Ageism and Artificial Intelligence: Protocol for a Scoping Review.

BACKGROUND: Artificial intelligence (AI) has emerged as a major driver of technological development in the 21st century, yet little attention has been paid to algorithmic biases toward older adults. OBJECTIVE: This paper documents the search strategy and process for a scoping review exploring how age-related bias is encoded or amplified in AI systems as well as the corresponding legal and ethical implications. METHODS: The scoping review follows a 6-stage methodology framework developed by Arksey and O'Malley. The search strategy has been established in 6 databases. We will investigate the legal implications of ageism in AI by searching grey literature databases, targeted websites, and popular search engines and using an iterative search strategy. Studies meet the inclusion criteria if they are in English, peer-reviewed, available electronically in full text, and meet one of the following two additional criteria: (1) include "bias" related to AI in any application (eg, facial recognition) and (2) discuss bias related to the concept of old age or ageism. At least two reviewers will independently conduct the title, abstract, and full-text screening. Search results will be reported using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) reporting guideline. We will chart data on a structured form and conduct a thematic analysis to highlight the societal, legal, and ethical implications reported in the literature. RESULTS: The database searches resulted in 7595 records when the searches were piloted in November 2021. The scoping review will be completed by December 2022. CONCLUSIONS: The findings will provide interdisciplinary insights into the extent of age-related bias in AI systems. The results will contribute foundational knowledge that can encourage multisectoral cooperation to ensure that AI is developed and deployed in a manner consistent with ethical values and human rights legislation as it relates to an older and aging population. We will publish the review findings in peer-reviewed journals and disseminate the key results with stakeholders via workshops and webinars. TRIAL REGISTRATION: OSF Registries AMG5P; https://osf.io/amg5p. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/33211.

Digital Ageism: Challenges and Opportunities in Artificial Intelligence for Older Adults.

Artificial intelligence (AI) and machine learning are changing our world through their impact on sectors including health care, education, employment, finance, and law. AI systems are developed using data that reflect the implicit and explicit biases of society, and there are significant concerns about how the predictive models in AI systems amplify inequity, privilege, and power in society. The widespread applications of AI have led to mainstream discourse about how AI systems are perpetuating racism, sexism, and classism; yet, concerns about ageism have been largely absent in the AI bias literature. Given the globally aging population and proliferation of AI, there is a need to critically examine the presence of age-related bias in AI systems. This forum article discusses ageism in AI systems and introduces a conceptual model that outlines intersecting pathways of technology development that can produce and reinforce digital ageism in AI systems. We also describe the broader ethical and legal implications and considerations for future directions in digital ageism research to advance knowledge in the field and deepen our understanding of how ageism in AI is fostered by broader cycles of injustice.

Catastrophic gastrointestinal complication of systemic immunosuppression.

We present a case of acute upper gastrointestinal haemorrhage in a patient with systemic vasculitis immunosuppressed on cyclophosphamide and prednisolone. The patient presented with a diffuse haemorrhagic oesophagitis and a non-specific duodenitis. Biopsies taken from the oesophagus and duodenum demonstrated infection with herpes simplex virus (HSV) and cytomegalovirus (CMV) respectively. Viral infection of the upper gastrointestinal tract is a recognised complication of immunosuppression and HSV is one of the most common pathogens. CMV on the other hand most commonly causes a colitis or less commonly oesophagitis. CMV enteritis is rare as is the synchronous infection with two viral agents in an immunocompromised patient having being described in a few case series only. Viral infection of the gastrointestinal tract in immunocompromised patients should be treated with systemic anti-viral medication and consideration to withdrawal of the immunosuppressive therapy if possible and appropriate. The authors highlight the need for a high suspicion of viral infection in immunosuppressed patients presenting with upper gastrointestinal bleeding.