Figure - available from: Reproductive Health
This content is subject to copyright. Terms and conditions apply.
Source publication
Background
Cervical cancer is the fourth most frequent cancer among women, with 90% of cervical cancer-related deaths occurring in low- and middle-income countries like Cameroon. Visual inspection with acetic acid is often used in low-resource settings to screen for cervical cancer; however, its accuracy can be limited. To address this issue, the S...
Citations
... While distrust was a complex subtheme threaded throughout all the papers and across all the themes, it was also specifically discussed in relation to the development and implementation of AI/ML, 46,47,55,57 and was greatly influenced by trust between consumers and doctors. 40,[44][45][46][47]53,[55][56][57]59,61 There was distrust in the purpose of AI/ ML, how it would be used, and by whom. Consumers expressly stated their distrust of insurance companies, 46,47 pharmaceutical companies 46,47 or other private companies 55 that 'were perceived to be driven by profit'. ...
... In fact, this issue was raised as a key concern in nearly all the papers. 40,42,[45][46][47][48]50,[53][54][55][58][59][60][61][62] Consumers expressed particular concern on the security, and potential misuse, of their data. 42,[46][47][48]50,54,55,59,60 This included concern on how the data would be stored, stating there was the 'potential for errors, breach of privacy, or loss of electronic information' 46 and there was a perception that existing 'data protection and security were … insufficient'. ...
... 40,42,[45][46][47][48]50,[53][54][55][58][59][60][61][62] Consumers expressed particular concern on the security, and potential misuse, of their data. 42,[46][47][48]50,54,55,59,60 This included concern on how the data would be stored, stating there was the 'potential for errors, breach of privacy, or loss of electronic information' 46 and there was a perception that existing 'data protection and security were … insufficient'. 50 Consumers expressed varying levels of distrust for current health system security measures, 42,47 55 Consumers wanted opt-in consent procedures 42,61 as well as the capacity to 'accumulate and search' their own health information. ...
Introduction
Given the increasing number of artificial intelligence and machine learning (AI/ML) tools in healthcare, we aimed to gain an understanding of consumer perspectives on the use of AI/ML tools for healthcare diagnostics.
Methods
We conducted a qualitative systematic review, following established standardized methods, of the existing literature indexed in the following databases up to 4 April 2022: OVID MEDLINE, OVID EMBASE, Scopus and Web of Science.
Results
Fourteen studies were identified as appropriate for inclusion in the meta-synthesis and systematic review. Most studies (n = 12) were conducted in high-income countries, with data extracted from both mixed methods (42.9%) and qualitative (57.1%) studies. The meta-synthesis identified four overarching themes across the included studies: (1) Trust, fear, and uncertainty; (2) Data privacy and ML governance; (3) Impact on healthcare delivery and access; and (4) Consumers want to be engaged.
Conclusion
The current evidence demonstrates consumers’ understandings of AI/ML for medical diagnosis are complex. Consumers express a complex combination of both hesitancy and support towards AI/ML in healthcare diagnosis. Importantly, their views of the use of AI/ML in medical diagnosis are influenced by the perceived trustworthiness of their healthcare providers who use these AI/ML tools. Consumers recognize the potential for AI/ML tools to improve diagnostic accuracy, efficiency and access, and express a strong interest to be engaged in the development and implementation process of AI/ML into routine healthcare.
... Therefore, we recommend replicating the study in other contexts for broader validation. Third, this study focused on HCPs; however, patient perspectives, crucial for understanding technology adoption, were not included but addressed in a separate study [49]. Finally, barriers can be attributed to the use of CAD tools or smartphones. ...
Background
Computer-aided detection and diagnosis (CAD) systems can enhance the objectivity of visual inspection with acetic acid (VIA), which is widely used in low- and middle-income countries (LMICs) for cervical cancer detection. VIA’s reliance on subjective health care provider (HCP) interpretation introduces variability in diagnostic accuracy. CAD tools can address some limitations; nonetheless, understanding the contextual factors affecting CAD integration is essential for effective adoption and sustained use, particularly in resource-constrained settings.
Objective
This study investigated the barriers and facilitators perceived by HCPs in Western Cameroon regarding sustained CAD tool use for cervical cancer detection using VIA. The aim was to guide smooth technology adoption in similar settings by identifying specific barriers and facilitators and optimizing CAD’s potential benefits while minimizing obstacles.
Methods
The perspectives of HCPs on adopting CAD for VIA were explored using a qualitative methodology. The study participants included 8 HCPs (6 midwives and 2 gynecologists) working in the Dschang district, Cameroon. Focus group discussions were conducted with midwives, while individual interviews were conducted with gynecologists to comprehend unique perspectives. Each interview was audio-recorded, transcribed, and independently coded by 2 researchers using the ATLAS.ti (Lumivero, LLC) software. The technology acceptance lifecycle framework guided the content analysis, focusing on the preadoption phases to examine the perceived acceptability and initial acceptance of the CAD tool in clinical workflows. The study findings were reported adhering to the COREQ (Consolidated Criteria for Reporting Qualitative Research) and SRQR (Standards for Reporting Qualitative Research) checklists.
Results
Key elements influencing the sustained use of CAD tools for VIA by HCPs were identified, primarily within the technology acceptance lifecycle’s preadoption framework. Barriers included the system’s ease of use, particularly challenges associated with image acquisition, concerns over confidentiality and data security, limited infrastructure and resources such as the internet and device quality, and potential workflow changes. Facilitators encompassed the perceived improved patient care, the potential for enhanced diagnostic accuracy, and the integration of CAD tools into routine clinical practices, provided that infrastructure and training were adequate. The HCPs emphasized the importance of clinical validation, usability testing, and iterative feedback mechanisms to build trust in the CAD tool’s accuracy and utility.
Conclusions
This study provides practical insights from HCPs in Western Cameroon regarding the adoption of CAD tools for VIA in clinical settings. CAD technology can aid diagnostic objectivity; however, data management, workflow adaptation, and infrastructure limitations must be addressed to avoid “pilotitis”—the failure of digital health tools to progress beyond the pilot phase. Effective implementation requires comprehensive technology management, including regulatory compliance, infrastructure support, and user-focused training. Involving end users can ensure that CAD tools are fully integrated and embraced in LMICs to aid cervical cancer screening.
