7 Healthcare staff perceptions on using artificial intelligence predictive tools: a qualitative study

N. Hassan, R. Slight, S. Slight
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Abstract

ObjectiveArtificial intelligence (AI) predictive tools can help inform the clinical decision-making process by, for example, detecting early signs of patient deterioration or predicting the likelihood of a patient developing a particular disease or complications postsurgery. However, it is unclear how acceptable or useful clinicians find these tools in practice. This project aims to explore healthcare staff’ perceptions on the benefits and challenges of using AI tools to inform clinical decision-making in practice.MethodsHealthcare staff (physicians, pharmacists and nurses) working in different departments at one large teaching hospital in the North East were invited to participate in semi-structured interviews. Interviews were conducted between August and November 2021 by zoom videoconferencing, with questions focused on what AI predictive tools they currently use, how they guide daily tasks around diagnosis, management, prevention, prognosis and screening, and what challenges they face with their use. All transcribed files were checked for accuracy. Thematic saturation guided the volume of qualitative data collection. Qualitative data analysis and development of themes was performed for each interview using Nvivo 12 software. Ethical approval was obtained (20/EM/0183, IRAS 280077).ResultsTen healthcare staff were interviewed (physicians (n=7), pharmacists (n=1), surgeons (n=2)) from different medical specialities (e.g., Oncology, Endocrinology, Cardiology, Head and Neck, and transplant surgery). Five themes emerged, including the meaning of the term AI, the usefulness of AI predictive tools in informing clinical decision-making, features that healthcare staff found helpful, and challenges around their use. Healthcare staff recognised the benefits of AI predictive tools in being able to ‘detect deterioration quicker than you would currently do’(05-ID), which informed decisions around patient discharge: ‘can you safely send them home (...) or do you want to keep them, in case they do deteriorate’ (05-ID). They found AI predictive tools useful when explaining the potential risk of cardiovascular events to patients and encouraging medication adherence ‘it does help so much convincing the patient to actually adhere to the medication’ (07-Endo).During COVID-19, AI prediction tools helped identify patients that might potentially need mechanical ventilation and ICU admission. Healthcare staff also felt it was important that AI predictive tools provided reliable information, that was easy to understand, and integrated with the current systems. A concern raised around the use of AI predictive tools was whether they might ‘mislead junior doctors or doctors who would not have that much of a clinical sense and would totally depend on it’ (07-Endo).ConclusionThis study demonstrated opportunities for the application of AI predictive tools in clinical practice. Concerns raised around the use of these tools should be considered by developers. We recognise that the perceptions of only a small number of clinicians were included mainly due to the increased time pressures on staff during the COVID-19 pandemic. Healthcare staff described essential features that will guide the future development of AI predictive tools with higher potential for application in real practice.
7医疗保健人员对使用人工智能预测工具的看法:一项定性研究
人工智能(AI)预测工具可以帮助为临床决策过程提供信息,例如,通过检测患者病情恶化的早期迹象,或预测患者患特定疾病或术后并发症的可能性。然而,目前尚不清楚临床医生在实践中如何接受或有用这些工具。该项目旨在探讨医护人员对使用人工智能工具在实践中为临床决策提供信息的好处和挑战的看法。方法对东北地区某大型教学医院不同科室的医务人员(医师、药师和护士)进行半结构化访谈。采访是在2021年8月至11月期间通过缩放视频会议进行的,问题集中在他们目前使用的人工智能预测工具,他们如何指导围绕诊断、管理、预防、预后和筛查的日常任务,以及他们在使用这些工具时面临的挑战。对所有转录文件的准确性进行了检查。专题饱和指导定性数据收集的数量。使用Nvivo 12软件对每次访谈进行定性数据分析和主题开发。获得伦理批准(20/EM/0183, IRAS 280077)。结果对来自肿瘤科、内分泌科、心脏科、头颈科、移植外科等不同专科的10名医护人员(内科(n=7)、药师(n=1)、外科(n=2))进行了访谈。五个主题出现了,包括术语人工智能的含义,人工智能预测工具在为临床决策提供信息方面的有用性,医疗保健人员发现有用的功能,以及使用它们的挑战。医护人员认识到人工智能预测工具的好处,因为它能够“比现在更快地检测到病情恶化”(05-ID),这为病人出院的决定提供了依据:“你是能安全地让他们回家(……),还是想留下他们,以防他们病情恶化”(05-ID)。他们发现人工智能预测工具在向患者解释心血管事件的潜在风险和鼓励药物依从性时非常有用,“它确实有助于说服患者真正坚持服药”(07-Endo)。在COVID-19期间,人工智能预测工具帮助识别可能需要机械通气和ICU住院的患者。医疗保健人员还认为,人工智能预测工具提供可靠的、易于理解的信息,并与当前系统集成,这一点很重要。关于使用人工智能预测工具的一个担忧是,它们是否会“误导初级医生或没有那么多临床意识的医生,而完全依赖于它”(07-Endo)。结论本研究展示了人工智能预测工具在临床实践中的应用机会。开发人员应该考虑有关使用这些工具的问题。我们认识到,只有少数临床医生的看法被纳入调查,主要原因是在COVID-19大流行期间,工作人员的时间压力增加。医疗保健人员描述了一些基本特征,这些特征将指导人工智能预测工具的未来发展,这些工具在实际实践中具有更高的应用潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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