Will Australia and New Zealand spearhead AI integration in surgical procedures?

Digital & Innovation: Australia and New Zealand could become international frontrunners in the safe use of artificial intelligence (AI) in surgical procedures. However, experts stress the crucial need for guidelines to protect patients effectively.

Researchers from the University of Adelaide and Flinders University have delved into the complexities surrounding AI integration in surgery. They not only scrutinised the current landscape but also identified ethical concerns alongside the potential to enhance patient care.

While non-surgical medical colleges (n =25) in Australia and New Zealand have initiated discussions on AI, only a fraction (12%) have issued AI position statements. Nevertheless, the researchers anticipate a shift in this paradigm over time and urge surgical colleges to remain abreast of these perspectives. Notably, no comprehensive examination of public opinion regarding AI in surgical services has been conducted in Australia and New Zealand, a critical gap the researchers advocate addressing.

Dr Joshua Kovoor, lead author of the study and researcher at the Adelaide Medical School, emphasised AI’s transformative potential in enhancing diagnostic precision and operational efficiency.

“The Adelaide Score algorithm is the perfect example of this as we have shown that it can successfully predict discharge within a 12-24 hour period, potentially helping to improve patient management in hospitals,” he said. “However, there are also some limitations with this new technology and it should in no way replace hospital staff. It should always be used as an assistive tool, and its implementation needs to be carefully regulated.”

Addressing concerns surrounding ethics and risk, Professor Guy Maddern, R.P Jepson Professor of Surgery at the University of Adelaide, and a Hepatobiliary Surgeon at the Queen Elizabeth Hospital, said “Surgeons may have difficulty having confidence in AI assisted recommendations due to the lack of reasoning behind the decisions. Current malpractice guidelines will also need to be revised to reflect the use of AI, along with policies around the handling of sensitive patient data.”

In January, the Australian Government released its interim response to the consultation on Safe and Responsible AI in Australia. The government is now considering mandatory guardrails for AI development and deployment in high-risk settings, such as healthcare, whether through changes to existing laws or the creation of new AI specific laws.

“We have heard loud and clear that Australians want stronger guardrails to manage higher-risk AI,” said Ed Husic, Minister for Industry and Science.

Surgical devices that incorporate AI are classified as software as a medical device (SaMD) and are regulated by the Therapeutic Goods Administration (TGA). The delicate balance between fostering clinical advancements and ensuring patient safety underscores the necessity for regulation, with surgical bodies like the Royal Australasian College of Surgeons (RACS) playing a central role.

“Australia has the opportunity to become a global leader in adopting this technology but there needs to be a strict evidence-based approach which reflects international frameworks as well as local factors,” said Professor Maddern. “We recommend the development of infrastructure to monitor and audit AI tools so we can make sure they are benefiting both patients and the system. Patients and surgical staff also need to be educated on the benefits and limitations of this technology.”

While the Australian Ethical Health Alliance and the Australian Alliance for Artificial Intelligence in Healthcare provide guidance for regulating AI, there is a need for a clear framework specifically for the use of AI by surgical services within Australia and New Zealand.

The government is closely monitoring how other countries are responding to the challenges of AI, including initial efforts in the EU, US and Canada. Building on its engagement at the UK AI Safety Summit in November 2023, the government has committed to working with other countries to shape international efforts in this area.

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