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PubMed2026

Privacy, security, and reliability risks of artificial intelligence in healthcare: a systematic review of empirical evidence.

BACKGROUND: Artificial intelligence (AI) is increasingly integrated into healthcare information systems, supporting clinical decision-making, imaging analysis, and predictive modeling. While these applications offer operational and clinical benefits, they also introduce emerging risks to patient privacy, data security, and system reliability. OBJECTIVE: To systematically review empirical evidence on privacy breaches, security vulnerabilities, and misuse associated with AI applications in healthcare settings. METHODS: PubMed, Embase, Web of Science, Scopus, IEEE Xplore, and ACM Digital Library were searched for empirical studies published between January 2015 and November 2025 that evaluated AI use or misuse in clinical diagnosis, treatment, or decision-making. Two reviewers independently screened studies and extracted data using a standardized form. Findings were synthesized narratively due to heterogeneity in study designs, AI methods, and reported outcomes. RESULTS: Of 7,285 records identified through database searches and 205 through citation screening, 22 empirical studies met the inclusion criteria, spanning multiple clinical domains and data modalities, predominantly medical imaging applications. Five recurring threat categories were identified: patient re-identification, membership inference, unauthorized access and adversarial exploitation, input manipulation, and misuse or overinterpretation of AI outputs. Across studies, AI models were shown to encode latent biometric signals across diverse data types, limiting the effectiveness of traditional anonymization and synthetic data approaches. Adversarial attacks and input manipulation were also shown to compromise diagnostic performance and system integrity. CONCLUSION: This systematic review provides empirical evidence suggesting that contemporary AI systems in healthcare introduce privacy and security risks that may challenge traditional assumptions about data protection. These findings underscore the need for privacy- and security-by-design approaches and governance frameworks that address risks across the AI lifecycle.

Humans↗

PubMed2004

FATCAT: a web server for flexible structure comparison and structure similarity searching.

Protein structure comparison, an important problem in structural biology, has two main applications: (i) comparing two protein structures in order to identify the similarities and differences between them, and (ii) searching for structures similar to a query structure. Many web-based resources for both applications are available, but all are based on rigid structural alignment algorithms. FATCAT server implements the recently developed flexible protein structure comparison algorithm FATCAT, which automatically identifies hinges and internal rearrangements in two protein structures. The server provides access to two algorithms: FATCAT-pairwise for pairwise flexible structure comparison and FATCAT-search for database searching for structurally similar proteins. Given two protein structures [in the Protein Data Bank (PDB) format], FATCAT-pairwise reports their structural alignment and the corresponding statistical significance of the similarity measured as a P-value. Users can view the superposition of the structures online in web browsers that support the Chime plug-in, or download the superimposed structures in PDB format. In FATCAT-search, users provide one query structure and the server returns a list of protein structures that are similar to the query, ordered by the P-values. In addition, FATCAT server can report the conformational changes of the query structure as compared to other proteins in the structure database. FATCAT server is available at http://fatcat.burnham.org.

Algorithms↗

PubMed2006

Information Rx: Evaluation of a new informatics tool for physicians, patients, and libraries.

This paper reports selected results from two comprehensive evaluation studies of the Information Prescription (or "Information Rx") Program implementation conducted from 2002-05 by the American College of Physicians Foundation (ACPF) and the U.S. National Library of Medicine (NLM). In this Program physicians are provided with Information Prescription pads, analogous to pads used to prescribe medications, that are used to direct patients to the MedlinePlus web site and its contents that are applicable to a patient's health condition. The results describe the Program's potential to enhance patient education and interpersonal communication from physician and patient perspectives. The findings suggest once physicians adopt the use of an information prescription, they perceive they are providing an additional clinical service that enhances patient education and interpersonal communication. For physicians, participation in information prescription may improve patient communication, encourage information seeking, and lessen the number of poor quality Internet searches that patients frequently self-perform and bring to a doctor's office. Similarly, once patients receive a recommendation from a physician to seek health information on the web, patients may be more comfortable with health seeking on the Internet and discussing their findings with their doctor. The conclusions of the two evaluation studies imply an Information Prescription fosters a dialogue between providers and patients, helps patients use the Internet more effectively and seems to favorably impact patient education. As the medical community and patient advocacy groups continue to emphasize the importance of evidence-based information as the gold standard for accepted care, it can be expected that informatics tools such as Information Rx will come to play an increasingly important role as a vehicle to help identify and access high quality health information on the Internet.

Journal Article↗

PubMed2001

The Internet as a communication tool for academic orthopaedic surgery departments in the United States.

BACKGROUND: The Internet's appeal as an affordable, accessible medium for information transfer makes it a potentially useful tool for practicing physicians. In the past several years, Internet-based health-care companies have proliferated, and many medical centers have established individual web sites. The purpose of the present study was to evaluate academic orthopaedic surgery departments in the United States with respect to Internet visibility and content. METHODS: We reviewed existing web sites for the 154 departments or divisions of orthopaedic surgery currently accredited for resident education by the Accreditation Council for Graduate Medical Education. The study sample consisted of the 113 departments that had a web page listed in the FREIDA (Fellowship and Residency Electronic Interactive Database) database. Each web site was assessed with regard to its informational value in the categories of clinical services, resident education, and physician recruitment. In addition, three commonly employed browsing engines were used to search for individual web sites and to determine their ease of accessibility. RESULTS: In the category of clinical services, sixty-five (57.5%) of the 113 sites provided faculty listings and forty-nine (43.4%) provided office telephone numbers and locations. Only thirteen sites provided information on common orthopaedic conditions, and five had links to other patient-education sites. In the category of resident education, twenty-four sites (21.2%) had online academic schedules, but only two provided access to complete conferences or teaching files. In the category of physician recruitment, ninety-one provided a description of their residency program and fifty-four had information on the application process, but only twenty-six web pages offered detailed departmental statistics. In terms of accessibility, fifty-three programs (46.9%) were identified by one of three popular search engines, seventeen (15%) were identified by more than one search engine, and two (1.8%) were identified by all three. CONCLUSIONS: Academic orthopaedic surgery departments in the United States underutilize the Internet as a source of clinical and educational services. In addition, existing orthopaedic web sites are difficult to access with use of popular search engines. Thus, academic orthopaedic surgery departments in the United States are missing a valuable opportunity to promote awareness of their institutions and to become educational resources for the community.

Academic Medical Centers↗

PubMed2003

Java-based Open Platform for distributed health telematics applications.

Within the European HARP project, a Java-based Open Platform has been specified and implemented to support trustworthy distributed applications for health. Emphasis was put on security services for enabling both communication and application security. The Open Platform is Web-based and comprises the Client environment, Web/Application server, as well as Database and Archive servers. Servlets composed and executed according to the user's authorisation create signed XML messages. From those messages, user-role-related applets are generated. The technical details of the realisation are presented. Possible future enhancements for user-centric, adaptable services based on next-generation mobile service environments are outlined.

Computer Communication Networks↗

PubMed2007

Organization of proteomics data with YassDB.

In recent years the organization of mass spectrometry (MS) data obtained in large-scale proteomics projects became an important issue. This has catalyzed the development of a few different database schemes for storing MS data, as well as some dedicated user interfaces. However, many of these projects are still rather immature and often do not cover all needs. Because our needs were quite specific, it was necessary to build a database that accommodates all the major types of experiments generated in house and that could be easily extended by new modules made by collaborators or students. A database application named "YassDB" will be described in this chapter. The application is implemented in a "three-tier" application architecture, with a database layer, a middle layer consisting of web services and a client layer, containing the user interface. This offers high flexibility: it allows other applications, written in any language, to be written as clients to the database. The setup and use of the YassDB database application with two client programs "pProRep" and "VEMS" will be outlined.

Databases, Protein↗

PubMedDate not supplied

[Internet in scientific investigation].

INTRODUCTION: In the United States all universities, public libraries and most colleges are equipped with rooms containing computers connected to the internet, with free access for both investigators and pupils. The web is the new frontier of telecommunications, particularly regarding science and especially medicine. DEVELOPMENT: One of the applications giving most popularity to the Internet is the World Wide Web system, a graphic environment which permits users to explore the information contained on the Internet, and which grows daily. The rapid access to well organized information is essential for genetic, epidemiological and clinical studies. Today, for instance, genetic investigation is unimaginable without the Internet. In the literature, one often finds specialized investigation which has been developed using the Internet, from which epidemiological data, examples of analysis or sophisticated programs for the presentation of results were obtained, or volunteers recruited for pharmacological studies. The internet gives access to articles published in 5,000 medical journals alone on the databases Medline and Embase. CONCLUSIONS: The availability of information and the ease of communication using the Internet is a prerequisite for scientific work and investigation in many disciplines. Internet is a means of enrichment, and in the future will be even more so, when the information which it contains can be more strictly selected by the users.

Databases, Bibliographic↗

PubMed2002

Patient web-resource interest and internet readiness in pediatric inflammatory bowel disease.

OBJECTIVE: The internet has been touted as a cost-effective method of providing valuable patient education and support resources. However, little is known of the level of internet interest in or access to web-based resources of most chronically ill populations generally, and pediatric populations in particular. Web-based patient resources could be especially applicable to the pediatric inflammatory bowel disease (IBD) population given the potential appeal of an anonymous forum for this group. METHODS: Tertiary-care clinic patients aged 8-18 years and diagnosed with IBD were surveyed by mail. chi and/or analysis of variance were used to compare demographic data from nonresponders and responders and for subgroup analyses. RESULTS: Of 162 eligible patients, 63 (38.9%) completed the survey. Responders did not differ significantly from nonresponders by age, sex, or distribution of disease. Overall, 98.4% of those surveyed had internet access, with 61.9% having access at school. Ninety-five percent had used the internet, while 91% expressed interest in visiting a pediatric IBD website for general IBD information (83%), for support (73%), to pose questions (78%) or read (73%) or respond (60%) to questions, or to chat with others (46%). Despite expressed interest, far fewer had ever used the internet as an IBD information (52.4%) or support (9.5%) resource. Similarly, although 15.8% anticipated visiting a pediatric IBD site weekly, only 1.5% had done so in the week of the survey. CONCLUSIONS: Reported levels of interest in web-based patient resources are high among pediatric IBD patients, yet use may be infrequent.

Adolescent↗

PubMed2006

Applications for protein sequence-function evolution data: mRNA/protein expression analysis and coding SNP scoring tools.

The vast amount of protein sequence data now available, together with accumulating experimental knowledge of protein function, enables modeling of protein sequence and function evolution. The PANTHER database was designed to model evolutionary sequence-function relationships on a large scale. There are a number of applications for these data, and we have implemented web services that address three of them. The first is a protein classification service. Proteins can be classified, using only their amino acid sequences, to evolutionary groups at both the family and subfamily levels. Specific subfamilies, and often families, are further classified when possible according to their functions, including molecular function and the biological processes and pathways they participate in. The second application, then, is an expression data analysis service, where functional classification information can help find biological patterns in the data obtained from genome-wide experiments. The third application is a coding single-nucleotide polymorphism scoring service. In this case, information about evolutionarily related proteins is used to assess the likelihood of a deleterious effect on protein function arising from a single substitution at a specific amino acid position in the protein. All three web services are available at http://www.pantherdb.org/tools.

Amino Acid Substitution↗

PubMed2001

'Televaluation' of clinical information systems: an integrative approach to assessing Web-based systems.

The World Wide Web provides an unprecedented opportunity for widespread access to health-care applications by both patients and providers. The development of new methods for assessing the effectiveness and usability of these systems is becoming a critical issue. This paper describes the distance evaluation (i.e. 'televaluation') of emerging Web-based information technologies. In health informatics evaluation, there is a need for application of new ideas and methods from the fields of cognitive science and usability engineering. A framework is presented for conducting evaluations of health-care information technologies that integrates a number of methods, ranging from deployment of on-line questionnaires (and Web-based forms) to remote video-based usability testing of user interactions with clinical information systems. Examples illustrating application of these techniques are presented for the assessment of a patient clinical information system (PatCIS), as well as an evaluation of use of Web-based clinical guidelines. Issues in designing, prototyping and iteratively refining evaluation components are discussed, along with description of a 'virtual' usability laboratory.

Attitude to Computers↗

PubMed2003

INCLUSive: A web portal and service registry for microarray and regulatory sequence analysis.

INCLUSive is a suite of algorithms and tools for the analysis of gene expression data and the discovery of cis-regulatory sequence elements. The tools allow normalization, filtering and clustering of microarray data, functional scoring of gene clusters, sequence retrieval, and detection of known and unknown regulatory elements using probabilistic sequence models and Gibbs sampling. All tools are available via different web pages and as web services. The web pages are connected and integrated to reflect a methodology and facilitate complex analysis using different tools. The web services can be invoked using standard SOAP messaging. Example clients are available for download to invoke the services from a remote computer or to be integrated with other applications. All services are catalogued and described in a web service registry. The INCLUSive web portal is available for academic purposes at http://www.esat.kuleuven.ac.be/inclusive.

Algorithms↗

PubMed2000

Studying clinician-computer interaction in Web-based systems.

A growing of health-care organizations are in the process of modifying their clinical information systems (CIS) to support browser-based access. Consequently, care-providers are expected to modify their workflow to take advantage of the new technology. Intuitive interfaces, fast response and new functionality are few of the features used to promote endorsement of the change. In parallel, administrators are required to constantly assess user compliance and intervene where necessary to prevent rejection. Such monitoring translates to frequent surveys, analysis of logs and prudent utilization of user-groups. These methods tend to further burden users, suffer from "post-hoc" temporality and are difficult to maintain. In this paper we suggest an alternative approach to such data acquisition. "CareQuest" is an interactive Web-based service that can be woven into clinical applications without coding. It acquires information from the clinician at the relevant point in her workflow. It allows extensive interaction customization, data-driven response, real-time Web-based data-analysis, and full Web-based administration.

Evaluation Studies as Topic↗

PubMedDate not supplied

An experience with an online learning environment to support a change in practice in an emergency department.

Providing continuing education to support a change in practice for a busy Emergency Department poses a challenge. Factors such as shift work, high patient acuity, and unpredictable patient flow create barriers to traditional methods of delivery of a comprehensive educational experience. This article describes an experience with introducing a change in practice using an innovative Web-based delivery plan. Specific strategies were employed to address presentation of content, application of knowledge, establishment of a shared understanding, and enhancement of communication opportunities. The Web-based learning environment proved to be a successful means of providing nurses with a collaborative learning experience around a new practice issue. This experience also highlighted the need for a new skill set for learners and educators using online learning technologies.

Computer-Assisted Instruction↗

PubMed2005

Integrating multiple clinical information systems using the Java message service framework to enable the delivery of urgent exam results at the point of care.

The aim of this study is to determine if network-enabled personal digital assistants (PDAs) can be used to facilitate the timely delivery of urgent radiological exam results by reducing the interval from when the radiologist's initial interpretation is available to when it is first viewed by an emergency department (ED) physician. A web- and Java message service (JMS)-based application was built to replace the original fax-based wet-read procedure. The new system allows radiologists to enter wet-reads from the picture archiving and communication system (PACS) display station and to track discrepancies between the wet-read and final report. It also notifies the ED physicians when exam results are available via the PDAs and permits them to view the full text of the wet-read and final reports from the devices. The new system is compared to the original procedure with the results showing improvements with the wireless method. Furthermore, feedback from a qualitative survey of PDA users was positive, suggesting that PDAs may provide one means for accessing urgent clinical data at the point of care.

Computer Communication Networks↗

PubMed2005

Automated water analyser computer supported system (AWACSS) Part I: Project objectives, basic technology, immunoassay development, software design and networking.

A novel analytical system AWACSS (automated water analyser computer-supported system) based on immunochemical technology has been developed that can measure several organic pollutants at low nanogram per litre level in a single few-minutes analysis without any prior sample pre-concentration nor pre-treatment steps. Having in mind actual needs of water-sector managers related to the implementation of the Drinking Water Directive (DWD) (98/83/EC, 1998) and Water Framework Directive WFD (2000/60/EC, 2000), drinking, ground, surface, and waste waters were major media used for the evaluation of the system performance. The instrument was equipped with remote control and surveillance facilities. The system's software allows for the internet-based networking between the measurement and control stations, global management, trend analysis, and early-warning applications. The experience of water laboratories has been utilised at the design of the instrument's hardware and software in order to make the system rugged and user-friendly. Several market surveys were conducted during the project to assess the applicability of the final system. A web-based AWACSS database was created for automated evaluation and storage of the obtained data in a format compatible with major databases of environmental organic pollutants in Europe. This first part article gives the reader an overview of the aims and scope of the AWACSS project as well as details about basic technology, immunoassays, software, and networking developed and utilised within the research project. The second part article reports on the system performance, first real sample measurements, and an international collaborative trial (inter-laboratory tests) to compare the biosensor with conventional anayltical methods.

Algorithms↗

PubMed2005

Comparative evaluation of two applications for delivering a multimedia medical course in the French-speaking Virtual Medical University (UMVF).

This paper describes a comparative evaluation of two applications delivering a multimedia course: a conventional web server (WS) and an integrated e-learning platform in the form of a virtual campus (VC). We used a qualitative method for comparing their acceptance of the on-line course provided by the two different interfaces. The two groups were globally satisfied. However, a decrease in satisfaction was noted at the end of the experimentation in the VC group. This may be explained by a more complex graphic user interface of the VC and some constraints which do not exist with the WS. Students from both groups also had limitations about the multimedia environment.

Consumer Behavior↗

PubMed2006

Effects of dimethoate on spiders from metal pollution gradient.

In this study, an attempt has been made to assess whether a chronic exposure to metals in habitats under a strong industrial pressure might have equipped spiders with biochemical defensive mechanisms enabling them to survive an additional chemical stress. To check this, non-web-building wolf spiders Pardosa lugubris (Lycosidae) and funnel web Agelena labyrinthica (Agelenidae) were collected at five variously polluted meadows and, under laboratory conditions, intoxicated with either single or multiple dose of dimethoate (OP pesticide). Then the activities of detoxifying (carboxylesterase: CarE, glutathione S-transferase: GST), antioxidative (selene-dependent and selene-independent glutathione peroxidases: GPOX and GSTPx) enzymes as well as acetylcholinesterase as a biomarker of exposure to OP pesticides were measured. In web-building A. labyrinthica, even a single application of the pesticide caused the inhibition of CarE, GSTPx and GPOX in individuals from less polluted sites and AChE and GST in specimens pre-exposed to high metal concentrations. Multiple intoxication, irrespectively of the site, caused significant, in comparison to controls, decrease in CarE, AChE and GSTPx activities. Actively hunting P. lugubris seem more resistant to acute pesticide intoxication, since the spiders from each site had a constant level of GST and AChE. In individuals of this species from heavily polluted sites, the inhibition caused by multiple intoxication with dimethoate was stated only for glutathione peroxidases.

Acetylcholinesterase↗

PubMed2002

Development and evaluation of an interactive Web-based breast imaging game for medical students.

RATIONALE AND OBJECTIVES: The purpose of this study was to develop and evaluate by student survey an interactive computer tool for teaching breast imaging to 4th-year medical students. MATERIALS AND METHODS: An interactive computer game was designed for competitive play between two students or between one student and one of two cyber players. Content was determined from a survey of faculty members in breast imaging, and the survey results were grouped into 10 learning objectives. Pre-existing knowledge of these objectives in 16 4th-year medical students was tested by a quiz. On the basis of the learning objectives, case scenarios and questions were incorporated into the game, which was programmed in JavaScript and available on a Web site. Preliminary and final versions of the game were used for teaching 55 4th-year medical students. A subgroup of 42 students received an informational handout. Student surveys were performed. RESULTS: Mean quiz score for pre-existing knowledge of the learning objectives was 45% (range, 13%-67%). Survey results showed that images contributed to educational value (92%), the Web site was more interesting to students than the handout (93.6%), and the Web site provided additional reinforcement of learning beyond that of the handout or lecture (88.8%). Students liked the Web site accessibility (96%), and more than 70% agreed the Web site was also appropriate for other medical specialties. An Internet search identified no other Web-based computer games for medical students. CONCLUSION: Students surveyed found the Web site to be worthwhile, convenient, and applicable to other specialties.

Breast↗