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Ethical Challenges in AI-based Clinical Decision Support System

2025· article· W4416799595 on OpenAlexaff
Xiaofan Wang

Bibliographic record

Venuenot available
Typearticle
Language
FieldMedicine
TopicArtificial Intelligence in Healthcare and Education
Canadian institutionsLakehead University
Fundersnot available
KeywordsSoftware deploymentDecision support systemClinical decision support systemField (mathematics)Ethical issuesResource (disambiguation)Health care

Abstract

fetched live from OpenAlex

Clinical decision support systems are AI-based systems utilizing AI methods to assist the decision making process. In recent years, the use of clinical support systems has grown in popularity. In addition to its significant benefits in improving healthcare efficiency, it also raises several ethical questions. In this research, three case studies of real AI applications in the medical field have been investigated. The first one is PainChek®, an AI pain assessment tool utilized in Australian residential care. It is helpful for people, especially those who are not able to speak, to express their pain levels, but issues such as transparency, security, and accuracy are raised. The second example is IDx-DR, an FDA-approved automated method for identifying retinopathy in diabetic patients. Even while it can lower costs, there are still some issues with data management transparency, possible risks, and consequences on human specialists. The last case study discusses a hospital’s deployment of an AI-assisted end-of-life system. Although the system can boost physicians’ confidence and lower treatment costs by improving resource allocation, its shortcomings include bias and trust. To address those challenges, a framework has been developed for tracking ethical dilemmas that arise when developing machine learning models for medical applications. The framework combines policy regulation with model implementation processes. This framework aims to help the AI-based clinical system become more transparent and responsible, enhancing the effectiveness of clinical treatment as well as minimizing ethical risks.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.189
metaresearch head score (Gemma)0.273
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.189
Threshold uncertainty score0.998

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.1890.273
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0020.002
Science and technology studies0.0090.028
Scholarly communication0.0210.017
Open science0.0040.013
Research integrity0.0170.015
Insufficient payload (model declined to judge)0.0040.001

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.

Opus teacher head0.434
GPT teacher head0.577
Teacher spread0.143 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreEmpirical

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".

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Citations0
Published2025
Admission routes1
Has abstractyes

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