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期刊来源：Ann Intern Med

原文链接：https://doi.org/10.7326/M24-0146

摘要内容如下：

内科医生越来越多地与实现人工智能（AI）和机器学习（ML）技术的系统进行交互。一些医生和医疗保健系统甚至在电子健康档案（EHR）系统内外开发自己的AI模型。这些技术在整个医疗保健的提供中具有各种应用，例如临床文档、诊断图像处理和临床决策支持。随着大量患者数据的可用性不断增加，以及临床医生的职业倦怠达到前所未有的水平，这些技术的扩散受到了一些医生的谨慎欢迎。另一些人则认为这对医患关系和医生的职业操守提出了挑战。考虑到一些人工智能模型的“黑箱”性质，这些部署是可以理解的，这些模型的规范和开发方法可能受到严格保护或专有，以及相对滞后或缺乏适当的监管审查和验证。这份美国内科医师学会（ACP）的立场文件描述了该学会关于在提供医疗保健中使用支持AI和ML的工具和系统的基本立场和建议。该学院的许多立场和建议，例如与以患者为中心、隐私和透明度相关的立场和建议，都是基于ACP伦理手册中的原则。它们也来自于对工具的临床安全性和有效性的考虑，以及它们对健康差异的潜在影响。该学院呼吁对这些技术的临床和伦理影响及其对患者健康和福祉的影响进行更多的研究。

英文原文如下：

Abstracts

Internal medicine physicians are increasingly interacting with systems that implement artificial intelligence (AI) and machine learning (ML) technologies. Some physicians and health care systems are even developing their own AI models, both within and outside of electronic health record (EHR) systems. These technologies have various applications throughout the provision of health care, such as clinical documentation, diagnostic image processing, and clinical decision support. With the growing availability of vast amounts of patient data and unprecedented levels of clinician burnout, the proliferation of these technologies is cautiously welcomed by some physicians. Others think it presents challenges to the patient-physician relationship and the professional integrity of physicians. These dispositions are understandable, given the "black box" nature of some AI models, for which specifications and development methods can be closely guarded or proprietary, along with the relative lagging or absence of appropriate regulatory scrutiny and validation. This American College of Physicians (ACP) position paper describes the College's foundational positions and recommendations regarding the use of AI- and ML-enabled tools and systems in the provision of health care. Many of the College's positions and recommendations, such as those related to patient-centeredness, privacy, and transparency, are founded on principles in the ACP Ethics Manual. They are also derived from considerations for the clinical safety and effectiveness of the tools as well as their potential consequences regarding health disparities. The College calls for more research on the clinical and ethical implications of these technologies and their effects on patient health and well-being.

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