Smart technology for Atrial Fibrillation Detection With advancement in technology there have been possibility that detection of atrial fibrillation with new technological advances and integrated with artificial intelligence algorithm has created new edge innovation in medical field. However real expectation of these advances is that these technologies support patient and doctors in detecting abnormalities at early phase or at least diagnose them rapidly with accuracy of results so that preventive treatment can be done to control complication. This is specifically essential in atrial fibrillation (AF) which has high prevalence of possible damage in patients if not detected regularly. The most significant restriction is that AF needs prolonged tracking of disease and heart activity trends for its diagnosis, which makes it tedious through traditional devices(Freedman, 2016).So with technology enabled smart devices the trends in AF can be accurately monitored to capably address this restrictions.As per data revealed by Harvard Health Publishing the earliest detection of AF is one of the initial applications of AI in medicine that was launched by AliveCor and their AliveECG app received FDA sanction in 2014 for their mobile application Kardia for smartphone based ECG tracking and detection of AF(Harvard Health Publishing, 2016).This version of app introduced by AliveCor helped patients track their ECG recording in real time using algorithms as well as aided doctors who were able to manage their patient’s conditions regularly die to intelligent, customized and easy to use features of AliveECG app (AliveCor, 2014).Monitoring of medication, lifestyle activities and continued symptoms in patients helped doctors in enhanced interpretation of their patient’s health status and with 1
advanced attributes, graphical trends a more comprehensive and reliable outlook of patients health status was possible through AliveEGG. The primary stakeholders of the case of AliveECG are patients and doctors who are involved in use and recommendation of these apps to track AF conditions which are life threatening conditions. Patients suffering from heart conditions or known case of AF are those who are primarily impacted by results and reliability rate of AliveECG app as they have believed and trusted the claims made. The secondary stakeholders are designers or developer of AliveECG app who are professional involved in designing, testing and deployment of these computing artifacts. The technicalconcernsin caseof AliveECGapp canemergefrom non-functionalityof algorithms due to which apps provide inaccurate results and records of ECG of patients. Another technical concern may emerge due to software bug that may interrupt the app and crash the software(Flaherty,2014).Thesetechnologyfailuresoftenemergewhendesignersand developer of apps do not correctly design or test these computing artifacts before these versions are launched. Ethically usage of such nonfunctional and faulty technology devices can generate issues of susceptible exposure of risk for patients who may be not aware of these possible failures. Even doctors and developers of technology enabled medical apps are surrounded by ethical issues when these computing artifacts fail which leads to sense of poor liability for failure and shifting of blames(Treskes, van der Velde, Barendse & Bruining, 2016).These ethical issues can be related to ethical principles from three diverse outlook, first in perspective of doctors it is suitable that they develop a legal contract with patients that relieves them from any liability due to technical failures as these are not caused by doctors lack of capability to do their job. This will make doctors interconnect with ethical principle of transparency where both 2
patients and doctors themselves agree to accept their liability for their parts if technology fails (Gilmartin, et al. 2018).Second perspective is of patients who may be exposed to susceptible life threatening risk conditions due to technical failure of apps and so they should receive cost and reimbursement for fault or failure of technology enabled medical devices. Moreover patients should be kept aware of all possible risks that can occur so that their right to informed consent and consciousness of risk is secured. This interrelates with ethical principle of reliability as patients must be able to trust their doctors who should maintain best interest for their patients. Third perspective is of developers of app and these people should be liable to validate the outcomes of their technology as well as insure liability toward possible risks in case of failures as they should test and validate their technology by keeping in perception the susceptibilities that can be caused to patients(Jin, et al. 2019).Ethical principle that relates is principle of liability towards securing patients safety and interests. Further as per Millers 5 rule of computing artifacts it can be stated that in context to ethical behavior and liability in first perspective for doctors the Rule no. 3 is found suitable which states that any person who is recommending technology is morally liable for its use. While in second perspective of patients it can be said that it interconnects with Millers Rule 5 where they have the right to get all information and details regarding the technology that is being used and they should also be made aware about possible risks and foreseeable failures. As per Millers Rule 5 people who use technology should not be directly or indirectly deceived by hiding details and foreseeable consequences of future that can occur due to integration with technology(Miller, 2011).Further third perspective of designers or developers of AliveECG app is interrelated to Millers Rule 1 which defines that these developers of computing artifacts should be liable for 3
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their artifacts as well as their outcomes in future. Thus designers or developers of medical apps should be more liable for their innovation and possible consequences. This solution insures interest of both stakeholders involved in the case as they remain liable to insure that their patients health status is kept in priority and so it should withstand criticism as it integrates ethical principles and insures that all people involved are liable first and foremost to maintain patients wellbeing. Moreover ethically and judiciously the solution secures patients interest and even insures that no single stakeholder involved is given entire blame for any possible outcomes or damages. Also after analysis of ethical principles I can suggest that all stakeholders involved should be made liable for any potential damages due to technology enabled medical devices so that potential of reducing susceptible risks to patient is reduced. Also through such solutions critics of technology can appease innovations and future concerns and complication can be addressed if both doctors, artificial intelligence experts work in collaboration with designers and developer of technology so that high quality and precision focused innovations are built and executed to reduce complications. References AliveCor (2014). AliveCor launches new app to auto detect Atrial Fibrillation in an ECG recording.AliveCor.Retrievedfrom: https://www.alivecor.com/press/press_release/alivecor-launches-new-app-to-auto-detect- atrial-fibrillation-in-an-ecg-recording/Accessed on 12 April, 2020 Flaherty, J. L. (2014). Digital diagnosis: privacy and the regulation of mobile phone health applications.Am.JL&Med.,40,416.Retrievedfrom: https://heinonline.org/HOL/LandingPage?handle=hein.journals/amlmed40&div=26&id= &page= 4
Freedman, B. (2016). Screening for atrial fibrillation using a smartphone: is there an app for that?.JournaloftheAmericanHeartAssociation.Retrievedfrom: https://www.ahajournals.org/doi/abs/10.1161/jaha.116.004000 Gilmartin, C., Arbe-Barnes, E. H., Diamond, M., Fretwell, S., McGivern, E., Vlazaki, M., & Zhu,L. (2018). Varsity medical ethics debate 2018: constant health monitoring-the advance of technology into healthcare.Philos Ethics Humanit MedRetrieved from:https://peh- med.biomedcentral.com/articles/10.1186/s13010-018-0065-0 Harvard Health Publishing (2016). Monitoring your heart rhythm with a smartphone: A good call?HarvardHealthPublishing,Retrievedfrom:https://www.health.harvard.edu/heart- health/monitoring-your-heart-rhythm-with-a-smartphone-a-good-callAccessedon12 April, 2020 Jin, D., Adams, H., Cocco, A. M., Martin, W. G., & Palmer, S. (2019). Smartphones and wearabletechnology: benefits and concerns in cardiology.Medical Journal of Australia. Retrievedfrom:esearchgate.net/profile/Anthony_Cocco/publication/338023103_ Miller,K.W.(2011).MoralResponsibilityforComputingArtifacts:"TheRules".IT Professional,13(3),57-59.Retrievedfrom: https://ieeexplore.ieee.org/abstract/document/5779006/ Treskes, R. W., van der Velde, E. T., Barendse, R., & Bruining, N. (2016). Mobile health in cardiology: a review of currently available medical apps and equipment for remote monitoring.Expertreviewofmedicaldevices,13(9),823-830.Retrievedfrom: https://www.tandfonline.com/doi/abs/10.1080/17434440.2016.1218277 5