Who is Trusted for a Second Opinion? Comparing Collective Advice from a Medical AI and Physicians in Biopsy Decisions After Mammography Screening
Henrik Detjen, Lars Densky, Niklas von Kalckreuth, Marvin Kopka
Abstract
Artificial Intelligence (AI) is increasingly integrated into clinical practice, but its influence on patient decision-making, particularly when AI and physicians disagree, remains unclear. To examine collective advice, we investigated a breast cancer screening scenario using (1) a qualitative interview study (N=9) and (2) a quantitative experiment (N=339) where participants received either consistent or conflicting biopsy recommendations. Qualitative findings include the need for empathetic care, the importance of patient autonomy, and a desire for a four-eyes principle. Quantitative findings accordingly show that patients generally trust physicians more than AI but still tend to follow AI recommendations due to risk aversion. When both advised a biopsy, 99% adhered; if both advised against it, 25% still proceeded. In conflicting scenarios, 97% followed the physician's advice, whereas 66% followed the AI if it recommended the biopsy. These results underscore the need for careful interaction design of collective healthcare advice to prevent unnecessary healthcare procedures.