Skip to main content

Foundation Models in Healthcare: Opportunities, Biases and Regulatory Prospects in Europe

  • Conference paper
  • First Online:
Electronic Government and the Information Systems Perspective (EGOVIS 2022)

Abstract

This article concerns the rise of a new paradigm in AI - “foundation models,” which are pre-trained on broad data at scale and subsequently adapted to particular downstream tasks. In particular, it explores the issue from the perspective of healthcare and biomedicine, focusing on the benefits of foundation models, as well as their propensity to encode bias, which threatens to exacerbate discriminatory practices already experienced by patients in Europe. Section 1 offers a brief introduction concerning the use of AI in healthcare and biomedicine and the problem of divergencies in access to and quality of healthcare across Europe. Section 2 familiarises the reader with the technical qualities of foundation models and recent developments in the field. Section 3 explains how the new health data strategy proposed by the EU could foster the development of foundation models in healthcare. Section 4 elaborates on their benefits in healthcare and biomedicine, while Sect. 5 explores the risk of bias exhibited by foundation models. Section 6 comments on the uncertain status of foundation models under the proposed Artificial Intelligence Act and offers brief recommendations concerning future regulation. Section 7 concludes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 44.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 59.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Abdi, J., et al.: Scoping review on the use of socially assistive robot technology in elderly care. BMJ Open 8(2), e018815 (2018). https://doi.org/10.1136/bmjopen-2017-018815

    Article  Google Scholar 

  2. Abid, A., Farooqi, M., Zou, J.: Persistent anti-Muslim bias in large language models. arXiv:2101.05783. arXiv (2021).https://doi.org/10.48550/arXiv.2101.05783

  3. Alpaydin, E.: Machine Learning, Revised and Updated Edition. The MIT Press (The MIT Press Essential Knowledge Series), Cambridge, Massachusetts (2021)

    Google Scholar 

  4. Alsentzer, E., et al.: Publicly available clinical BERT embeddings. arXiv:1904.03323. arXiv (2019). https://doi.org/10.48550/arXiv.1904.03323

  5. Auffray, C., et al.: Making sense of big data in health research: towards an EU action plan. Genome Med. 8(1), 71 (2016). https://doi.org/10.1186/s13073-016-0323-y

    Article  Google Scholar 

  6. Barera, M.: Mind the gap: addressing structural equity and inclusion on Wikipedia. http://hdl.handle.net/10106/29572 (2020). Accessed 20 Mar 2022

  7. Bender, E.M., et al.: On the dangers of stochastic parrots: can language models be too big?. In: Proceedings of the 2021 ACM Conference on Fairness, Accountability, and Transparency, pp. 610–623. Association for Computing Machinery (FAccT ’21), New York, NY, USA (2021). doi:https://doi.org/10.1145/3442188.3445922

  8. Birhane, A., Prabhu, V.U., Kahembwe, E.: Multimodal datasets: misogyny, pornography, and malignant stereotypes. arXiv:2110.01963. arXiv (2021). https://doi.org/10.48550/arXiv.2110.01963

  9. Bolukbasi, T., et al.: ‘Man is to computer programmer as woman is to homemaker? debiasing word embeddings In: Lee, D., et al. (eds.) Advances in Neural Information Processing Systems’, Vol. 29. Curran Associates, Inc. https://proceedings.neurips.cc/paper/2016/file/a486cd07e4ac3d270571622f4f316ec5-Paper.pdf (2016). Accessed 20 Mar 2022

  10. Bommasani, R., et al.: On the opportunities and risks of foundation models. arXiv:2108.07258. arXiv (2021). https://doi.org/10.48550/arXiv.2108.07258

  11. Broadband Commission for Sustainable Development: Working group on digital and AI in health: reimagining global health through artificial intelligence: the roadmap to AI maturity (Sep 2020)

    Google Scholar 

  12. Brown, T.B., et al.: Language models are few-shot learners. arXiv:2005.14165. arXiv (2020). https://doi.org/10.48550/arXiv.2005.14165

  13. Caruana, R., et al.: Intelligible models for healthcare: predicting pneumonia risk and hospital 30-day readmission. In: Proceedings of the 21th ACM SIGKDD International Conference on Knowledge Discovery and Data Mining, pp. 1721–1730. Association for Computing Machinery (KDD ’15), New York, NY, USA (2015). https://doi.org/10.1145/2783258.2788613

  14. Chaix, B., et al.: When chatbots meet patients: one-year prospective study of conversations between patients with breast cancer and a chatbot. JMIR Cancer 5(1), e12856 (2019). https://doi.org/10.2196/12856

    Article  Google Scholar 

  15. Chowdhery, A., et al.: PaLM: scaling language modeling with pathways. arXiv. http://arxiv.org/abs/2204.02311 (2022)

  16. Communication from the Commission to the European Parliament and the Council: A European health data space: harnessing the power of health data for people, patients and innovation COM, 196 final (2022)

    Google Scholar 

  17. Communication from the Commission to the European Parliament: the council, the european economic and social committee and the committee of the regions. A European strategy for data COM, 66 final (2020)

    Google Scholar 

  18. Council of Europe: Recommendation Rec: 10 of the committee of ministers to member states on better access to health care for Roma and Travellers in Europe (Adopted by the Committee of Ministers on 12 July 2006 at the 971st meeting of the Ministers’ Deputies) (2006)

    Google Scholar 

  19. Council of the European Union: Proposal for a regulation of the european parliament and of the council laying down harmonised rules on artificial intelligence (Artificial Intelligence Act) and amending certain Union legislative acts - Slovenian Presidency compromise text. Brussels, 2021/0106(COD) (29 Nov 2021)

    Google Scholar 

  20. Cui, C., et al.: Deep multi-modal fusion of image and non-image data in disease diagnosis and prognosis: a review. arXiv:2203.15588. arXiv (2022). https://doi.org/10.48550/arXiv.2203.15588

  21. Demner-Fushman, D., Mrabet, Y., Ben Abacha, A.: Consumer health information and question answering: helping consumers find answers to their health-related information needs. J. Am. Med. Inform. Assoc.: JAMIA 27(2), 194–201 (2020). https://doi.org/10.1093/jamia/ocz152

    Article  Google Scholar 

  22. Dias Oliva, T., Antonialli, D.M., Gomes, A.: Fighting hate speech, silencing drag queens? artificial intelligence in content moderation and risks to LGBTQ voices online. Sex. Cult. 25(2), 700–732 (2020). https://doi.org/10.1007/s12119-020-09790-w

    Article  Google Scholar 

  23. Federico, G.: Access to healthcare in the European Union: are EU patients (Effectively) protected against discriminatory practices? In: Rossi, L.S., Casolari, F. (eds.) The Principle of Equality in EU Law, pp. 229–253. Springer, Cham (2017). https://doi.org/10.1007/978-3-319-66137-7_8

    Chapter  Google Scholar 

  24. Di Federico, G.: ‘Stuck in the middle with you…wondering what it is I should do. Some Considerations on EU’s Response to COVID-19’ 7 EUROJUS, pp. 60–85 (2020)

    Google Scholar 

  25. Directive (EU): 2019/1024 of the European Parliament and of the Council of 20 June 2019 on Open Data and the Re-use of Public Sector Information OJ L 172, pp. 56–83 (26 Jun 2019)

    Google Scholar 

  26. European Union Agency for Fundamental Rights: Inequalities and Multiple Discrimination in Access to and Quality of Healthcare. Publications Office, LU. (2013). https://doi.org/10.2811/17523. Accessed 12 May 2022

  27. European Union Agency for Fundamental Rights: Coronavirus Pandemic in the EU: Impact on Roma and Travellers, Bulletin #5, 1 March - 30 June 2020. Publications Office, LU (2020). https://doi.org/10.2811/978921. (Accessed 13 May 2022

  28. European Commission: Horizon 2020 Work Programme 2018–2020: Health, Demographic Change and Wellbeing. European Commission Decision C(2020)4029 of (17 Jun 2020)

    Google Scholar 

  29. European Commission: Study to Support the Preparation of the European’s Commission Initiative to Extend the List of EU Crimes in Article 83 of the Treaty on the Functioning of the EU to Hate Speech and Hate crime. Publications Office of the European Union, Luxembourg (2021)

    Google Scholar 

  30. European Parliament: Draft Opinion of the Committee on Legal Affairs for the Committee on the Internal Market and Consumer Protection and the Committee on Civil Liberties, Justice and Home Affairs on the proposal for a regulation of the European Parliament and of the Council laying down Harmonised Rules on Artificial Intelligence (Artificial Intelligence Act) and Amending Certain Union Legislative Acts. Brussels, 2021/0106(COD) (2 Mar 2022)

    Google Scholar 

  31. Equinet: Equality, Diversity and Non-Discrimination in Healthcare: Learning from the Work of Equality Bodies, Brussels (2021)

    Google Scholar 

  32. Funahashi, K.: Big data in health care - predicting your future health’ 94 southern California law review, pp. 355–390 (2021)

    Google Scholar 

  33. Guo, W., Caliskan, A.: Detecting emergent intersectional biases: contextualized word embeddings contain a distribution of human-like biases. In: Proceedings of the 2021 AAAI/ACM Conference on AI, Ethics, and Society, pp. 122–133 (2021). https://doi.org/10.1145/3461702.3462536

  34. Harrer, S., et al.: Artificial intelligence for clinical trial design. Trends Pharmacol. Sci. 40(8), 577–591 (2019). https://doi.org/10.1016/j.tips.2019.05.005

    Article  Google Scholar 

  35. High-Level Conference: Governing the Game Changer – Impacts of artificial intelligence development on human rights, democracy and the rule of law. (Helsinki 2019) CommDH/Speech (2019)

    Google Scholar 

  36. International Coalition of Medicines Regulatory Authorities (ICMRA): Informal Innovation Network Horizon Scanning Assessment Report – Artificial Intelligence (Aug 2021)

    Google Scholar 

  37. Korngiebel, D.M., Mooney, S.D.: ‘Considering the possibilities and pitfalls of generative pre-trained transformer 3 (GPT-3) in healthcare delivery. NPJ Digit. Med. 4(1), 1–3 (2021). https://doi.org/10.1038/s41746-021-00464-x

  38. Kulpa, E., Rahman, A.T., Vahia, I.V.: Approaches to assessing the impact of robotics in geriatric mental health care: a scoping review. Int. Rev. Psychiatry (Abingdon, England) 33(4), 424–434 (2021). https://doi.org/10.1080/09540261.2020.1839391

    Article  Google Scholar 

  39. Lu, K., et al.: Pretrained transformers as universal computation engines. arXiv:2103.05247. arXiv (2021). https://doi.org/10.48550/arXiv.2103.05247

  40. Muller, C., et al.: AIA in-depth #1: objective, scope, definition.https://allai.nl/wp-content/uploads/2022/03/AIA-in-depth-Objective-Scope-and-Definition.pdf (ALLAI 2022). Accessed 20 May 2022

  41. Percha, B.: Modern clinical text mining: a guide and review. Ann. Rev. Biomed. Data Sci. 4, 165–187 (2021). https://doi.org/10.1146/annurev-biodatasci-030421-030931

    Article  Google Scholar 

  42. Proposal for a Regulation of the European Parliament and of the Council on European data governance and amending Regulation (EU) 2018/1724 (Data Governance Act) COM, 767 final (2020)

    Google Scholar 

  43. Proposal for the Regulation of the European Parliament and of the Council laying down harmonized rules on Artificial Intelligence and amending certain Union legislative acts COM, 206 final (2021)

    Google Scholar 

  44. Proposal for a Regulation of the European Parliament and of the Council on harmonised rules on fair access to and use of data (Data Act) COM, 68 final (2022)

    Google Scholar 

  45. Proposal for a Regulation of the European Parliament and the Council on the European Health Data Space COM, 197 final (2022)

    Google Scholar 

  46. Rae, J.W., et al.: Scaling language models: methods, analysis & insights from training gopher. arXiv:2112.11446. arXiv (2022). https://doi.org/10.48550/arXiv.2112.11446

  47. Ramesh, A. et al. (2022) Hierarchical Text-Conditional Image Generation with CLIP Latents. arXiv:2204.06125. arXiv. doi:https://doi.org/10.48550/arXiv.2204.06125

  48. Rasmy, L., et al.: Med-BERT: pretrained contextualized embeddings on large-scale structured electronic health records for disease prediction. NPJ Digit. Med. 4(1), 86 (2021). https://doi.org/10.1038/s41746-021-00455-y

    Article  Google Scholar 

  49. Regulation 2017/745 of the European Parliament and the Council of 5 April 2017 on medical devices amending Directive 2001/83/EC, Regulation (EC) No 178/2002 and Regulation (EC) No 1223/2009 and repealing Council Directives 90/385/EEC and 93/42/EEC OJ L 117, pp. 1–175 (5 May 2017)

    Google Scholar 

  50. Rousseau, A., Baudelaire, C., Riera, K.: Doctor GPT-3: hype or reality?. Nabla. https://www.nabla.com/blog/gpt-3/ (27 Oct 2020). Accessed 20 Mar 2022

  51. Scholz, N., European parliament, and directorate-general for parliamentary research services: Addressing health inequalities in the European Union: concepts, action, state of play: in-depth analysis. https://op.europa.eu/publication/manifestation_identifier/PUB_QA0120125ENN (2020). Accessed 12 May 2022

  52. Tsaban, T., et al.: Harnessing protein folding neural networks for peptide–protein docking. Nat. Commun. 13(1), 176 (2022). https://doi.org/10.1038/s41467-021-27838-9

    Article  Google Scholar 

  53. World Health Organization: Ethics and governance of artificial intelligence for health: WHO guidance. World Health Organization, Geneva. https://apps.who.int/iris/handle/10665/341996 (2021). Accessed 12 May 2022

  54. Zhang, H., et al.: Hurtful words: quantifying biases in clinical contextual word embeddings. arXiv:2003.11515. arXiv (2020).https://doi.org/10.48550/arXiv.2003.11515

  55. Zhang D., et al.: The AI Index 2022 Annual Report’ AI Index Steering Committee. Stanford Institute for Human-Centered AI (2022)

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Malwina Anna Wójcik .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this paper

Check for updates. Verify currency and authenticity via CrossMark

Cite this paper

Wójcik, M.A. (2022). Foundation Models in Healthcare: Opportunities, Biases and Regulatory Prospects in Europe. In: Kő, A., Francesconi, E., Kotsis, G., Tjoa, A.M., Khalil, I. (eds) Electronic Government and the Information Systems Perspective. EGOVIS 2022. Lecture Notes in Computer Science, vol 13429. Springer, Cham. https://doi.org/10.1007/978-3-031-12673-4_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-12673-4_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-12672-7

  • Online ISBN: 978-3-031-12673-4

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics