Objective Artificial 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.
Methods Healthcare 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).
Results Ten 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).
Conclusion This 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.
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