arXiv:2607.18884cs.HCcs.AI2026-07

研究公众对医疗AI决策的看法,发现信任医生比信任技术更重要。

Public perceptions of AI-driven decision-making in healthcare: A structural equation modeling approach

  • 用结构方程模型分析3915人数据,探究影响感知的因素。
  • 使用对话式健康助手者更觉得有用、风险更低。
  • 对医生识别AI内容能力的信心最影响公平感判断。

人工智能(AI)在医疗领域日益用于辅助诊断、决策和行政流程。但其成功应用不仅依赖技术性能,还取决于公众对其有用性、风险性和公平性的认知。本研究基于一项长期纵向调查的首轮数据,共纳入3,915名受访者,采用结构方程模型分析公众对医疗自动化决策(ADM)的感知。将有用性、风险性和公平性作为因变量,考察了AI素养、对不同形式AI的熟悉度、对临床医生识别AI生成内容能力的信心、使用对话式健康助手获取信息的情况以及传统数字健康信息源的使用情况等自变量的影响。结果显示:对不同形式AI更熟悉、更相信医生能区分AI与人类生成内容、使用对话式健康助手的人群,更倾向于认为医疗决策系统有帮助;使用对话式健康助手与较低风险感知相关,而对AI更熟悉及依赖传统健康信息源则与更高风险感知相关。对公平性的感知最强由对医生识别能力的信心驱动,其次为对AI的熟悉度、素养及对话式助手的使用。总体而言,公众对医疗自动化决策的感知主要受技术熟悉度、对话式工具使用及对人类监督的信任所塑造。在医疗场景中,对医生的信任远超对技术本身的信任,是提升接纳度的关键。

原文摘要 · Abstract (English)

Artificial intelligence (AI) is increasingly integrated into healthcare to support diagnostics, decision-making, and administrative processes. However, the successful implementation of AI depends not only on technical performance but also on public perceptions of its helpfulness, riskiness, and fairness. This study examines public perceptions of automated decision-making (ADM) in healthcare. Data were drawn from the first wave of an ongoing longitudinal survey panel. The final sample consisted of 3,915 respondents and was analyzed with structural equation modeling. Perceptions of ADM in healthcare as helpful, risky, and fair were treated as the dependent variables. AI literacy, familiarity with different forms of AI, confidence in clinicians' ability to distinguish AI- from human-generated content, use of conversational agents for health information, and use of traditional digital health information sources were included as exogenous. Greater familiarity with different forms of AI, higher confidence in the clinician's ability to recognize AI-generated content, and use of conversational agents for health information were associated with greater perceived helpfulness. Use of conversational agents was associated with lower perceived risk, whereas greater familiarity with AI and greater reliance on traditional health information sources were associated with higher perceived risk. Perceptions of ADM as fair were most strongly predicted by confidence in the clinician's ability, with additional small positive associations with AI familiarity, AI literacy, and use of conversational agents. Public perceptions of ADM in healthcare are shaped by technological familiarity, use of conversational agents, and confidence in human oversight. Overall, ADM's perceived helpfulness and fairness are driven more by trust in healthcare professionals than by trust in the technology itself.

医疗AI公众认知信任机制对话系统

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