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澳大利亚乳腺癌筛查中使用人工智能的偏好:一项离散选择实验

Preferences for the Use of Artificial Intelligence for Breast Cancer Screening in Australia: A Discrete Choice Experiment.

作者信息

Woode Maame Esi, De Silva Perera Udeni, Degeling Chris, Aquino Yves Saint James, Houssami Nehmat, Carter Stacy M, Chen Gang

机构信息

Centre for Health Economics, Monash Business School, Monash University, 900 Dandenong Road, East Caulfield, VIC, 3145, Australia.

Monash Data Futures Research Institute, Monash University, East Caulfield, Australia.

出版信息

Patient. 2025 May 10. doi: 10.1007/s40271-025-00742-w.

Abstract

BACKGROUND

Breast cancer screening is considered an effective early detection strategy. Artificial intelligence (AI) may both offer benefits and create risks for breast screening programmes. To use AI in health screening services, the views and expectations of consumers are critical. This study examined the preferences of Australian women regarding AI use in breast cancer screening and the impact of information on preferences using discrete choice experiments.

METHODS

The experiment presented two alternative screening services based on seven attributes (reading method, screening sensitivity, screening specificity, time between screening and receiving results, supporting evidence, fair representation, and who should be held accountable) to 2063 women aged between 40 and 74 years recruited from an online panel. Participants were randomised into two arms. Both received standard information on AI use in breast screening, but one arm received additional information on its potential benefits. Preferences for hypothetical breast cancer screening services were modelled using a random parameter logit model. Relative attribute importance and uptake rates were estimated.

RESULTS

Participants preferred mixed reading (radiologist + AI system) over the other two reading methods. They showed a strong preference for fewer missed cases with a high attribute relative importance. Fewer false positives and a shorter waiting time for results were also preferred. Strength of preferences for mixed reading was significantly higher compared to two radiologists when additional information on AI is provided, highlighting the impact of information.

CONCLUSIONS

This study revealed the preferences among Australian women for the use of AI-driven breast cancer screening services. Results generally suggest women are open to their mammograms being read by both a radiologist and an AI-based system under certain conditions.

摘要

背景

乳腺癌筛查被认为是一种有效的早期检测策略。人工智能(AI)可能给乳腺癌筛查项目带来益处,也可能带来风险。要在健康筛查服务中使用人工智能,消费者的观点和期望至关重要。本研究通过离散选择实验,调查了澳大利亚女性对在乳腺癌筛查中使用人工智能的偏好,以及信息对偏好的影响。

方法

该实验向从在线小组招募的2063名年龄在40至74岁之间的女性提供了基于七个属性(阅读方法、筛查敏感性、筛查特异性、筛查与收到结果之间的时间、支持证据、公平代表性以及责任主体)的两种替代筛查服务。参与者被随机分为两组。两组都收到了关于在乳腺癌筛查中使用人工智能的标准信息,但其中一组还收到了关于其潜在益处的额外信息。使用随机参数logit模型对假设的乳腺癌筛查服务偏好进行建模。估计了相对属性重要性和接受率。

结果

与其他两种阅读方法相比,参与者更喜欢混合阅读(放射科医生+人工智能系统)。她们强烈倾向于漏诊病例更少的情况,且该属性的相对重要性较高。也更倾向于假阳性更少以及等待结果的时间更短。当提供关于人工智能的额外信息时,与两名放射科医生相比,对混合阅读的偏好强度显著更高,突出了信息的影响。

结论

本研究揭示了澳大利亚女性对使用人工智能驱动的乳腺癌筛查服务的偏好。结果总体表明,在某些条件下,女性愿意接受由放射科医生和基于人工智能的系统共同解读她们的乳房X光片。

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