AI may lead to loss of skills among endoscopists – study

AI may lead to loss of skills among endoscopists – study


“Our results are concerning given the adoption of AI in medicine is rapidly spreading” – research author

The use of artificial intelligence (AI) to assist colonoscopies is linked to a reduction in the ability of endoscopists to detect precancerous growths in the colon on their own, according to new research.

The study of more than 1,400 colonoscopies conducted without AI found that the rate of adenoma detection reduced after endoscopists began using AI as part of their regular workload.

The average rate of adenoma detection at non-AI assisted colonoscopies significantly decreased from 28.4 per cent (226/795) before AI exposure to 22.4 per cent (145/648) after AI exposure, corresponding to a 20 per cent relative and six per cent absolute reduction in adenoma detection rate.

When other AI-assisted colonoscopies carried out by the same 19 endoscopists were examined, the researchers found that there was a 25.3 per cent (186/734) adenoma detection rate.

The study was carried out across four colonoscopy centres in Poland between September 2021 and March 2022. Regular AI use was introduced at the centres at the end of 2021 after which colonoscopies were randomly done, either with or without AI assistance.

“To our knowledge this is the first study to suggest a negative impact of regular AI use on healthcare professionals’ ability to complete a patient-relevant task in medicine of any kind,” said research author Dr Marcin Romańczyk of Poland’s Academy of Silesia.

“Our results are concerning given the adoption of AI in medicine is rapidly spreading.

“We urgently need more research into the impact of AI on health professional’s skills across different medical fields. “We need to find out which factors may cause or contribute to problems when healthcare professionals and AI systems don’t work well together, and to develop ways to fix or improve these interactions.”

The research was published this week in The Lancet Gastroenterology & Hepatology journal.

“These results pose an interesting question about previous randomised controlled trials which found AI-assisted colonoscopy enabled a higher adenoma detection rate than non-AI assisted colonoscopy,” said co-author Prof Yuichi Mori of the University of Oslo in Norway.

“It could be the case that non-AI assisted colonoscopy assessed in these trials is different from standard non-AI assisted colonoscopy as the endoscopists in the trials may have been negatively affected by continuous AI exposure.”

The authors acknowledge some limitations, including that the observational nature of the study means that factors other than the implementation of AI use may have influenced the findings.

Additionally, as the study was conducted with experienced endoscopists this may limit its generalisation to all endoscopists – further studies with less experienced health professionals are needed to see if long term AI tool use has a larger impact on their ability to detect of adenomas without AI.

“These findings temper the current enthusiasm for rapid adoption of AI based technologies […] and highlight the importance of carefully considering possible unintended clinical consequences,” said Dr Omer Ahmad of University College London in an article accompanying the research paper.

“Although previous experimental studies have alluded to negative modification of behaviour after AI exposure, the study by Budzyń and colleagues provides the first real-world clinical evidence for the phenomenon of deskilling, potentially affecting patient-related outcomes.

He added: “Although AI continues to offer great promise to enhance clinical outcomes, we must also safeguard against the quiet erosion of fundamental skills required for high-quality endoscopy.”



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