• Jonathan Montomoli, Maria Maddalena Bitondo, Marco Cascella, Emanuele Rezoagli, Luca Romeo, Valentina Bellini, Federico Semeraro, Emiliano Gamberini, Emanuele Frontoni, Vanni Agnoletti, Mattia Altini, Paolo Benanti, and Elena Giovanna Bignami.
• Department of Anesthesia and Intensive Care, Infermi Hospital, Romagna Local Health Authority, Viale Settembrini 2, Rimini, 47923, Italy. jonathan.montomoli@gmail.com.
• J Clin Monit Comput. 2024 Apr 4.

AbstractThe integration of Clinical Decision Support Systems (CDSS) based on artificial intelligence (AI) in healthcare is groundbreaking evolution with enormous potential, but its development and ethical implementation, presents unique challenges, particularly in critical care, where physicians often deal with life-threating conditions requiring rapid actions and patients unable to participate in the decisional process. Moreover, development of AI-based CDSS is complex and should address different sources of bias, including data acquisition, health disparities, domain shifts during clinical use, and cognitive biases in decision-making. In this scenario algor-ethics is mandatory and emphasizes the integration of 'Human-in-the-Loop' and 'Algorithmic Stewardship' principles, and the benefits of advanced data engineering. The establishment of Clinical AI Departments (CAID) is necessary to lead AI innovation in healthcare, ensuring ethical integrity and human-centered development in this rapidly evolving field.© 2024. The Author(s).

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