The impact of AI feedback on the accuracy of diagnosis, decision switching and trust in radiography

Artificial intelligence decision support systems have been proposed to assist a struggling National Health Service (NHS) workforce in the United Kingdom. Its implementation in UK healthcare systems has been identified as a priority for deployment. Few studies have investigated the impact of the feedback from such systems on the end user. This study investigated the impact of two forms of AI feedback (saliency/ heatmaps and AI diagnosis with percentage confidence) on student and qualified diagnostic radiographers’ accuracy when determining binary diagnosis on skeletal radiographs. The AI feedback proved beneficial to accuracy in all cases except when the AI was incorrect and for pathological cases in the student group. The self-reported trust of all participants decreased from the beginning to the end of the study. The findings of this study should guide developers in the provision of the most advantageous forms of AI feedback and direct educators in tailoring education to highlight weaknesses in human interaction with AI-based clinical decision support systems.