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Artificiell intelligens eller intelligent läkekonst? : Om kropp, hälsa och ovisshet i digitaliseringens tidevarv / Artificial intelligence or intelligent art of medicine? : On body, health and uncertainty in the era of digitalizationTamaddon, Leila January 2019 (has links)
Denna essä syftar till att ur filosofiska och idéhistoriska perspektiv belysa utmaningar och möjligheter med artificiell intelligens (AI) och digitalisering inom hälso- och sjukvården, med fokus på läkekonst, kropp, hälsa och ovisshet. Essän undersöker hur automatisering och digitala vårdformer omformar läkekonstens grund, nämligen mötet mellan patienten och läkaren. Genom en fenomenologisk kritik av AI och teknikens väsen, belyses skillnaden mellan människan och maskinen och hur den levda erfarenheten är situerad, förkroppsligad, fylld av mening och delad med andra. Essän utforskar hur situationsunik kunskap som praktisk klokhet, fronesis, samt ett reflekterande förnuft, intellectus,kan hantera den ovisshet som är inbäddad i det allmänmedicinska mötet. Essän belyser även hur digitalisering och AI passar väl med pågående marknadsanpassning av sjukvården, där homo economicus och homo digitalis båda omformar kropp och hälsa till mätbara resurser och data. Avslutningsvis lyfts etiska dilemman kring AI och digitalisering, samt vikten av praktisk och existentiell kunskap som förutsättningar för utvecklandet och designen av en teknik som syftar främja det mänskligt goda. / This essay aims to illuminate challenges and opportunities with artificial intelligence (AI) and digitalization in health care, focusing on the art of medicine, body, health and uncertainty. The theoretical framework is mainly within the fields of phenomenology and philosophical hermeneutics. The essay explores how automatization and digital health care are transforming the essence of medicine: the patient – physician encounter. By a phenomenological critique of AI and the essence of technology, the essay highlights the difference between machines and humans and how lived experience is situated, embodied, filled with meaning and shared with others. The essay explores how situational knowledge such as practical wisdom, phronesis, and reflective understanding, intellectus, can deal with the uncertainty that is embedded in the medical encounter in primary health care. The essay also highlights how digitalization and AI fit well with current market adaptation of health care, where homo economicus and homo digitalis both transform body and health into measurable resources and data. Finally, ethical dilemmas of AI and digitalization are highlighted, as well as the importance of practical and existential knowledge as preconditions for the development and design of a technology that aims to promote the human good.
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Patient and other factors influencing the prescribing of cardiovascular prevention therapy in the general practice setting with and without nurse assessmentMohammed, Mohammed A., El Sayed, C., Marshall, T. January 2012 (has links)
Although guidelines indicate when patients are eligible for antihypertensives and statins, little is known about whether general practitioners (GPs) follow this guidance. To determine the factors influencing GPs decisions to prescribe cardiovascular prevention drugs. DESIGN OF STUDY: Secondary analysis of data collected on patients whose cardiovascular risk factors were measured as part of a controlled study comparing nurse-led risk assessment (four practices) with GP-led risk assessment (two practices). SETTING: Six general practices in the West Midlands, England. PATIENTS: Five hundred patients: 297 assessed by the project nurse, 203 assessed by their GP. MEASUREMENTS: Cardiovascular risk factor data and whether statins or antihypertensives were prescribed. Multivariable logistic regression models investigated the relationship between prescription of preventive treatments and cardiovascular risk factors. RESULTS: Among patients assessed by their GP, statin prescribing was significantly associated only with a total cholesterol concentration >/= 7 mmol/L and antihypertensive prescribing only with blood pressure >/= 160/100 mm Hg. Patients prescribed an antihypertensive by their GP were five times more likely to be prescribed a statin. Among patients assessed by the project nurse, statin prescribing was significantly associated with age, sex, and all major cardiovascular risk factors. Antihypertensive prescribing was associated with blood pressures >/= 140/90 mm Hg and with 10-year cardiovascular risk. LIMITATIONS: Generalizability is limited, as this is a small analysis in the context of a specific cardiovascular prevention program. CONCLUSIONS: GP prescribing of preventive treatments appears to be largely determined by elevation of a single risk factor. When patients were assessed by the project nurse, prescribing was much more consistent with established guidelines.
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