefits and harms of using artificial intelligence in radiology?" When human beings make decisions, the action itself is normally connected with a direct responsibility by the agent who generated the action. You have an effect on others, and therefore, you are responsible for what you do and what you decide to do. But if you do not do this yourself, but an artificial intelligence system, it becomes difficult and important to be able to ascribe responsibility when something goes wrong. The manuscript addresses the following statements: (1) using AI, the radiologist is responsible for the diagnosis; (2) radiologists must be trained on the use of AI since they are responsible for the actions of machines; (3) radiologists involved in R&D have the responsibility to guide the respect of rules for a trustworthy AI; (4) radiologist responsibility is at risk of validating the unknown (black box); (5) radiologist decision may be biased by the AI automation; (6)risk of a paradox: increasing AI tools to compensate the lack of radiologists; (7) need of informed consent and quality measures. Future legislation must outline the contours of the professional's responsibility, with respect to the provision of the service performed autonomously by AI, balancing the professional's ability to influence and therefore correct the machine, limiting the sphere of autonomy that instead technological evolution would like to recognize to robots.

Use of CT and artificial intelligence in suspected or COVID-19 positive patients: statement of the Italian Society of Medical and Interventional Radiology

“…Few data are available about the role of artificial intelligence as a radiological decision support system in COVID-19 patients; it is too early to apply this technology in clinical practice as first-line modality. There are in fact many ethical and medico-legal implications in the use of this technology that, even in this emergency situation, do not allow its routine use [23][24][25]. As for any new technology, a clinical validation phase is needed with single or multicenter trials, and standardized approaches for imaging methodology and artificial intelligence algorithms.…”

Artificial intelligence to codify lung CT in Covid-19 patients

“…Beside clinical procedures and treatments, AI promises a new paradigm for health care, with different tools that are built upon machine learning (ML) algorithms and support the decision-making processes. AI software must be useful categorizing the disease into different severities, integrating the structured report [14], prepared according to subjective considerations, with quantitative, objective assessments of the extent of the lesions.…”

“…In the post-processing phase, software, thanks to the help of a colorimetric map, recognizes the ground glass and differentiates it from consolidation and quantifies them as a percentage with respect to the healthy parenchyma. AI software therefore allows to accurately calculate the volume of each of these areas [1,14]. This "objective" information is useful for evaluating regression or progression disease in response to drug therapy as well as evaluating the effectiveness of pronation maneuvers for alveolar recruitment in ICU patients.…”

Artificial Intelligence in Radiology—Ethical Considerations

“…It sought to identify key issues, and to provide guidance on how potential problems can be avoided or solved. Within the full statement, the possible ethical dilemmas or abuses that could arise, deliberately or inadvertently, from AI applications in radiology have been reviewed.Other national societies have published consensus recommendations on the ethical use of AI, such as the Italian Society of Medical and Interventional Radiology [7], the Canadian Association of Radiologists [8], and the French Radiology Community [9].The aim of the review is to discuss some technological drawbacks of AI, certain related ethical issues, and to address potential solutions.…”

“…Other national societies have published consensus recommendations on the ethical use of AI, such as the Italian Society of Medical and Interventional Radiology [7], the Canadian Association of Radiologists [8], and the French Radiology Community [9].…”