Impact of Artificial Intelligence, With and Without Information, on Pathologists’ Decisions: An Experiment

Abstract

Background: Artificial intelligence (AI) is rapidly gaining attention in medicine and in pathology in particular. While much progress has been made in refining the accuracy of algorithms, thereby increasing their potential use, we need to better understand how these algorithms will be used by pathologists, who will remain for the foreseeable future the decision-makers. The objective of this paper is to determine the propensity of pathologists to rely on AI decision aids and to investigate whether providing information on the algorithm impacts this reliance.Methods: To test our hypotheses, we conducted an experiment with within-subjects design using an online survey study. 116 respondent pathologists and pathology students participated in the experiment. Each participant was tasked with assessing the Gleason grade for a series of 12 prostate cancer samples under three conditions: without advice, with advice from an AI decision aid, and with advice from an AI decision aid with information provided on the algorithm, namely the algorithm accuracy rate and the algorithm model. Scores were computed by comparing the respondents’ scores with the “true” score at the individual-question level. A mixed effects logistic regression was used to analyze the difference in scores between the different conditions, controlling for the random effects of participants and images and to assess the interactions with Experience, Gender and beliefs towards AI.Results: Participant responses to the questions with AI decision aids were significantly more accurate than the control condition without aid. However, no significant difference was found when subjects were provided with additional accuracy rate and model information on the AI advice. Moreover, the propensity to rely on AI was found to relate to general beliefs on AI but not with particular assessments of the AI tool offered. Males also performed better in the No-aid condition but not in the AI-aid condition.Conclusions: AI can significantly influence pathologists and the general beliefs in AI could be major predictors of future reliance on AI by pathologists.