Scholarlink

<p>Artificial intelligence (AI) is increasingly used for diagnostic screening. In diabetic retinopathy screening, autonomous AI systems can identify disease without a specialist. However, patient trust in AI remains a challenge, and it remains unknown whether and how financial incentives—commonly used to promote uptake of medical services—can increase patient acceptance of AI-based care. We examined, in a randomized vignette experiment, whether eliminating a copay would increase patients’ willingness to choose AI over an eye care professional’s (ECP’s) exam, and how patients would respond to an AI diagnosis. We conducted a randomized vignette experiment with 248 U.S. adults with type 1 diabetes, recruited online between August and December 2024. Participants were presented with a primary-care vignette in which they were due for annual diabetic eye screening. An autonomous AI tool was available as an alternative to ECP referral. Participants were randomized in a 2×2 design: (1) no copay vs. $50 copay for AI screening; (2) copay waiver sponsored by insurer vs. AI developer. Participants chose between AI or ECP screening, and rated AI effectiveness. Those choosing AI or ECP indicated their willingness to seek a second opinion (from ECP or AI, respectively) after receiving a normal vs. abnormal result. Waiving the copay significantly increased AI selection (81% vs. 43%, <i>p</i> &lt; 0.001); the source of the incentive did not affect choice. No copay also improved perceived AI effectiveness (mean score 3.67 vs. 3.24, <i>p</i> = 0.02). Patients choosing AI (vs. ECP) were far more likely to seek reconfirmation after abnormal (mean 6.69 vs. 2.41) or even normal (3.43 vs. 2.47) results (both <i>p</i> &lt; 0.001). Eliminating cost barriers increases participants’ willingness to opt for AI-based screening, but they still seek human reconfirmation. Incentives can promote AI adoption, but integration strategies must address persistent preferences for ECP reconfirmation—even when AI results are normal.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Financial incentives increase uptake and perceived effectiveness of autonomous medical AI, yet patients still seek human reconfirmation

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月7日

查看全文
  • Haiyang Yang,
  • Tinglong Dai,
  • Risa M. Wolf

摘要

Artificial intelligence (AI) is increasingly used for diagnostic screening. In diabetic retinopathy screening, autonomous AI systems can identify disease without a specialist. However, patient trust in AI remains a challenge, and it remains unknown whether and how financial incentives—commonly used to promote uptake of medical services—can increase patient acceptance of AI-based care. We examined, in a randomized vignette experiment, whether eliminating a copay would increase patients’ willingness to choose AI over an eye care professional’s (ECP’s) exam, and how patients would respond to an AI diagnosis. We conducted a randomized vignette experiment with 248 U.S. adults with type 1 diabetes, recruited online between August and December 2024. Participants were presented with a primary-care vignette in which they were due for annual diabetic eye screening. An autonomous AI tool was available as an alternative to ECP referral. Participants were randomized in a 2×2 design: (1) no copay vs. $50 copay for AI screening; (2) copay waiver sponsored by insurer vs. AI developer. Participants chose between AI or ECP screening, and rated AI effectiveness. Those choosing AI or ECP indicated their willingness to seek a second opinion (from ECP or AI, respectively) after receiving a normal vs. abnormal result. Waiving the copay significantly increased AI selection (81% vs. 43%, p < 0.001); the source of the incentive did not affect choice. No copay also improved perceived AI effectiveness (mean score 3.67 vs. 3.24, p = 0.02). Patients choosing AI (vs. ECP) were far more likely to seek reconfirmation after abnormal (mean 6.69 vs. 2.41) or even normal (3.43 vs. 2.47) results (both p < 0.001). Eliminating cost barriers increases participants’ willingness to opt for AI-based screening, but they still seek human reconfirmation. Incentives can promote AI adoption, but integration strategies must address persistent preferences for ECP reconfirmation—even when AI results are normal.