Towards clinical implementation of artificial intelligence in cancer care: Concept mapping analysis of provincial workshop findings
Nayyar, C.; Xu, H. H.; Bates, A. T.; Conati, C.; Hilbers, D.; Avery, J.; Raman, S.; Fayaz-Bakhsh, A.; Nunez, J.-J.
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Background: Artificial intelligence (AI) has rapidly garnered interest in healthcare, with research showing promise to improve quality, efficiency, and outcomes. Cancer care's multidisciplinary nature and high coordination demands are well positioned to benefit from AI. While attitudes in the uptake of evidence and toward the implementation of AI in medicine has been explored generally, literature remains scarce with specific regards to AI in cancer care. This study sought to understand how perspectives of both patients and professionals are essential for guiding responsible, effective implementation of evidence-based (EB) AI in cancer care. Methods: We conducted a workshop at the 2024 British Columbia (BC) Cancer Summit (Vancouver, Canada). Discussions addressed three guiding questions: concerns, benefits, and priorities for AI in cancer care. Responses from 48 workshop participants (patients and families, AI/computer science/cancer researchers, clinicians and allied health professionals, information technology professionals, healthcare administrators) underwent structured conceptualization by concept mapping, leveraging multidimensional scaling and hierarchical cluster and subcluster analysis to produce visual and quantitative maps of stakeholder priorities. Results: A total of 265 statements on perceived benefits, concerns, and priorities related to the implementation of AI in cancer care were generated from the workshop and underwent concept mapping. Two clusters were identified; Cluster 1 focused on "Challenges and Safeguards for AI Implementation," and Cluster 2 focused on "Clinical Benefits and Efficiency Gains." Subcluster analysis distinguished 8 thematic subclusters (4 per cluster). Both mean importance (P < .001) and feasibility (P < .001) ratings were significantly higher for Cluster 2. No differences were found between ratings by clinical and nonclinical professionals. Further go-zone analysis classified statements according to their relative superiority/inferiority in importance and feasibility compared to the overall average. Conclusions: Stakeholder ratings were higher for statements describing clinical benefits and efficiency gains than for those describing challenges and safeguards for AI implementation in cancer care. Concept mapping analysis distinguished between workflow-aligned AI applications, perceived as ready for implementation, and system-level governance requirements requiring longer-term investment. Present findings provide a structured, stakeholder-informed framework for prioritizing and sequencing AI implementation efforts in cancer care, constituting a practical blueprint to catalyze meaningful progress.
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