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Ethical, Legal and Social Implications in the Use of Digital Technology for Mental Health Applications

使用数字技术进行心理健康应用的伦理、法律和社会影响

基本信息

批准号：
10478953
负责人：
Nicole A Martinez-Martin
金额：
$ 12.69万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-01 至 2023-10-15
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10478953
关键词：
Accountability Address Adolescent Adoption Algorithms Area Attention Behavior monitoring Behavioral Big Data Caring Categories Cellular Phone Clinical Communication Cultural Backgrounds Data Data Protection Devices Diagnostic Dimensions Empirical Research Ethical Issues Ethics Family Foundations Future Genetic Genomics Goals Guidelines Health Health Services Accessibility Health Technology Healthcare Improve Access Informed Consent Institution Interview Judgment Knowledge Location Machine Learning Mediating Mental Health Mental Health Services Mental disorders Methods Minority Groups Monitor Mood Disorders Motion Patient Care Patient Self-Report Patients Physicians Privacy Psychotic Disorders Psychotic Mood Disorders Qualitative Methods Recommendation Recording of previous events Research Research Personnel Risk Risk Assessment Safety Scholarship Social Policies Surveys Technology Therapeutic Training Translating Translations Trust Voice age group behavioral health chatbot clinical care community setting computer science dashboard data management digital digital health digital mental health ethical legal social implication expectation experience health application health data health information technology improved mHealth neurotechnology novel patient subsets programs risk minimization sensor social implication socioeconomics tool treatment adherence uptake

项目摘要

Digital mental health technology (DMHT) –digital devices (smartphones, sensors) that can monitor and collect personal data from patients (tracking location/voice/motion, self-report), apply algorithms and machine learning (“ML”) to generate and integrate health and risk information (from genomics/family history), and even mediate care (monitoring treatment adherence or chatbot therapy)– is being integrated into mental health clinical care, with the goal of improving access, diagnostics and treatment for mental illness. DMHT poses novel ethical challenges because (1) use of DMHT disrupts traditional frameworks, such as the physician-patient dyad, for addressing ethical obligations and challenges in mental health care; (2) DMHT will contribute to the creation of novel and massive amount of behavioral data and risk categories, particularly when combined with other technologies, such as WGS, which may be difficult for clinicians and patients to evaluate and meaningfully use; and 3) behavioral health data will be created and used outside of frameworks for protecting the privacy of health data and may be experienced as surveillance by patients. The goals of the project are to: (1) examine how key stakeholders – DMHT developers, clinicians and patients – conceptualize and operationalize the ethical, legal and social implications of DMHT as it is translated into clinical care for the treatment of mood and psychotic disorders; and (2) use qualitative and quantitative methods to interview and survey clinicians, patients and consumers who use DMHT to examine the ethical, legal and social implications of the technology, particularly in relation to trust, privacy, data protection and management, and surveillance; and (3) provide improved understandings of how developers, patients, and clinicians perceive and manage ethical, legal and social implications of DMHT, that can be used as a foundation for further research and to provide guidance for ethical and safe use of digital technology in mental health care. he long-term goals of the project are to: 1) develop a research program exploring the ethical, legal and social implications of digital health technologies in mental health care and the potential impact on ethical frameworks in healthcare; 2) generate empirical research that improves understandings of the ethical, legal and social, implications of digital health technology; and 3) to improve understandings of the ethical issues involved in the use of DMHT to inform guidelines and social policy for the use of digital health technology in research, clinical, and community settings.

数字心理健康技术（DMHT）——可以的数字设备（智能手机、传感器）监控并收集患者的个人数据（跟踪位置/语音/动作、自我报告）、申请用于生成和整合健康和风险信息的算法和机器学习（“ML”）（来自基因组学/家族史），甚至调解护理（监测治疗依从性或聊天机器人疗法）——正在融入心理健康临床护理，目标是改善精神疾病的获取、诊断和治疗。 DMHT 带来新的伦理挑战因为 (1) DMHT 的使用破坏了传统框架，例如医患二元关系，解决精神卫生保健中的道德义务和挑战； (2) DMHT将有助于创建新颖且大量的行为数据和风险类别，特别是当与其他技术相结合，例如WGS，这对临床医生和患者来说可能很困难评估并有意义地使用； 3）行为健康数据将在外部创建和使用保护健康数据隐私的框架，可能会被视为监视由患者。该项目的目标是：(1) 检查主要利益相关者 – DMHT 如何开发人员、临床医生和患者——将伦理、法律和社会理念概念化并付诸实施 DMHT 的影响，因为它被转化为治疗情绪和精神病的临床护理疾病； (2) 使用定性和定量方法对临床医生进行访谈和调查，使用 DMHT 来检查道德、法律和社会影响的患者和消费者技术，特别是与信任、隐私、数据保护和管理相关的技术，以及监视; (3) 更好地了解开发人员、患者和临床医生如何认识并管理 DMHT 的道德、法律和社会影响，可将其用作为进一步研究奠定基础，并为数字技术的道德和安全使用提供指导精神卫生保健技术。该项目的长期目标是：1）开展研究项目探讨数字健康技术对精神疾病的伦理、法律和社会影响医疗保健以及对医疗保健道德框架的潜在影响； 2）生成经验旨在提高对数字技术的伦理、法律和社会影响的理解的研究健康技术； 3）提高对使用中涉及的道德问题的理解 DMHT 为在研究中使用数字健康技术提供指导方针和社会政策，临床和社区环境。

项目成果

期刊论文数量（9）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Ethical Development of Digital Phenotyping Tools for Mental Health Applications: Delphi Study.

DOI：
10.2196/27343
发表时间：
2021-07-28
期刊：
JMIR mHealth and uHealth
影响因子：
5
作者：
Martinez-Martin N;Greely HT;Cho MK
通讯作者：
Cho MK

Bridging the AI Chasm: Can EBM Address Representation and Fairness in Clinical Machine Learning?

DOI：
10.1080/15265161.2022.2055212
发表时间：
2022-05
期刊：
AMERICAN JOURNAL OF BIOETHICS
影响因子：
13.4
作者：
Martinez-Martin, Nicole;Cho, Mildred K.
通讯作者：
Cho, Mildred K.

Ethical issues in using ambient intelligence in health-care settings.

DOI：
10.1016/s2589-7500(20)30275-2
发表时间：
2021-03
期刊：
The Lancet. Digital health
影响因子：
0
作者：
Martinez-Martin N;Luo Z;Kaushal A;Adeli E;Haque A;Kelly SS;Wieten S;Cho MK;Magnus D;Fei-Fei L;Schulman K;Milstein A
通讯作者：
Milstein A

Addressing COVID-19 Health Disparities & Latinidad.