Equity, Inclusivity, and Innovative Digital Technologies to Improve Adolescent and Young Adult Health Article Swipe

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Sonoo Thadaney Israni , Michael E. Matheny , Ryan Matlow , Danielle Whicher ·

YOU? · · 2020 · Open Access · · DOI: https://doi.org/10.1016/j.jadohealth.2020.05.014

The author Yuval Harari opined, "humans were always far better at inventing tools than using them wisely" [[1]Hariri Y.N. 21 lessons for the 21st century. Speigel & Grau, New York2018Google Scholar]. The "tool" to which this caution is most relevant in the 21st century is artificial intelligence (AI), the use of which has proliferated in many fields. Health care is no exception, and adolescent and young adult (AYA) health care is of special interest to AI. For example, in this supplement, Giovanelli et al. see the hope and promise of carefully leveraging AI to support adolescent health, underscoring the need for multidisciplinary developmental science teams with expertise in cognitive development, medicine, psychology, computer science, and medical informatics [[2]Giovanelli A. Ozer E.M. Dahl R.E. Leveraging technology to improve health in adolescence: A developmental science perspective.J Adolesc Health. 2020; 67: S7-S13Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar]. Rowe and Lester contribute a computer science perspective on how emerging AI technologies create new opportunities for personalizing technology-based health interventions to adolescents [[3]Rowe J. Lester J.C. Artificial intelligence for personalized preventive adolescent healthcare.J Adolesc Health. 2020; 67: S52-S58Abstract Full Text Full Text PDF Scopus (17) Google Scholar]. This Commentary explores the other side: the unique perils of applying AI to AYA health care. Given this population's vulnerability, health care needs, and graduated autonomy from the adults who have thus far governed their lives, centering equitable and inclusive AI is crucial. Consider the Google Nightingale whistleblower case disclosing the "transfer of medical history data, which can be accessed by Google staff" [[4]Pilkington E. Google's secret cache of medical data includes names and full details of millions – whistleblower. The Guardian, 2019Google Scholar]. Add the lifetime risk for vulnerable populations lacking relevant safeguards while profit-motivated organizations compete for health care market share, targeting consumer behavior, and leveraging health care and other data for profit. The potential unintended consequences for personal privacy and equitable inclusion are staggering. Despite their tech-savviness, AYAs are vulnerable because their online identities are being created, whereas their offline identities are still forming. Social and pragmatic pressures, such as the use of technology in education, result in AYA technology usage and the sharing of personal information without clear guidance or consent around the potential implications of said sharing [[5]McVeigh T. Iranian fugitive: Identity mix-up with shot Neda wrecked my life. The Guardian, 2012Google Scholar]. AYAs are unwittingly creating life-long, permanent internet and social media records (unless they are governed by General Data Protection Regulation's right to be forgotten clause), increasing the probability of privacy breaches [[6]Sarker A. Chandrashekar P. Magge A. et al.Discovering cohorts of pregnant women from social media for safety surveillance and analysis.J Med Internet Res. 2017; 19: e361Crossref PubMed Scopus (10) Google Scholar]. When consent is treated as merely a checkbox—and not a truly informed bidirectional process—this permanence is especially troubling. In particular, technological platforms create new venues for bullying, assault, and victimization, with permanent digital records leaving lasting opportunities for insult or attack. The characteristics of technology-based assault (and the corresponding reduction in personal control of sensitive and private information) can leave AYA feeling helpless and lacking agency, thereby constituting new forms of traumatization and childhood adversity. Robust AI systems should prioritize collaboration, open communication, safety, and social responsibility. Otherwise, AYAs are left at significant psychological and social risk. Wong et al. describe several challenges to leveraging AI to improve preventative health care for AYA: "the disconnectedness between digital health tools and clinical care, threats to AYA privacy and security, and difficulty identifying high-value digital health products for AYA." The challenges of applying AI to health care have been well documented [[7]Matheny M. Thadaney Israni S. Ahmed M. Whicher D. Artificial Intelligence in Health Care: The Hope, the Hype, the Promise, the Peril. National Academy of Medicine, Washington, DC2019Google Scholar]. Three perils most relevant to AYA are data bias, surveillance capitalism, and sharenting. Digital tools rely on data for the training and robustness of algorithms, and the lack of population-representative and of historically biased data leads to "Weapons of Math Destruction" [[8]O'Neill C. Weapons of Math destruction. Crown, New York2018Google Scholar]. Currently deployed health care AI has already created discriminatory outcomes for minorities, and this could be further exacerbated via race, age, sex, and heteronormativity bias [[9]Nordling L. A fairer way forward for AI in health care.Nature. 2019; 573: S103-S105Crossref PubMed Scopus (28) Google Scholar,[10]Stein V. Genetic research has a white bias, and it may be hurting everyone's health.PBS Newshour. 2019; Google Scholar]. Another concern is the use of improper proxies. For example, the use of health care usage as a proxy for health care needs caused an algorithm deployed on 100 million patients in the U.S. to be racially biased against black patients when prioritizing health resources [[11]Obermeyer Z. Powers B. Vogeli C. Mullainathan S. Dissecting racial bias in an algorithm used to manage the health of populations.Science. 2019; 366: 447-453Crossref PubMed Scopus (1109) Google Scholar]. The computer science adage, Garbage-In, Garbage-Out, necessitates closely inspecting the data used to develop digital tools: questioning underlying biases and ensuring population representativeness in the development team; appropriateness of how the tool should and/or could be deployed; and assessing unintended consequences if the tool were to be misused [[12]Thadaney Israni S. Verghese A. Humanizing artificial intelligence.JAMA. 2019; 321: 29-30Crossref PubMed Scopus (32) Google Scholar]. "Surveillance capitalism" is particularly challenging for youth because it widely collects consumer data and monetizes it via digital tools [[13]Zuboff S. The age of surveillance capitalism. PublicAffairs, New York2019Google Scholar]. Lacking clear consent, we run the risk of patient-provided data assets unethically monetized. There is a need to address and clarify current regulations, legislation, and patient expectations when patient data are used for building profit-motivated products or for research, which creates intellectual property. The promise of influencing human behavior for ideal health outcomes often proposes linking data from social media, environmental surveillance, education, and other life spaces. But, issues of consent, privacy, potential misuse, and data governance have not been clearly addressed. In 2019, Google and the University of Chicago were sued because the university shared deidentified data with Google. The suit alleges the data could be reidentified given "Google's expertise in data mining and AI" [[14]Copeland R. Google's 'Project Nightingale' gathers personal health data on millions of Americans.Wall Street J. 2019; Google Scholar]. "Sharenting" is a unique conundrum for children. Described as "online sharing about parenting," parents shape their children's digital identity long before young people define themselves. The disclosures parents make online follow their children into adulthood. Social media and blogging have changed the landscape facing today's children as they come of age. Parents' rights to control the upbringing of their children and parents' rights to free speech trumps a child's interest in their own privacy [[15]Steinberg S.B. Sharenting: Children's privacy in the age of social media.Emory L J. 2017; 66: 839Google Scholar]. From a psychological perspective, these conundrums may have negative implications for AYA's mental health and general well-being. Despite these aforementioned perils, AI has the promise to advance AYA health care if adopted appropriately. The 2019 National Academy of Medicine publication on AI health care (developed through an iterative process involving a multistakeholder group of experts) proposes a human rights values framework for implementing AI. Prioritizing human-centeredness over business criteria such as efficiency and cost will prevent unintended consequences of "automating inequality" [[12]Thadaney Israni S. Verghese A. Humanizing artificial intelligence.JAMA. 2019; 321: 29-30Crossref PubMed Scopus (32) Google Scholar,[16]Eubanks V. Automating inequality: How high-tech tools profile, police, and punish the poor. St. Martin's Press, New York2019Google Scholar] (Figure 1). Today, social determinants of health, adverse childhood experiences, and perverse incentives already skew health outcomes. In addition, many technologies worsen inequities in health care via the digital divide [17Bay area regional health inequities initiative. Framework.http://barhii.org/framework/Date accessed: May 15, 2020Google Scholar, 18Rosenthal E. How economic incentives have created our dysfunctional US medical market.https://medium.com/@RosenthalHealth/how-economic-incentives-have-created-our-dysfunctional-us-medical-market-b681c51d6436Date accessed: May 15, 2020Google Scholar, 19Makri A. Bridging the digital divide in health care.Lancet Digital Health. 2019; 1: e204-e205Abstract Full Text Full Text PDF Google Scholar]. "Technochauvinim" refers to the belief that the proverbial AI hammer is the only solution [[20]Broussard M. Artificial unintelligence: How computers misunderstand the world. The MIT Press, Cambridge, Mass2019Google Scholar]. Sadly, it delivers transactional care because digital tools focus on that which is currently measurable and digitizable, disregarding transformative care, which is human-centered and true caring. Thus, permitting the business of medicine to minimize the caring in health care. Because AI has the potential to exacerbate existing inequities in health and health care, we must balance innovative digital technologies for improving AYA health with equitable inclusivity. We recommend explicitly incorporating the quintuple aim when building and deploying health care AI (Figure 2). That which is measured is prioritized and delivered. Else the caring in health care will be reserved for those with the privilege of concierge medicine, leaving kiosk-dispensed empty health delivery for the less privileged.Figure 2Quintuple aim for devising and deploying health care interventions.(source: NAM "AI in Healthcare: The Hope, The Hype, The Promise, The Peril," 2019).View Large Image Figure ViewerDownload Hi-res image Download (PPT) AI is a game-changing technology, but it needs to be thoughtfully integrated with health care to avoid societal harm. We must center a human rights framework, prioritizing equitable inclusion, when devising and deploying solutions. We must also welcome regulatory scrutiny, which promotes the use of technologies for improving population health. "Technology that is not subject to such scrutiny does not deserve our trust, nor should we ever allow it to be deeply integrated into our work" [[21]Verghese A. How tech can turn doctors into clerical workers. The New York Times, 2018Google Scholar]. This Commentary benefits from Thadaney Israni, Matheny, and Whicher's roles as coeditors of the National Academy of Medicine's Working Group on artificial intelligence in health care and their coauthoring and coediting of the NAM Special Publication: "AI in Healthcare: The Hope, The Hype, The Promise, The Peril" (available at: https://aboutdigitalhealth.com/2019/12/18/report-ai-in-healthcare-the-hope-the-hype-the-promise-the-peril/).

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Landing Page: https://doi.org/10.1016/j.jadohealth.2020.05.014
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Title: Equity, Inclusivity, and Innovative Digital Technologies to Improve Adolescent and Young Adult Health

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Authors: Sonoo Thadaney Israni, Michael E. Matheny, Ryan Matlow, Danielle Whicher

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Concepts: Health care, Scopus, Psychology, Psychological intervention, Population, Digital health, Autonomy, Health equity, Medical education, Medicine, Public relations, Public health, MEDLINE, Nursing, Political science, Psychiatry, Law, Environmental health

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abstract_inverted_index.their	231, 325, 331, 338, 1065, 1081, 1108, 1121, 1630
abstract_inverted_index.these	1145, 1159
abstract_inverted_index.those	1465
abstract_inverted_index.tools	12, 575, 649, 904, 1243, 1372
abstract_inverted_index.truly	467
abstract_inverted_index.usage	360, 763
abstract_inverted_index.using	14
abstract_inverted_index.which	34, 51, 253, 955, 1376, 1385, 1448, 1551
abstract_inverted_index.while	291
abstract_inverted_index.white	735
abstract_inverted_index.women	437
abstract_inverted_index.work"	1586
abstract_inverted_index.young	65, 1071
abstract_inverted_index.youth	892
abstract_inverted_index."tool"	32
abstract_inverted_index.(1109)	819
abstract_inverted_index.Crown,	682
abstract_inverted_index.Figure	1505
abstract_inverted_index.Google	147, 195, 242, 258, 455, 728, 746, 820, 884, 1000, 1048, 1236, 1334
abstract_inverted_index.Harari	3
abstract_inverted_index.Health	57, 618
abstract_inverted_index.Hi-res	1507
abstract_inverted_index.Israni	609, 871, 1223
abstract_inverted_index.Lester	151, 174
abstract_inverted_index.Peril"	1649
abstract_inverted_index.Peril.	627
abstract_inverted_index.Powers	795
abstract_inverted_index.Press,	1252, 1361
abstract_inverted_index.PubMed	144, 452, 725, 817, 881, 1233
abstract_inverted_index.Robust	532
abstract_inverted_index.Sadly,	1365
abstract_inverted_index.Scopus	145, 193, 453, 726, 818, 882, 1234
abstract_inverted_index.Social	344, 1085
abstract_inverted_index.Street	1045
abstract_inverted_index.Times,	1600
abstract_inverted_index.Today,	1258
abstract_inverted_index.Vogeli	797
abstract_inverted_index.[17Bay	1286
abstract_inverted_index.adage,	825
abstract_inverted_index.adults	225
abstract_inverted_index.always	7
abstract_inverted_index.and/or	855
abstract_inverted_index.around	372
abstract_inverted_index.assets	926
abstract_inverted_index.author	1
abstract_inverted_index.before	1070
abstract_inverted_index.belief	1340
abstract_inverted_index.better	9
abstract_inverted_index.biased	668, 785
abstract_inverted_index.biases	840
abstract_inverted_index.caring	1400, 1457
abstract_inverted_index.caused	771
abstract_inverted_index.center	1532
abstract_inverted_index.create	162, 479
abstract_inverted_index.deeply	1582
abstract_inverted_index.define	1073
abstract_inverted_index.divide	1285, 1320
abstract_inverted_index.facing	1093
abstract_inverted_index.fairer	714
abstract_inverted_index.follow	1080
abstract_inverted_index.hammer	1345
abstract_inverted_index.health	68, 127, 168, 211, 217, 296, 305, 566, 574, 590, 600, 688, 720, 761, 768, 791, 811, 967, 1039, 1154, 1169, 1183, 1271, 1280, 1289, 1322, 1402, 1414, 1416, 1427, 1442, 1459, 1475, 1487, 1524, 1627
abstract_inverted_index.insult	495
abstract_inverted_index.issues	984
abstract_inverted_index.lives,	232
abstract_inverted_index.manage	809
abstract_inverted_index.market	298
abstract_inverted_index.media,	975
abstract_inverted_index.mental	1153
abstract_inverted_index.merely	462
abstract_inverted_index.mining	1029
abstract_inverted_index.mix-up	384
abstract_inverted_index.needs,	219
abstract_inverted_index.online	332, 1079
abstract_inverted_index.people	1072
abstract_inverted_index.perils	205, 636
abstract_inverted_index.punish	1247
abstract_inverted_index.racial	802
abstract_inverted_index.refers	1337
abstract_inverted_index.result	356
abstract_inverted_index.rights	1102, 1112, 1199, 1535
abstract_inverted_index.safety	442
abstract_inverted_index.secret	263
abstract_inverted_index.share,	299
abstract_inverted_index.shared	1011
abstract_inverted_index.should	535, 854, 1575
abstract_inverted_index.social	403, 439, 542, 552, 974, 1133, 1259
abstract_inverted_index.speech	1115
abstract_inverted_index.staff"	259
abstract_inverted_index.tools:	837
abstract_inverted_index.trumps	1116
abstract_inverted_index.trust,	1573
abstract_inverted_index.unique	204, 1053
abstract_inverted_index.values	1200
abstract_inverted_index.venues	481
abstract_inverted_index.widely	895
abstract_inverted_index.world.	1358
abstract_inverted_index.worsen	1277
abstract_inverted_index."humans	5
abstract_inverted_index."online	1059
abstract_inverted_index.(Figure	1256, 1445
abstract_inverted_index.(unless	406
abstract_inverted_index.19Makri	1315
abstract_inverted_index.Academy	629, 1177, 1618
abstract_inverted_index.Adolesc	134, 183
abstract_inverted_index.Another	748
abstract_inverted_index.Because	1404
abstract_inverted_index.Chicago	1005
abstract_inverted_index.Despite	324, 1158
abstract_inverted_index.Digital	648, 1324
abstract_inverted_index.General	411
abstract_inverted_index.Genetic	731
abstract_inverted_index.Google.	1015
abstract_inverted_index.Health.	135, 184, 1325
abstract_inverted_index.Iranian	381
abstract_inverted_index.Israni,	1608
abstract_inverted_index.Lacking	916
abstract_inverted_index.Peril,"	1501
abstract_inverted_index.Special	1637
abstract_inverted_index.Speigel	25
abstract_inverted_index.Weapons	678
abstract_inverted_index.Whicher	613
abstract_inverted_index.Working	1621
abstract_inverted_index.address	934
abstract_inverted_index.adopted	1172
abstract_inverted_index.advance	1167
abstract_inverted_index.adverse	1263
abstract_inverted_index.against	786
abstract_inverted_index.agency,	522
abstract_inverted_index.alleges	1018
abstract_inverted_index.already	692, 1269
abstract_inverted_index.assault	502
abstract_inverted_index.attack.	497
abstract_inverted_index.balance	1420
abstract_inverted_index.because	330, 893, 1008, 1370
abstract_inverted_index.between	572
abstract_inverted_index.caring.	1390
abstract_inverted_index.caution	36
abstract_inverted_index.century	43
abstract_inverted_index.changed	1090
abstract_inverted_index.child's	1118
abstract_inverted_index.clarify	936
abstract_inverted_index.clearly	996
abstract_inverted_index.closely	829
abstract_inverted_index.cohorts	434
abstract_inverted_index.compete	294
abstract_inverted_index.concern	749
abstract_inverted_index.consent	371, 458
abstract_inverted_index.control	509, 1104
abstract_inverted_index.created	693, 1304
abstract_inverted_index.creates	956
abstract_inverted_index.current	937
abstract_inverted_index.deserve	1571
abstract_inverted_index.details	272
abstract_inverted_index.develop	835
abstract_inverted_index.digital	489, 573, 589, 836, 903, 1067, 1284, 1319, 1371, 1422
abstract_inverted_index.doctors	1593
abstract_inverted_index.feeling	518
abstract_inverted_index.fields.	56
abstract_inverted_index.forward	716
abstract_inverted_index.further	702
abstract_inverted_index.gathers	1037
abstract_inverted_index.general	1156
abstract_inverted_index.health,	96, 1262
abstract_inverted_index.health.	1560
abstract_inverted_index.history	251
abstract_inverted_index.hurting	741
abstract_inverted_index.improve	126, 564
abstract_inverted_index.lacking	288, 521
abstract_inverted_index.lasting	492
abstract_inverted_index.leaving	491, 1472
abstract_inverted_index.lessons	20
abstract_inverted_index.linking	971
abstract_inverted_index.medical	115, 250, 266, 1308
abstract_inverted_index.million	777
abstract_inverted_index.misuse,	989
abstract_inverted_index.misused	869
abstract_inverted_index.offline	339
abstract_inverted_index.opined,	4
abstract_inverted_index.parents	1063, 1077
abstract_inverted_index.patient	941, 944
abstract_inverted_index.perils,	1161
abstract_inverted_index.police,	1245
abstract_inverted_index.prevent	1216
abstract_inverted_index.privacy	318, 424, 582, 1123, 1128
abstract_inverted_index.private	513
abstract_inverted_index.process	1189
abstract_inverted_index.profit.	311
abstract_inverted_index.promise	88, 960, 1165
abstract_inverted_index.records	405, 490
abstract_inverted_index.safety,	540
abstract_inverted_index.science	103, 132, 155, 824
abstract_inverted_index.several	558
abstract_inverted_index.sharing	363, 378, 1060
abstract_inverted_index.spaces.	982
abstract_inverted_index.special	72
abstract_inverted_index.subject	1565
abstract_inverted_index.support	94
abstract_inverted_index.systems	534
abstract_inverted_index.thereby	523
abstract_inverted_index.threats	579
abstract_inverted_index.through	1186
abstract_inverted_index.today's	1094
abstract_inverted_index.treated	460
abstract_inverted_index.welcome	1548
abstract_inverted_index.whereas	337
abstract_inverted_index.wisely"	16
abstract_inverted_index.without	367
abstract_inverted_index.wrecked	388
abstract_inverted_index."Weapons	672
abstract_inverted_index.'Project	1035
abstract_inverted_index.Bridging	1317
abstract_inverted_index.Consider	240
abstract_inverted_index.Download	1509
abstract_inverted_index.Google's	262, 1034
abstract_inverted_index.Identity	383
abstract_inverted_index.Internet	447
abstract_inverted_index.Martin's	1251
abstract_inverted_index.Matheny,	1609
abstract_inverted_index.Medicine	1179
abstract_inverted_index.National	628, 1176, 1617
abstract_inverted_index.Parents'	1101
abstract_inverted_index.Promise,	625, 1499, 1647
abstract_inverted_index.Scholar,	1297, 1314
abstract_inverted_index.Scholar]	1255
abstract_inverted_index.Thadaney	608, 1607
abstract_inverted_index.Verghese	873, 1225
abstract_inverted_index.[[3]Rowe	172
abstract_inverted_index.accessed	256
abstract_inverted_index.applying	207, 597
abstract_inverted_index.assault,	484
abstract_inverted_index.autonomy	222
abstract_inverted_index.behavior	964
abstract_inverted_index.benefits	1605
abstract_inverted_index.blogging	1088
abstract_inverted_index.breaches	425
abstract_inverted_index.building	949, 1439
abstract_inverted_index.business	1208, 1394
abstract_inverted_index.century.	24
abstract_inverted_index.children	1082, 1095, 1109
abstract_inverted_index.clause),	419
abstract_inverted_index.clerical	1595
abstract_inverted_index.clinical	577
abstract_inverted_index.collects	896
abstract_inverted_index.computer	112, 154, 823
abstract_inverted_index.consent,	918, 986
abstract_inverted_index.consumer	301, 897
abstract_inverted_index.created,	336
abstract_inverted_index.creating	398
abstract_inverted_index.criteria	1209
abstract_inverted_index.crucial.	239
abstract_inverted_index.delivers	1367
abstract_inverted_index.delivery	1476
abstract_inverted_index.deployed	687, 774
abstract_inverted_index.describe	557
abstract_inverted_index.devising	1484, 1541
abstract_inverted_index.economic	1301
abstract_inverted_index.emerging	159
abstract_inverted_index.ensuring	842
abstract_inverted_index.example,	77, 757
abstract_inverted_index.existing	1411
abstract_inverted_index.experts)	1195
abstract_inverted_index.explores	199
abstract_inverted_index.forming.	343
abstract_inverted_index.governed	230, 409
abstract_inverted_index.guidance	369
abstract_inverted_index.helpless	519
abstract_inverted_index.identity	1068
abstract_inverted_index.improper	754
abstract_inverted_index.includes	268
abstract_inverted_index.informed	468
abstract_inverted_index.interest	73, 1119
abstract_inverted_index.internet	401
abstract_inverted_index.lifetime	283
abstract_inverted_index.measured	1450
abstract_inverted_index.medicine	1396
abstract_inverted_index.millions	274, 1042
abstract_inverted_index.minimize	1398
abstract_inverted_index.negative	1149
abstract_inverted_index.outcomes	695, 968
abstract_inverted_index.parents'	1111
abstract_inverted_index.patients	778, 788
abstract_inverted_index.personal	317, 365, 508, 1038
abstract_inverted_index.perverse	1267
abstract_inverted_index.pregnant	436
abstract_inverted_index.privacy,	987
abstract_inverted_index.products	591, 951
abstract_inverted_index.profile,	1244
abstract_inverted_index.promotes	1552
abstract_inverted_index.proposes	970, 1196
abstract_inverted_index.proxies.	755
abstract_inverted_index.racially	784
abstract_inverted_index.regional	1288
abstract_inverted_index.relevant	39, 289, 638
abstract_inverted_index.research	732
abstract_inverted_index.reserved	1463
abstract_inverted_index.science,	113
abstract_inverted_index.scrutiny	1568
abstract_inverted_index.societal	1528
abstract_inverted_index.solution	1349
abstract_inverted_index.training	655
abstract_inverted_index.workers.	1596
abstract_inverted_index."Google's	1025
abstract_inverted_index."transfer	248
abstract_inverted_index.839Google	1139
abstract_inverted_index.Currently	686
abstract_inverted_index.Described	1057
abstract_inverted_index.Guardian,	278, 392
abstract_inverted_index.Medicine,	631
abstract_inverted_index.Newshour.	744
abstract_inverted_index.Scholar].	30, 148, 196, 280, 394, 456, 634, 685, 747, 821, 885, 915, 1049, 1140, 1335, 1364, 1602
abstract_inverted_index.Whicher's	1611
abstract_inverted_index.accessed:	1293, 1310
abstract_inverted_index.addition,	1274
abstract_inverted_index.algorithm	773, 806
abstract_inverted_index.assessing	860
abstract_inverted_index.behavior,	302
abstract_inverted_index.bullying,	483
abstract_inverted_index.carefully	90
abstract_inverted_index.centering	233
abstract_inverted_index.childhood	530, 1264
abstract_inverted_index.children.	1056
abstract_inverted_index.coediting	1633
abstract_inverted_index.coeditors	1614
abstract_inverted_index.cognitive	108
abstract_inverted_index.computers	1355
abstract_inverted_index.concierge	1470
abstract_inverted_index.conundrum	1054
abstract_inverted_index.currently	1378
abstract_inverted_index.deployed;	858
abstract_inverted_index.deploying	1441, 1486, 1543
abstract_inverted_index.equitable	234, 320, 1429, 1538
abstract_inverted_index.expertise	106, 1026
abstract_inverted_index.forgotten	418
abstract_inverted_index.framework	1201
abstract_inverted_index.fugitive:	382
abstract_inverted_index.graduated	221
abstract_inverted_index.high-tech	1242
abstract_inverted_index.improving	1425, 1558
abstract_inverted_index.inclusion	321
abstract_inverted_index.inclusive	236
abstract_inverted_index.inventing	11
abstract_inverted_index.involving	1190
abstract_inverted_index.iterative	1188
abstract_inverted_index.landscape	1092
abstract_inverted_index.medicine,	110, 1471
abstract_inverted_index.monetizes	900
abstract_inverted_index.outcomes.	1272
abstract_inverted_index.permanent	400, 488
abstract_inverted_index.platforms	478
abstract_inverted_index.potential	313, 374, 988, 1408
abstract_inverted_index.pragmatic	346
abstract_inverted_index.privilege	1468
abstract_inverted_index.property.	958
abstract_inverted_index.quintuple	1436
abstract_inverted_index.recommend	1432
abstract_inverted_index.reduction	506
abstract_inverted_index.research,	954
abstract_inverted_index.resources	792
abstract_inverted_index.scrutiny,	1550
abstract_inverted_index.security,	584
abstract_inverted_index.sensitive	511
abstract_inverted_index.targeting	300
abstract_inverted_index.(available	1650
abstract_inverted_index.(developed	1185
abstract_inverted_index.2012Google	393
abstract_inverted_index.2018Google	1601
abstract_inverted_index.2019).View	1502
abstract_inverted_index.2019Google	279
abstract_inverted_index.2020Google	1296, 1313
abstract_inverted_index.2Quintuple	1481
abstract_inverted_index.Artificial	176, 615, 1352
abstract_inverted_index.Automating	1239
abstract_inverted_index.Cambridge,	1362
abstract_inverted_index.Children's	1127
abstract_inverted_index.Commentary	198, 1604
abstract_inverted_index.Dissecting	801
abstract_inverted_index.Giovanelli	81
abstract_inverted_index.Humanizing	875, 1227
abstract_inverted_index.Leveraging	123
abstract_inverted_index.Medicine's	1620
abstract_inverted_index.Otherwise,	544
abstract_inverted_index.Protection	413
abstract_inverted_index.University	1003
abstract_inverted_index.[[1]Hariri	17
abstract_inverted_index.[[6]Sarker	426
abstract_inverted_index.addressed.	997
abstract_inverted_index.adolescent	63, 95, 181
abstract_inverted_index.adulthood.	1084
abstract_inverted_index.adversity.	531
abstract_inverted_index.analysis.J	445
abstract_inverted_index.artificial	45, 876, 1228, 1624
abstract_inverted_index.challenges	559, 595
abstract_inverted_index.children's	1066
abstract_inverted_index.contribute	152
abstract_inverted_index.conundrums	1146
abstract_inverted_index.delivered.	1454
abstract_inverted_index.difficulty	586
abstract_inverted_index.disclosing	246
abstract_inverted_index.documented	605
abstract_inverted_index.education,	355, 978
abstract_inverted_index.efficiency	1212
abstract_inverted_index.especially	473
abstract_inverted_index.everyone's	742
abstract_inverted_index.exacerbate	1410
abstract_inverted_index.exception,	61
abstract_inverted_index.explicitly	1433
abstract_inverted_index.framework,	1536
abstract_inverted_index.governance	992
abstract_inverted_index.health.PBS	743
abstract_inverted_index.high-value	588
abstract_inverted_index.identities	333, 340
abstract_inverted_index.incentives	1268, 1302
abstract_inverted_index.inclusion,	1539
abstract_inverted_index.increasing	420
abstract_inverted_index.inequities	1278, 1290, 1412
abstract_inverted_index.innovative	1421
abstract_inverted_index.inspecting	830
abstract_inverted_index.integrated	1522, 1583
abstract_inverted_index.leveraging	91, 304, 561
abstract_inverted_index.life-long,	399
abstract_inverted_index.measurable	1379
abstract_inverted_index.monetized.	928
abstract_inverted_index.permanence	471
abstract_inverted_index.permitting	1392
abstract_inverted_index.population	843, 1559
abstract_inverted_index.pressures,	347
abstract_inverted_index.preventive	180
abstract_inverted_index.prioritize	536
abstract_inverted_index.proverbial	1343
abstract_inverted_index.regulatory	1549
abstract_inverted_index.robustness	657
abstract_inverted_index.safeguards	290
abstract_inverted_index.solutions.	1544
abstract_inverted_index.technology	124, 353, 359
abstract_inverted_index.troubling.	474
abstract_inverted_index.underlying	839
abstract_inverted_index.unintended	314, 861, 1217
abstract_inverted_index.university	1010
abstract_inverted_index.upbringing	1106
abstract_inverted_index.vulnerable	286, 329
abstract_inverted_index."Technology	1561
abstract_inverted_index."automating	1220
abstract_inverted_index.18Rosenthal	1298
abstract_inverted_index.Garbage-In,	826
abstract_inverted_index.Healthcare:	1493, 1641
abstract_inverted_index.Nightingale	243
abstract_inverted_index.Sharenting:	1126
abstract_inverted_index.Washington,	632
abstract_inverted_index.[[13]Zuboff	905
abstract_inverted_index.[[5]McVeigh	379
abstract_inverted_index.[[7]Matheny	606
abstract_inverted_index.[[8]O'Neill	676
abstract_inverted_index.adolescents	171
abstract_inverted_index.algorithms,	659
abstract_inverted_index.capitalism"	887
abstract_inverted_index.capitalism,	645
abstract_inverted_index.capitalism.	911
abstract_inverted_index.care.Lancet	1323
abstract_inverted_index.challenging	890
abstract_inverted_index.coauthoring	1631
abstract_inverted_index.development	847
abstract_inverted_index.disclosures	1076
abstract_inverted_index.exacerbated	703
abstract_inverted_index.identifying	587
abstract_inverted_index.inequality"	1221
abstract_inverted_index.inequality:	1240
abstract_inverted_index.influencing	962
abstract_inverted_index.informatics	116
abstract_inverted_index.information	366
abstract_inverted_index.initiative.	1291
abstract_inverted_index.media.Emory	1134
abstract_inverted_index.minorities,	697
abstract_inverted_index.parenting,"	1062
abstract_inverted_index.particular,	476
abstract_inverted_index.perspective	156
abstract_inverted_index.populations	287
abstract_inverted_index.prioritized	1452
abstract_inverted_index.probability	422
abstract_inverted_index.psychology,	111
abstract_inverted_index.publication	1180
abstract_inverted_index.questioning	838
abstract_inverted_index.sharenting.	647
abstract_inverted_index.significant	549
abstract_inverted_index.staggering.	323
abstract_inverted_index.supplement,	80
abstract_inverted_index.technology,	1515
abstract_inverted_index.themselves.	1074
abstract_inverted_index.unethically	927
abstract_inverted_index.unwittingly	397
abstract_inverted_index.well-being.	1157
abstract_inverted_index."Sharenting"	1050
abstract_inverted_index.DC2019Google	633
abstract_inverted_index.Destruction"	675
abstract_inverted_index.Garbage-Out,	827
abstract_inverted_index.Intelligence	616
abstract_inverted_index.Mullainathan	799
abstract_inverted_index.Nightingale'	1036
abstract_inverted_index.Prioritizing	1205
abstract_inverted_index.Publication:	1638
abstract_inverted_index.Regulation's	414
abstract_inverted_index.[[9]Nordling	711
abstract_inverted_index.adolescence:	129
abstract_inverted_index.care.Nature.	721
abstract_inverted_index.consequences	315, 862, 1218
abstract_inverted_index.constituting	524
abstract_inverted_index.deidentified	1012
abstract_inverted_index.destruction.	681
abstract_inverted_index.determinants	1260
abstract_inverted_index.development,	109
abstract_inverted_index.digitizable,	1381
abstract_inverted_index.disregarding	1382
abstract_inverted_index.e361Crossref	451
abstract_inverted_index.expectations	942
abstract_inverted_index.experiences,	1265
abstract_inverted_index.healthcare.J	182
abstract_inverted_index.historically	667
abstract_inverted_index.implementing	1203
abstract_inverted_index.implications	375, 1150
abstract_inverted_index.inclusivity.	1430
abstract_inverted_index.information)	514
abstract_inverted_index.intellectual	957
abstract_inverted_index.intelligence	46, 177, 1625
abstract_inverted_index.legislation,	939
abstract_inverted_index.necessitates	828
abstract_inverted_index.particularly	889
abstract_inverted_index.personalized	179
abstract_inverted_index.perspective,	1144
abstract_inverted_index.population's	215
abstract_inverted_index.preventative	565
abstract_inverted_index.prioritizing	790, 1537
abstract_inverted_index.proliferated	53
abstract_inverted_index.regulations,	938
abstract_inverted_index.reidentified	1023
abstract_inverted_index.surveillance	443, 644, 910
abstract_inverted_index.technologies	161, 1276, 1423, 1556
abstract_inverted_index.thoughtfully	1521
abstract_inverted_index.underscoring	97
abstract_inverted_index."Surveillance	886
abstract_inverted_index.29-30Crossref	880, 1232
abstract_inverted_index.Chandrashekar	428
abstract_inverted_index.[[12]Thadaney	870, 1222
abstract_inverted_index.[[14]Copeland	1032
abstract_inverted_index.[[21]Verghese	1587
abstract_inverted_index.bidirectional	469
abstract_inverted_index.corresponding	505
abstract_inverted_index.developmental	102, 131
abstract_inverted_index.dysfunctional	1306
abstract_inverted_index.environmental	976
abstract_inverted_index.game-changing	1514
abstract_inverted_index.incorporating	1434
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