Challenges for human oversight in detecting system malfunctions in AI-assisted medical diagnostics
Authors:
- Nadine SchlickerNSNadine Schlicker
- Constanze TepohlCTConstanze Tepohl
- Ali KholmovaiaAKAli Kholmovaia
- Noëlle SteffensNSNoëlle Steffens
- Niels van BerkelNBNiels van Berkel
- Andreas MayrAMAndreas Mayr
- Ivica GrgicIGIvica Grgic
- Martin C. HirschMHMartin C. Hirsch
- Markus LangerMLMarkus Langer
Open Access
- 13 November 2026
- journal article
- Published by Springer Nature in npj Digital Medicine
- Vol. 9 (1)
Abstract
Increasingly, physicians must oversee AI systems to detect system malfunctions. We studied 48 physicians in a randomized controlled study using an increasingly malfunctioning AI for cardiac auscultation. Diagnostic performance declined alongside AI reliability, even when physicians were cognitively forced to make an initial classification, and when human performance exceeded AI reliability. Physicians’ confidence declined faster than their trust in AI. Results call for specification of oversight goals and processes ensuring patient safety.Funding Information
- Deutsche Forschungsgemeinschaft (389792660 as part of TRR 248 – CPEC)
This publication has 32 references indexed in Scilit:
- Endoscopist deskilling risk after exposure to artificial intelligence in colonoscopy: a multicentre, observational studyThe Lancet Gastroenterology & Hepatology, 2025
- Assessing the impact of AI on physician decision-making for mental health treatment in primary carenpj Mental Health Research, 2025
- Opportunities and risks of artificial intelligence in patient portal messaging in primary carenpj Digital Medicine, 2025
- How do we assess the trustworthiness of AI? Introducing the trustworthiness assessment model (TrAM)Computers in Human Behavior, 2025
- Effective Human Oversight of AI-Based Systems: A Signal Detection Perspective on the Detection of Inaccurate and Unfair OutputsMinds and Machines, 2024
- When combinations of humans and AI are useful: A systematic review and meta-analysisNature Human Behaviour, 2024
- Navigating the EU AI Act: implications for regulated digital medical productsnpj Digital Medicine, 2024
- The flaws of policies requiring human oversight of government algorithmsComputer Law & Security Review, 2022
- Theoretical Considerations and Development of a Questionnaire to Measure Trust in Automation2018
- The effects of errors on system trust, self-confidence, and the allocation of control in route planningInternational Journal of Human-Computer Studies, 2003