Study finds over 60% of adults want to be notified, with preferences varying by age, sex, race, and education
In a recent article published in JAMA Network Open, researchers explored the perceptions and attitudes of the American public towards the use of artificial intelligence (AI) in healthcare.
Their findings indicate that a majority of respondents want to be notified about the use of AI in the healthcare services that they access.
Background
Patient notification is an important part of research and clinical ethics. It is fundamental to informed consent and laws related to data privacy. The applications of AI are increasing rapidly across industries, including in healthcare.
Though policy frameworks and experts in AI ethics highlight the need for transparency through notification to be a critical part of using AI tools appropriately, health systems lack standardized policies and recommendations for how they notify patients.
Members of the public's expectations on this subject are also not well understood; research in this field can support health systems and policymakers in setting priorities and strengthening notification processes.
About the study
In 2023, researchers conducted surveys to understand the attitudes of the American public toward the healthcare-related applications of AI. This survey included a video that explained the use of AI in this field and elicited perspectives using questions based on scenarios. Researchers validated the survey through stakeholder feedback and cognitive interviews.
While the survey was conducted through a panel representative of American residents, researchers oversampled Hispanic and Black participants to ensure the group comparisons could be made accurately. Ethical guidelines were followed throughout the process, and participants gave informed consent.
Participants were asked how important it was to them that they were notified about AI use in the health care services that they accessed. The possible answers ranged from 'very true' with a score of four to 'not true at all' with a score of one. Researchers weighted these responses by demographic information such as education, ethnicity, race, age, and sex.
Findings
The study included 2021 adults, whose average weighted response was 3.39 out of 4, which indicated a general agreement that being notified about AI use in healthcare was important to them. Overall, a majority of respondents, nearly 63%, indicated that it was very important to them to be notified, while less than 5% did not believe it to be important.
Females responded with an average score of 3.45, indicating that they rated the importance of notification more highly than males, with an average score of 3.32. Older adults, specifically those over the age of 60, expressed the strongest desire for notification, rating its importance at 3.57. Conversely, younger adults between 18 and 29 showed the least concern, with an average score of 3.14. This difference was statistically significant.
Based on ethnicity and race, non-Hispanic White individuals rated the importance of notification most highly, with an average score of 3.46, while Hispanic people reported a score of 3.28, Black respondents reported a score of 3.21, and other groups reported a score of 3.33. Differences between groups were statistically significant.
Comparing groups based on education, researchers found that respondents with postgraduate education and bachelor's degrees showed the highest concern, rating the importance of notification at approximately 3.5. However, those with less than a high school education rated it lowest, with a score of 3.14. Differences between education levels were statistically significant.
Conclusions
A prior study found that people preferred being notified about the use of health information (mean score: 3.15) slightly more than about biospecimens (3.13). This study showed an even higher preference for notification about AI use in healthcare.
While limited by its cross-sectional nature, the findings emphasize the need for transparent AI practices. Policymakers and health organizations should consider notifying the public about AI, focusing on not just if but how and when to inform patients.
Demographic differences highlight ethical considerations. Women were more likely than men to value notification, and White respondents showed a greater preference than Black respondents. This suggests that notification, while important, must also address historical inequities.
Collaborative approaches involving experts, the public, and patients are essential to create transparent and trustworthy health systems. Multiple strategies for AI notification will ensure ethical implementation and build public trust in healthcare AI systems.