[Skip to Navigation]
Views 298
Citations 0
Comment & Response
May 6, 2020

Reactive Artificial Intelligence Using Big Data in the Era of Precision Medicine—Reply

Author Affiliations
  • 1Department of Surgery, University of Florida Health, Gainesville
  • 2Department of Medicine, University of Florida Health, Gainesville
JAMA Surg. 2020;155(7):671-672. doi:10.1001/jamasurg.2020.0856

In Reply We thank Kar et al for their thoughtful appraisal of artificial intelligence–based decision-support systems and delays between technological advances and clinical application in reference to our article.1 Similar phenomena have been observed for pharmaceutical innovations and evidence-based guidelines, with lag times commonly exceeding 10 years.2 It seems prudent to address these delays in context, promoting early adoption of low-risk, high-benefit interventions supported by level I evidence while exercising caution for high-risk interventions supported by weak evidence. We agree with Kar et al that evidence supporting artificial intelligence augmentation of clinical decision-making is currently weak and discuss 2 potential clinical hazards in a JAMA Surgery article1: the use of biased or misrepresentative model training data could produce erroneous model outputs, and many patients could be harmed in a short time frame if model outputs are not carefully monitored and interpreted. Kar et al wisely propose that large, robust data sets are needed to allow self-learning, minimize the effect of outliers in small data, and ensure model validity and generalizability. We echo these sentiments and remain hopeful that application of the Fast Healthcare Interoperability Resources framework to large-scale, multi-institutional electronic health record data will achieve these important objectives. This would require cooperation and collaboration among clinicians, data scientists, computer engineers, administrators, implementation scientists, and most importantly patients, who deserve data privacy and security as well as personalized, precise, shared decision-making.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words