New AI projects tackle health inequalities

NHSX awards more than £1.4m in funding to four academic research projects aimed at addressing racial and ethnic minority health inequalities

Artificial Intelligence technology (AI) is increasingly being used to enhance health and care services

NHSX has awarded £1.4m in funding to four innovative projects that will help address racial and ethnic health inequalities using artificial intelligence (AI).

The cash, awarded through the NHS AI Lab and The Health Foundation, will help develop projects ranging from using AI to investigate disparities in maternal health outcomes, to developing standards and guidance to ensure that datasets for training and testing AI systems are inclusive and generalisable.

The NHS AI Lab introduced the AI Ethics Initiative to support research and practical interventions that complement existing efforts to validate, evaluate, and regulate AI-driven technologies in health and care, with a focus on countering health inequalities.

And the announcement this week is the result of a partnership with The Health Foundation on a research competition enabled by the National Institute for Health Research (NIHR) to understand and enable opportunities to use AI to address inequalities and optimise datasets as well as improve AI development, testing and deployment.

Dr Indra Joshi, director of the NHS AI Lab at NHSX, said: “As we strive to ensure NHS patients are among the first in the world to benefit from leading AI, we also have a responsibility to ensure those technologies don’t exacerbate existing health inequalities.

Data-driven technology is having a profound impact on our health and health care system, but we need to focus on making sure the impacts are positive, so that everyone’s health and care benefits

“These projects will ensure the NHS can deploy safe and ethical Artificial Intelligence tools that meet the needs of minority communities and help our workforce deliver patient-centred and inclusive care to all.”

Subject to contract, the chosen projects are:

The University of Westminster

The project aims to increase uptake of screening for sexually-transmitted diseases and HIV among minority ethnic communities through an automated AI-driven chatbot.

The research will also inform the development and implementation of chatbots designed for minority ethnic populations in public health more widely and within the NHS.

Loughborough University

This project aims to use AI to improve the investigation of factors contributing to adverse maternity incidents among mothers from different ethnic groups.

The research will provide a way of understanding how a range of causal factors combine, interact, and lead to maternal harm, and make it easier to design interventions that are targeted and more effective for these groups.

St George’s, University of London, and Moorfields Eye Hospital

This collaborative project aims to ensure that AI technologies that detect diabetic retinopathy work for all, by validating the performance of AI retinal image analysis systems that will be used in the NHS Diabetic Eye Screening Programme (DESP) in different subgroups of the population.

We hope the projects being supported through this partnership can make an important contribution, helping ensure the advancement of AI-driven technologies improves health outcomes for minority ethnic populations in the UK

In parallel, the perceptions, acceptability, and expectations of healthcare professionals and people with diabetes will be evaluated in relation to the application of AI systems within the North East London NHS diabetic eye screening programme (DESP).

This study will provide evidence of effectiveness and safety prior to potential commissioning and deployment within the NHS.

Co-investigators include Homerton University Hospital, Kingston University, and the University of Washington, USA.

University Hospitals Birmingham NHS Foundation Trust

University Hospitals Birmingham NHS Foundation Trust and partners will lead STANDING Together, an international consensus process to develop standards for datasets underpinning AI systems to ensure they are diverse, inclusive, and can support development of AI systems which work across all demographic groups.

The resulting standards will help inform regulators, commissioners, policymakers and health data institutions on whether AI systems are underpinned by datasets which represent everyone and don’t risk leaving underrepresented and minority groups behind.

Artificial intelligence has the potential to revolutionise care for patients, and we are committed to ensuring this potential is realised for all patients by accounting for the health needs of diverse communities

Josh Keith, a senior fellow at The Health Foundation, said: “Data-driven technology is having a profound impact on our health and health care system, but we need to focus on making sure the impacts are positive, so that everyone’s health and care benefits.

“We hope the projects being supported through this partnership can make an important contribution to this, helping ensure the advancement of AI-driven technologies improves health outcomes for minority ethnic populations in the UK.”

Brhmie Balaram, head of AI research and ethics at NHSX, added: “We’re excited to support innovative projects that demonstrate the power of applying AI to address some of our most-pressing challenges.

“In this case, we're keen to prove that AI can potentially be used to close gaps in minority ethnic health outcomes.

“Artificial intelligence has the potential to revolutionise care for patients, and we are committed to ensuring this potential is realised for all patients by accounting for the health needs of diverse communities.”

Launched in March, the AI Ethics Initiative at NHSX kicked off with three initial projects, including the competition on AI and Racial and Ethnic Health Inequalities.

The initiative is also exploring addressing algorithmic risk, in partnership with the Ada Lovelace Institute, and is working with Health Education England to empower healthcare professionals to make the most of AI.

Speaking to BBH following this week’s announcement, Mark Frankish, data scientist at SAS UK & Ireland, said: “AI and automation exist to help people make better decisions.

“By implementing well-trained AI, the NHS can provide more-accurate, effective, and personalised treatments for patients than ever before, regardless of background, through assisting decision-making and complementing human expertise.

“However, to trust an algorithm to produce unbiased results, organisations must train it with the widest range of high-quality and relevant data available.

Ultimately, it’s doctors that save lives and who make the final decisions; but the technology is there to help make the best, most-personalised decisions, as quickly as possible

“Only truly-diverse teams will be sufficiently sensitive to the problems of biased models and bring the necessary awareness and vigilance. And this is vital to creating machines which accurately represent ethical human values.

“High-quality, trained AI systems can understand how patient treatment can be optimised for the individual in myriad ways: for instance by calculating the potential effects that cocktails of drugs would have on different types of bodies.

“From here they can make recommendations which the GP can take into consideration when personalising their plan for the patient’s care.

“Ultimately, it’s doctors that save lives and who make the final decisions; but the technology is there to help make the best, most-personalised decisions, as quickly as possible.”

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