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Rapid advancements in artificial intelligence and machine learning (AI/ML) in healthcare raise pressing questions about how much users should trust AI/ML systems, particularly for high stakes clinical decision-making. Ensuring that user trust is properly calibrated to a tool's computational capacities and limitations has both practical and ethical implications, given that overtrust or undertrust can influence over-reliance or under-reliance on algorithmic tools, with significant implications for patient safety and health outcomes. It is, thus, important to better understand how variability in trust criteria across stakeholders, settings, tools and use cases may influence approaches to using AI/ML tools in real settings. As part of a 5-year, multi-institutional Agency for Health Care Research and Quality-funded study, we identify trust criteria for a survival prediction algorithm intended to support clinical decision-making for left ventricular assist device therapy, using semistructured interviews (n=40) with patients and physicians, analysed via thematic analysis. Findings suggest that physicians and patients share similar empirical considerations for trust, which were primarily in nature, focused on accuracy and validity of AI/ML estimates. Trust evaluations considered the nature, integrity and relevance of training data rather than the computational nature of algorithms themselves, suggesting a need to distinguish 'source' from 'functional' explainability. To a lesser extent, trust criteria were also relational (endorsement from others) and sometimes based on personal beliefs and experience. We discuss implications for promoting appropriate and responsible trust calibration for clinical decision-making use AI/ML.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11101592 | PMC |
http://dx.doi.org/10.1136/jme-2023-109338 | DOI Listing |
Radiology
December 2024
From the Departments of Radiology (G. Brembilla, M.C., A.D.P., T.R., R.P., S.L., F.D.C.), Urology (G. Basile, M.B., M.M., A.B., F.M.), and Medical Oncology (D.R., C.M., V.T., A.C., D.P., E.C., A.N.), IRCCS Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy (G. Brembilla, G. Basile, M.C., T.R., R.P., D.P., E.C., M.B., M.M., A.B., F.M., A.N., F.D.C.); Division of Surgery and Interventional Science, University College London, London, United Kingdom (F.G.); Department of Radiology, University College London Hospital NHS Foundation Trust, London, United Kingdom (F.G.); Genitourinary Department, Programma Prostata (P.G.) and Department of Radiology (A. Messina, G. Calareso), Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Urology, University of Texas MD Anderson Cancer Center, Houston, Tex (A. Martini); and Department of Radiology, IRCCS Ospedale San Raffaele-Turro, Milan, Italy (G. Cardone).
Background An accurate method of assessing the response of muscle-invasive bladder cancer (MIBC) to neoadjuvant treatment is needed for selecting candidates for bladder-sparing strategies. Purpose To evaluate the diagnostic accuracy and reproducibility of neoadjuvant chemotherapy Vesical Imaging Reporting and Data System (nacVI-RADS) scores and posttreatment Vesical Imaging Reporting and Data System (VI-RADS) scores when assessing MIBC response to neoadjuvant immunotherapy with multiparametric MRI (mpMRI). Materials and Methods A retrospective analysis of MRI scans was conducted in patients enrolled in the PURE-01 study (NCT02736266) from February 2017 to December 2019 who underwent pre- and postimmunotherapy mpMRI before radical cystectomy.
View Article and Find Full Text PDFPacing Clin Electrophysiol
December 2024
Department of Cardiology, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK.
Background: Pulmonary vein isolation (PVI) has been established as an effective management option for symptomatic paroxysmal atrial fibrillation (PAF). We aimed to explore the role of P-wave parameters in a 12-lead electrocardiogram (ECG) in predicting the success of repeat PAF ablation.
Methods: We enrolled consecutive patients who underwent a second AF ablation procedure for PAF in a UK tertiary center after an index ablation conducted between 2018 and 2019 and a repeat ablation up to 2021.
Ther Adv Musculoskelet Dis
December 2024
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, Windmill Road, Oxford OX3 7HE, UK.
Background: Psoriatic arthritis (PsA) is a chronic inflammatory condition that can affect individuals of all ages. Patients may experience a range of physical and psychological issues.
Objective: To examine the impact of PsA on an individual's quality of life (QoL) and physical function.
Biliary sepsis, characterized by contamination and infection of the biliary tract, poses a serious medical issue with detrimental effects on the patients. While cholecystectomy is the usual treatment for symptomatic gallstones, the most desirable management approach for biliary sepsis remains debated, prompting a scientific evaluation of the long-term effects of cholecystectomy. To compare the long-term outcomes of biliary sepsis in patients undergoing cholecystectomy versus conservative management (CM), this study will systematically review the existing literature to clarify differences in recurrence rates, complication rates, and overall survival.
View Article and Find Full Text PDFHealth Informatics J
December 2024
The University of Queensland, Brisbane, QLD, Australia.
Objective: This study aimed to assess the practicality and trustworthiness of explainable artificial intelligence (XAI) methods used for explaining clinical predictive models.
Methods: Two popular XAIs used for explaining clinical predictive models were evaluated based on their ability to generate domain-appropriate representations, impact clinical workflow, and consistency. Explanations were benchmarked against true clinical deterioration triggers recorded in the data system and agreement was quantified.
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