arXiv:2608.13618cs.AIecon.TH2026-08

AI医疗算法差异引发责任风险,影响医生使用决策与企业设计策略。

Algorithm Design and Physician Liability

论文配图:Algorithm Design and Physician Liability
图 1 · 摘自论文原文
  • 医生权衡误诊责任与不确定性,决定是否使用AI辅助诊断。
  • 责任规则导致对弱势群体的AI使用减少,且效果非单调变化。
  • 强制算法公平反而可能损害所有患者,因扭曲了企业和医生行为。

单一临床算法在不同患者群体中可能表现出不均衡的准确性,随着人工智能在临床决策中普及,对此类差异的担忧日益加剧。美国引入的责任规则规定,当医疗机构依赖存在偏差的算法导致错误决策时,需承担法律责任。本文研究该责任机制如何影响(1)AI公司针对两组患者设计算法时的准确性策略,以及(2)医生是否采用AI进行诊疗的决策。算法优化对弱势群体更昂贵。医生作为最终责任主体,需权衡使用AI降低临床不确定性与因算法偏差导致弱势群体更多误诊所带来预期责任风险。研究发现,责任规则可能导致对算法的差异化使用:医生整体上可能减少使用AI,且在中等责任强度下,对弱势群体更少依赖AI。这一效应呈非单调性。随着责任上升,医生对弱势群体使用AI先下降后回升——因企业调整投资以减小偏差,或转向均等准确设计。强制要求算法在各群体间达到相同准确率,反而可能损害所有群体利益,因其扭曲了企业的投资激励和医生的最优使用策略。

原文摘要 · Abstract (English)

A single clinical algorithm can deliver unequal accuracy across patient groups, and concern about such disparity has grown as artificial intelligence (AI) spreads through clinical decision-making. In response, a liability rule introduced in the United States holds healthcare providers responsible when their reliance on disparate algorithms contributes to erroneous clinical decisions. We examine how such liability considerations reshape (i) an AI firm's algorithm design decisions that drive group-specific accuracy and (ii) a physician's decisions to use AI in healthcare delivery. The AI firm designs an algorithm for two patient groups, and improving accuracy for the disadvantaged group is more costly. The physician (who remains the accountable decision-maker) then decides whether to consult AI, weighing the reduction in clinical uncertainty against expected liability exposure when AI errors disproportionately affect the disadvantaged group. We find the liability rule can induce disparate use of AI: the physician may reduce AI use overall and, over an intermediate range of liability, rely on AI less for disadvantaged patients. The effect is non-monotone. As liability increases, the physician's use of AI for disadvantaged patients first declines, then rises as the firm reallocates investment toward reducing disparity or switches to an equal-accuracy design. Mandating equal algorithmic accuracy across patient groups can then inadvertently harm both groups, because a uniform accuracy requirement distorts the firm's investment incentives and the physician's equilibrium AI-use decisions.

AI医疗责任机制算法公平医生决策

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