Implementing AI in healthcare—the relevance of trust: a scoping review

Abstract

BackgroundThe process of translation of AI and its potential benefits into practice in healthcare services has been slow in spite of its rapid development. Trust in AI in relation to implementation processes is an important aspect. Without a clear understanding, the development of effective implementation strategies will not be possible, nor will AI advance despite the significant investments and possibilities.ObjectiveThis study aimed to explore the scientific literature regarding how trust in AI in relation to implementation in healthcare is conceptualized and what influences trust in AI in relation to implementation in healthcare.MethodsThis scoping review included five scientific databases. These were searched to identify publications related to the study aims. Articles were included if they were published in English, after 2012, and peer-reviewed. Two independent reviewers conducted an abstract and full-text review, as well as carrying out a thematic analysis with an inductive approach to address the study aims. The review was reported in accordance with the PRISMA-ScR guidelines.ResultsA total of eight studies were included in the final review. We found that trust was conceptualized in different ways. Most empirical studies had an individual perspective where trust was directed toward the technology's capability. Two studies focused on trust as relational between people in the context of the AI application rather than as having trust in the technology itself. Trust was also understood by its determinants and as having a mediating role, positioned between characteristics and AI use. The thematic analysis yielded three themes: individual characteristics, AI characteristics and contextual characteristics, which influence trust in AI in relation to implementation in healthcare.ConclusionsFindings showed that the conceptualization of trust in AI differed between the studies, as well as which determinants they accounted for as influencing trust. Few studies looked beyond individual characteristics and AI characteristics. Future empirical research addressing trust in AI in relation to implementation in healthcare should have a more holistic view of the concept to be able to manage the many challenges, uncertainties, and perceived risks.

Moving beyond Technical Issues to Stakeholder Involvement: Key Areas for Consideration in the Development of Human-Centred and Trusted AI in Healthcare

“…(Banerjee et al 2022). Those with more input in decision-making or those who feel they have been consulted and kept informed may feel more inclined to trust the use of AI in healthcare (Steerling et al 2023).…”

“…Trust needs to be built not only in AI algorithms, but the training data, software, and complex environment in which humans are situated.” (Banerjee et al 2022 ). Those with more input in decision-making or those who feel they have been consulted and kept informed may feel more inclined to trust the use of AI in healthcare (Steerling et al 2023 ).…”

The Paradoxes of Digital Tools in Hospitals: Qualitative Interview Study

“…Research has consistently highlighted the significance of trust as a crucial component for the successful use and implementation of health care technologies. To establish trust, it is essential to align AI with existing values and consider social interactions and negotiations of values comprehensively [ 72 ].…”

The leading global health challenges in the artificial intelligence era

“…Crucial ethics, privacy, and bias issues were raised to ensure AI’s responsible and equitable integration in the global public health landscape. Additionally, the human inability to see how ML systems make their decisions “black box,” brought uncertainty and threatened trust among the users regarding its application ( 12 ). This review aims to explore the current state of AI in those mentioned global public health challenges and provide insights about its current application in disease diagnosis, medicinal product development, and medical intervention.…”