印度皮肤科医生用AI辅助临床与管理,聚焦特应性皮炎流程优化。
How Indian Dermatologists are Utilizing Artificial Intelligence for Clinical Practice and Workflow Management: A Nationwide Survey with a Special Focus on atopic dermatitis
- 调研377名医生,发现慢性病管理是主要痛点,尤其特应性皮炎的严重度评估困难
- 近半数医生使用通用大模型处理文献、文书等任务,而非专业图像诊断
- 经验丰富的医生担忧培训不足,年轻医生更关注工具临床实用性
背景:皮肤科人工智能多聚焦于图像诊断,而对慢性病管理流程关注较少。本研究通过全国横断面调查,由特应性皮炎研究学会委托,针对377名印度执业皮肤科医生,评估临床挑战、特应性皮炎(AD)管理障碍、人工智能使用情况、采纳障碍及伦理顾虑。分析采用描述性统计、卡方检验、错误发现率校正和多变量逻辑回归。结果显示,患者依从性(61.3%)和难治性病例治疗方案制定(57.0%)被报告为比诊断不确定(48.0%)更常见的问题。在AD诊疗中,严重度评分被47.7%医生视为挑战,且满意度最低。当前使用人工智能者占49.9%,主要用于通用大语言模型进行文献综述、文档撰写和学术工作,而非专用图像分析。不同经验层次医生面临不同障碍:从业20年以上者更常提到缺乏培训,5年以下者则因尝试后认为临床效用不足而质疑。使用AI者更可能报告对患者自我误诊和焦虑的担忧,此结论在调整经验和学术归属后仍显著。结论:受访者主要将通用人工智能用于认知与行政任务,但其核心临床需求在于慢性病管理和特应性皮炎流程支持。医师监督下的流程化工具或比独立诊断应用更具价值。
原文摘要 · Abstract (English)
Background: Dermatology AI has mainly focused on image-based diagnosis, while chronic disease workflows have received less attention. We surveyed Indian dermatologists to map routine clinical challenges, with a focus on atopic dermatitis (AD), and assess current AI use. Methods: A nationwide cross-sectional survey commissioned by the Society for Eczema Studies included 377 practicing Indian dermatologists. The survey assessed clinical challenges, AD workflow barriers, AI use, adoption barriers, and ethical concerns. Analyses used descriptive statistics, chi-square tests, false discovery rate correction, and multivariable logistic regression. Results: Patient adherence (61.3%) and treatment planning in difficult or refractory cases (57.0%) were reported more often than diagnostic uncertainty (48.0%). In AD care, severity scoring was reported as a challenge by 47.7% and had the lowest satisfaction among measured workflow areas. Current AI use was reported by 49.9%, most often involving general large language models for literature synthesis, documentation, and academic tasks rather than specialized image analysis. Barriers differed by experience: dermatologists with more than 20 years of practice more often cited lack of training, while those with 5 years or less more often cited lack of clinical utility after trying AI tools. AI users were more likely than non-users to report concern about patient self-misdiagnosis and anxiety, which remained significant after adjustment for experience and academic affiliation. Conclusion: Respondents reported using general-purpose AI mainly for cognitive and administrative tasks, while their clinical needs centered on chronic disease management and AD workflow support. Clinician-supervised workflow tools may be more useful than standalone diagnostic applications.
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