Palliative Care Physicians' Perceptions about Using Artificial Intelligence for Prognostication.

CONTEXT: Statistical and artificial intelligence (AI)-based methods have informed clinical prognostication for decades, evolving into machine learning models integrated into electronic health records. Despite increasing deployment of AI-based prognostic tools, palliative care physicians' perceptions of these tools remain understudied. OBJECTIVES: To understand palliative care physician perspectives on clinical use and implementation of AI-based prognostic tools. METHODS: We conducted a national survey of n=2,500 Hospice and Palliative Medicine physicians in the United States (January 2024-March 2025) to assess current prognostic practices, AI knowledge, and perceived benefits and risks of AI-based prognostication. RESULTS: 537 completed surveys were included for analysis. Respondents were predominantly White (73.2%) and female (52.9%). . Most reported being early technology adopters (69%) with low knowledge of AI (79.3%) and AI-based prognostication (91.8%). Overall, 72.9% routinely provide prognoses; 24.0% have used AI-generated prognoses at least once. Attitudes toward AI were favorable: 70.9% believed AI could facilitate earlier palliative care, 78.0% thought it could improve patients' ability to plan for end-of-life, 62.8% supported its role in hospice eligibility decisions, and 71.7% felt it might reduce team disagreements about prognosis. However, 36.3% were concerned about legal liability, and 37.5% thought it might negatively affect patients' sense of hope. Multivariate analyses found current users were more likely to hold positive beliefs (e.g., AI will help them better meet their patients' needs (aOR: 1.75; CI: 1.09-2.92; p=0.026). CONCLUSIONS: Palliative care physicians report limited current use of AI-based prognostic tools but generally favorable attitudes toward potential benefits, especially among current AI tool users.