Sustainable development goals applied to digital pathology and artificial intelligence applications in low- to middle-income countries

Digital Pathology (DP) and Artificial Intelligence (AI) can be useful in low- and middle-income countries; however, many challenges exist. The United Nations developed sustainable development goals that aim to overcome some of these challenges. The sustainable development goals have not been applied to DP/AI applications in low- to middle income countries. We established a framework to align the 17 sustainable development goals with a 27-indicator list for low- and middle-income countries (World Bank/WHO) and a list of 21 essential elements for DP/AI. After categorization into three domains (human factors, IT/electronics, and materials + reagents), we permutated these layers into 153 concatenated statements for prioritization on a four-tiered scale. The two authors tested the subjective ranking framework and endpoints included ranked sum scores and visualization across the three layers. The authors assigned 364 points with 1.1–1.3 points per statement. We noted the prioritization of human factors (43%) at the indicator layer whereas IT/electronic (36%) and human factors (35%) scored highest at the essential elements layer. The authors considered goal 9 (industry, innovation, and infrastructure; average points 2.33; sum 42), goal 4 (quality education; 2.17; 39), and goal 8 (decent work and economic growth; 2.11; 38) most relevant; intra-/inter-rater variability assessment after a 3-month-washout period confirmed these findings. The established framework allows individual stakeholders to capture the relative importance of sustainable development goals for overcoming limitations to a specific problem. The framework can be used to raise awareness and help identify synergies between large-scale global objectives and solutions in resource-limited settings.