AI-enabled clinical decision support software: a “trust and value checklist” for clinicians
Abstract
SummaryMachine learning and other forms of artificial intelligence (AI) are playing an increasing role in health care, particularly as an addition to human judgment in the form of clinical decision support (CDS). But as with all technologies, machine learning and AI will also have unintended consequences that could disrupt care and pose considerable risks for patients. It is vitally important that clinicians understand what is behind the recommendations that a CDS system offers and that any such system adds real value and enables clinicians to perform more effectively and efficiently in serving the needs of patients. This article presents a "trust and value checklist" that is aimed not at senior health system leadership, but rather at the clinicians who will be using these systems. The questions that the checklist poses include both those that the clinicians should be considering themselves and some that they will want to make sure that their leadership has addressed when making system selections. All of these questions should be considered, and answered to clinicians' satisfaction, before they start using and relying on CDS.
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Evaluating AI within health care organizations using their patients' data is a strategy to address concerns about inaccuracy and limit inaccuracies.
“One strategy to address this concern and limit inaccuracies is to evaluate AI within health care organizations using their patients’ data.4,20,21”
From Uptake of Generative AI Integrated With Electronic Health Records in US Hospitals (2025) · cites this paper as [21]
Cites
Dissecting racial bias in an algorithm used to manage the health of populations
Obermeyer, Z., Powers, B., Vogeli, C., & Mullainathan, S. (2019) · Science · doi:10.1126/science.aax2342 · Cited by 7,137 · cited 1× · see citing works
“13 The reason: this part of the software used health costs as a proxy for health needs.”
MethodPotential liability for physicians using artificial intelligence
Price, W. N., Gerke, S., & Cohen, I. G. (2019) · JAMA · doi:10.1001/jama.2019.15064 · Cited by 579 · see citing works
Kim, M. O., Coiera, E., & Magrabi, F. (2017) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocw154 · Cited by 263 · see citing works
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Uptake of Generative AI Integrated With Electronic Health Records in US Hospitals
Everson, J., Nong, P., & Richwine, C. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.49463 · Cited by 33 · see citing works
- Authors
- Silcox, C., Dentzer, S., & Bates, D. W.
- Affiliations
- Duke University (US)
- Brigham and Women's Hospital (US)
- Venue
- NEJM Catalyst
- Publisher
- Massachusetts Medical Society
- Published
- 2020-11
- Volume
- 1
- Issue
- 6
- ISSN
- 2642-0007 (ISSN-L)
- OpenAlex
- W3094150112
- Cited by
- 18
- References
- 3
- Citations by year
- 2025: 2 · 2024: 3 · 2023: 2 · 2022: 6 · 2021: 4 · 2020: 1
- FWCI
- 0.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- NEJM Catalyst (publishedVersion)
- Topics
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Health Professions › Health Information Management › Artificial Intelligence in Healthcare
- Keywords
- clinical decision support, artificial intelligence in healthcare, machine learning, trust in AI, clinician decision-making, AI risks, unintended consequences of AI
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