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Information science

Information science Perspectives 4 March 2024 Open Access

Artificial intelligence for surgical services in Australia and New Zealand: opportunities, challenges and recommendations

Artificial intelligence is being rapidly taken up by health care services, presenting opportunities and challenges for its use in the surgical services of Australia and New Zealand

Joshua G Kovoor · Stephen Bacchi · Prakriti Sharma · Srishti Sharma · Medhir Kumawat · Brandon Stretton · Aashray K Gupta · WengOnn Chan · Amal Abou‐Hamden · Guy J Maddern

Mja2 52225
Mental health Research 4 September 2023 Open Access

Substance use, socio‐demographic characteristics, and self‐rated health of people seeking alcohol and other drug treatment in New South Wales: baseline findings from a cohort study

Health services should collect comprehensive patient information during assessment to facilitate more holistic, tailored, person-centred care

Emma Black · Raimondo Bruno · Kristie Mammen · Llewellyn Mills · Krista J Siefried · Rachel M Deacon · Anthony Shakeshaft · Adrian J Dunlop · Nadine Ezard · Mark Montebello · Steven Childs · David Reid · Jennifer Holmes · Nicholas Lintzeris

Mja2 52039
Information science Letters 3 July 2023 Free

Health care in the metaverse

To the Editor: Curtis and colleagues1 describe important implications for consideration as the metaverse begins to affect health care. These implications are particularly salient for individuals with specific physical impairments, especially vision loss. Emphasis on visual input in the metaverse may have implications for patients with vision loss. The lack of tactile input in the metaverse will disproportionately affect people with profound vision loss. The consequences include social isolation, motion sickness, and reduced access to services. In addition, people who lack stereopsis may also be disadvantaged in a metaverse. These individuals do not experience the stereopsis‐derived depth perception required for the three‐dimensional perception of the visual world. Efforts must be made to ensure that monocular depth cues, including linear perspective and motion parallax, are considered during metaverse development.2 Should health care be provided via the metaverse, vision impairment may limit access to these services. Difficulty accessing services may lead to deterioration in ocular conditions and potentially compound the initial vision loss precluding access.3 There are existing strategies that facilitate the use of visual media for people with vision impairment. These methods have been developed for telecommunication, cinematic and video game technologies. Mechanisms to improve accessibility, including having the capacity to increase text size substantially without disrupting user interfaces, could be employed in all screen‐based technologies.4 Effective accessibility features, such as adaptive audio description, must be available for visually impaired users. Ongoing technological development may facilitate metaverse access for people with visual impairment. There is ongoing research into the optimisation of head‐mounted and digital visual displays to facilitate use for those with vision impairment and visual field defects.5 However, this digital display technology will not facilitate access for people with profound vision loss, such as those with no perception of light. Moving forward, companies should strive to provide equal access to services to all individuals, including those with visual impairment. Regulatory frameworks may help to standardise this incorporation of accessibility. The proactive consideration of the needs of the visually impaired during the development of the metaverse may facilitate the implementation of more effective technology. Engaging disability stakeholders during testing phases of technology may help to identify issues at early stages of development.

James Pietris · Yiran Tan · Weng Onn Chan

Mja2 51986
Information science Letters 16 January 2023 Open Access

Health care in the metaverse

To the Editor: The metaverse is a virtual environment merging physical and digital realities.1 Once the thing of movies, metaverses are tipped to be worth $800 billion by 2024.2 They have potential to revolutionise digital health care delivery, access, education, and patient outcomes.3 Artificial intelligence (AI)‐enabled health care, with metaverse enhancement, could create virtual hospitals,4 transform clinical workflows and accelerate the diagnosis and treatment of conditions relating to mental health,5 cardiology,6,7 ophthalmology,8 and oral health,9 for example. AI‐enabled technology demonstrated potential during the pandemic by predicting the incidence of coronavirus disease 2019 (COVID‐19)10 and helping to identify sites for vaccine trials.11 Yet in the absence of strong national and global health governance and accountability mechanisms, digital health ecosystems create risk for medical confidentiality and privacy breaches12 resulting in data sharing13 and use/reuse by corporations or governments outside its intended purpose and the bounds of patient consent.14 For example, a National Health Service (NHS) Foundation Trust in the United Kingdom established patient data sharing with the international technology company DeepMind to develop machine learning‐based management tools,15 but British patient data moved to the United States when Google acquired DeepMind.14 Repurposing health‐related biometric and genomic data that cannot be altered is similarly concerning, and can result in racial profiling16 and privacy violations in the absence of appropriate legislation. Metaverses also have potential to accelerate discriminatory practices. Bias may be embedded in data used to train AI models through lack of community representation or participation.17 Structural inequalities may be reflected in health care datasets, creating risk for discriminatory outcomes.18 For instance, racial bias in a health care therapy algorithm resulted in the discriminatory underestimation of health risk for millions of American citizens, precluding access to vital treatments.19 Prioritising protections for underserved populations and their right to access safe virtual health care is crucial,20 especially for Australians at the intersection of inequities driven by poverty, disability, gender, homelessness, Indigeneity, and for the 11% highly excluded from accessing digital technologies.21 We recommend that the Department of Health and the Australian Digital Health Agency partner with the Australian eSafety Commissioner's work examining metaverse deployment,2 to ensure the highest ethical standards are upheld as planning moves forward and regulatory frameworks are developed.

Caitlin Curtis · Claire E Brolan

Mja2 51793
Information science Letters 19 September 2022 Free

The need for improved Australian data on social determinants of health inequities

To the Editor: We endorse the call of Flavel and colleagues1 for improved data on, and greater attention to inequities in, social determinants of health. People with disability experience poorer health than the general population. Much of this disparity is attributable to entrenched disadvantage in social determinants of health such as employment, housing, and violence.2 Ongoing impacts from the coronavirus disease 2019 (COVID‐19) pandemic may increase disparities in social determinants and health outcomes for people with disability. Yet people with disability remain largely invisible in key data sources.3,4 Disability identifiers are included in several national surveys conducted by the Australian Bureau of Statistics (eg, the Survey of Disability, Ageing and Carers5 and General Social Survey6) and some of the longitudinal datasets mentioned by Flavel and colleagues. However, survey data have limitations: they are based on a population sample, capture data at specific time points, and rely on self‐report information (eg, on income, service use). National surveys typically exclude individuals living in settings such as boarding houses and welfare institutions, where people with disability are over‐represented. Administrative datasets complement survey data. They capture more detailed and often continuous data on individuals, their contact with services and related outcomes. Regrettably, disability status is rarely collected in administrative datasets in Australia. Work is underway on the National Disability Data Asset,7 comprising linked data from multiple state, territory and national administrative sources. This asset will require a robust and consistent basis for identifying individuals with disability, beyond the subset of people identified by their contact with disability‐specific programs or payments. Australia urgently needs a nationally agreed, consistent disability identifier to leverage the opportunity provided by the National Disability Data Asset to identify and monitor disparities in health and social determinants experienced by Australians with disability. Development of such a disability identifier is essential to build a strong evidence base to deliver better outcomes and reduce health inequities. Crucially, people with disability and their representative organisations must be involved as key drivers and decision makers at every stage of development and implementation of the to‐be‐developed national disability identifier.

Nicola Fortune · Jodie Bailie · Gwynnyth Llewellyn

Mja2 51698

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