Rams, hounds and white boxes: Investigating human-AI collaboration protocols in medical diagnosis.

Journal: Artificial intelligence in medicine
Published Date:

Abstract

In this paper, we study human-AI collaboration protocols, a design-oriented construct aimed at establishing and evaluating how humans and AI can collaborate in cognitive tasks. We applied this construct in two user studies involving 12 specialist radiologists (the knee MRI study) and 44 ECG readers of varying expertise (the ECG study), who evaluated 240 and 20 cases, respectively, in different collaboration configurations. We confirm the utility of AI support but find that XAI can be associated with a "white-box paradox", producing a null or detrimental effect. We also find that the order of presentation matters: AI-first protocols are associated with higher diagnostic accuracy than human-first protocols, and with higher accuracy than both humans and AI alone. Our findings identify the best conditions for AI to augment human diagnostic skills, rather than trigger dysfunctional responses and cognitive biases that can undermine decision effectiveness.

Authors

  • Federico Cabitza
    Department of Informatics, Systems and Communication, University of Milano-Bicocca, Milano, Italy.
  • Andrea Campagner
    IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi, 4, 20161, Milano, Italy. Electronic address: a.campagner@campus.unimib.it.
  • Luca Ronzio
    Dipartimento di Informatica, Sistemistica e Comunicazione, Università degli Studi di Milano-Bicocca, Viale Sarca 336 - 20126, Milano, Italy.
  • Matteo Cameli
    Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100, Siena, Italy.
  • Giulia Elena Mandoli
    Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100, Siena, Italy.
  • Maria Concetta Pastore
    Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100, Siena, Italy.
  • Luca Maria Sconfienza
    Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
  • Duarte Folgado
    Associação Fraunhofer Portugal Research, Rua Alfredo Allen 455/461, 4200-135 Porto, Portugal. duarte.folgado@fraunhofer.pt.
  • Marília Barandas
    Associação Fraunhofer Portugal Research, Rua Alfredo Allen 455/461, 4200-135, Porto, Portugal; Laboratório de Instrumentação, Engenharia Biomédica e Física da Radiação (LIBPhys-UNL), Departamento de Física, Faculdade de Ciências e Tecnologia, FCT, Universidade Nova de Lisboa, 2829-516, Caparica, Portugal.
  • Hugo Gamboa
    LIBPhys-UNL, Departamento de Física, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Caparica, Portugal.