Digital health and some thematic shifts in bioethics in academic publications after the pandemic
Bibliographic record
Abstract
Abstract Background Digital health (DH) presents vast opportunities, but also dynamic shift in viewpoints, which is reflected in academic works. Since DH concerns patient data, a major issue is complying with the bioethical principles, and ensuring patients’ privacy and security. The aim of this research is to explore avenues, in which ethics and privacy are reflected in DH, especially in terms of research, legislation, artificial intelligence (AI) and blockchain applications in medicine and public health. Methods Literature search for full text publications in PubMed, Scopus and ScienceDirect focused on ethics and privacy in DH in the period 2019-2023 found 325 articles in English authored by academicians. Six thematic categories were identified: ethics (fundamental principles; ethics in using novel DH tools); privacy (in use of apps/wearables; as a challenge/barrier to DH interventions/technologies); ethics/privacy in: DH research (data gathering, use, sharing); policy and legislation (for DH applications); AI and blockchains (in medicine and public health). Results Articles were from 32 countries: USA-24.3%; UK-13.5%; Germany-7.7%; Canada-7.4%; Australia-6.7%; Netherlands, Italy, Switzerland-4.7% each; China, India-3.0% each and 20.3% from 22 other countries; 86.5% in medical/DH journals. Only 10.2% were published in 2019; 17.8% - 2020; 19.4% - 2021; 27.1% - 2022 and 25.5% - 2023. Privacy was discussed in 26.5%; ethics-23.7%; research-19.4%; AI-15.1%; policy and legislation-9.5% and blockchains-5.5% of the articles. The publication activity of all six categories increased after the unfold of the pandemic in 2020. In 2023 publications for ethics (13%), privacy (5.8%) and research (6.3%) decreased; for legislation (12.9%), AI (14.3%) and blockchains in healthcare (16.8%) increased. Conclusions The pandemic and its aftermath present a change in academic interest. Traditional ethical fundaments in DH slightly lose position in favor of top notch technologies and apt legislation. Key messages • The pandemic and modern technologies enforced new digital health applications. Further research will reveal the needs of AI and blockchain applications respecting privacy and the ethical principles. • Besides existing legislation and regulations, in order to catch up with the dynamic developments in DH, the legal base needs to become more flexible. Technologies change, privacy importance does not.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.066 | 0.130 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.017 | 0.024 |
| Science and technology studies | 0.006 | 0.022 |
| Scholarly communication | 0.019 | 0.022 |
| Open science | 0.001 | 0.009 |
| Research integrity | 0.005 | 0.004 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".