Evidence map›Paper›PMID 41884556›Full record

ArticleFrontiers in digital health2026

Ethical integration of patient-reported outcomes and digital biomarkers in AI healthcare models: an expert consensus framework.

Joana Seringa, João V Cordeiro, Rui Santana, Teresa Magalhães

Abstract read
In one paragraph

Article in Frontiers in digital health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Joana SeringaNOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal.
João V CordeiroNOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal.
Rui SantanaNOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal.
Teresa MagalhãesNOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Alongside expected benefits, several ethical concerns arise from Artificial Intelligence (AI) based models. From the design to the implementation and subsequent evaluation, it is crucial to map potential ethical concerns regarding the use of AI models in healthcare. Patient-Reported Outcomes (PROs) and Digital Biomarkers (DBs) are being increasingly collected to improve patient-centered healthcare systems. However, due to the sensitive nature of this data, its processing into AI models may raise ethical concerns that should be considered. While general AI ethics frameworks exist, no expert consensus has specifically addressed the unique ethical challenges of integrating PROs and DBs in AI healthcare models. Objective: This study aims to address this gap by establishing expert consensus on ethical, legal, and social considerations for integrating PROs and DBs into AI-driven healthcare models. Methods: A mixed-method study was performed. Phase 1 consisted of a narrative review to map the ethical landscape and generate an initial pool of recommendations. Phase 2 involved a two-round modified e-Delphi survey to validate and refine these recommendations among a multidisciplinary panel of experts ( Results: The findings of the two complementary components of this study (narrative review and modified e-Delphi study) were organized around five core ethical principles: autonomy, beneficence, non-maleficence, justice, and transparency and accountability. The modified e-Delphi study achieved high consensus (≥80%) on 55 specific recommendations across these principles. Key recommendations included implementing dynamic consent models, establishing continuous model validation protocols, conducting regular impact assessments, ensuring diverse stakeholder engagement to mitigate biases, and maintaining human oversight within AI systems. Conclusion: This study provides the first comprehensive expert-validated ethical framework specifically designed for PROs and DBs integration in AI healthcare models, filling a gap in the literature that has primarily focused on general AI ethics rather than the unique challenges posed by patient-generated health data.

Indexed as

artificial intelligencedigital biomarkerse-Delphi studyethicsnarrative reviewpatient-generated datapatient-reported outcomes

Identifiers

PMID41884556
PMCPMC13008942

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.