Artificial intelligence and primary care research: a scoping review
Open accessPublished version of a preprint
Abstract
ABSTRACT Objective The purpose of this study was to assess the nature and extent of the body of research on artificial intelligence (AI) and primary care. Methods We performed a scoping review, searching 11 published and grey literature databases with subject headings and key words pertaining to the concepts of 1) AI and 2) primary care: MEDLINE, EMBASE, Cinahl, Cochrane Library, Web of Science, Scopus, IEEE Xplore, ACM Digital Library, MathSciNet, AAAI, arXiv. Screening included title and abstract and then full text stages. Final inclusion criteria: 1) research study of any design, 2) developed or used AI, 3) used primary care data and/or study conducted in a primary care setting and/or explicit mention of study applicability to primary care; exclusion criteria: 1) narrative, editorial, or textbook chapter, 2) not applicable to primary care population or settings, 3) full text inaccessible in the English Language. We extracted and summarized seven key characteristics of included studies: overall study purpose(s), author appointments, primary care functions, author intended target end user(s), target health condition(s), location of data source(s) (if any), subfield(s) of AI. Results Of 5,515 non-duplicate documents, 405 met our eligibility criteria. The body of literature is primarily focused on creating novel AI methods or modifying existing AI methods to support physician diagnostic or treatment recommendations, for chronic conditions, using data from higher income countries. Meaningfully more studies had at least one author with a technology, engineering, or math appointment than with a primary care appointment (57 (14%) compared to 217 (54%)). Predominant AI subfields were supervised machine learning and expert systems. Discussion Overall, AI research associated with primary care is at an early stage of maturity with respect to widespread implementation in practice settings. For the field to progress, more interdisciplinary research teams with end-user engagement and evaluation studies are needed. SUMMARY BOXES Section 1: What is already known on this topic Advancements in technology and the availability of health data have increased opportunities for artificial intelligence to be used for primary care purposes. No comprehensive review of research on artificial intelligence associated with primary care has been performed. Section 2: What this study adds The body of research on artificial intelligence and primary care is driven by authors without appointments in primary care departments and is focused on developing artificial intelligence methods to support diagnostic and treatment decisions. There is a need for more interdisciplinary research teams and evaluation of artificial intelligence projects in ‘real world’ practice settings.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Primary care has been slower to realize the benefits of AI.
“Primary care has been slower to realize the benefits of AI. [6][7][8]”
From Clinician Adoption of an Artificial Intelligence Algorithm to Detect Left Ventricular Systolic Dysfunction in Primary Care. (2022) · cites this paper as [7]
AI utilization in primary care clinics is in the early stages of development, with most studies focusing on AI methods to support physician clinical decision-making with diagnostic and treatment recommendations, particularly for chronic conditions.
“A recent scoping review found that AI utilization in primary care clinics (PCCs) is in the early stages of development, with most studies focusing on AI methods to support physician clinical decision-making (CDM) with diagnostic and treatment recommendations, particularly with management of chronic conditions.1,2”
From The use of an artificial intelligence platform OpenEvidence to augment clinical decision-making for primary care physicians (2025) · cites this paper as [1]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation
Tricco, A. C., Lillie, E., Zarin, W., O'Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M. D. J., Horsley, T., Weeks, L., et al. (2018) · Annals of Internal Medicine · doi:10.7326/m18-0850 · Cited by 43,565 · see citing works
Scoping studies: towards a methodological framework
Arksey, H., & O'Malley, L. (2005) · International Journal of Social Research Methodology · doi:10.1080/1364557032000119616 · Cited by 36,742 · see citing works
Dermatologist-level classification of skin cancer with deep neural networks
Esteva, A., Kuprel, B., Novoa, R. A., Ko, J., Swetter, S. M., Blau, H. M., & Thrun, S. (2017) · Nature · doi:10.1038/nature21056 · Cited by 14,362 · see citing works
Explanation in artificial intelligence: Insights from the social sciences
Miller, T. (2019) · Artificial Intelligence · doi:10.1016/j.artint.2018.07.007 · Cited by 5,302 · see citing works
Towards A Rigorous Science of Interpretable Machine Learning
Doshi-Velez, F., & Kim, B. (2017) · arXiv · doi:10.48550/arxiv.1702.08608 · Cited by 3,121 · see citing works
A scoping review on the conduct and reporting of scoping reviews
Tricco, A. C., Lillie, E., Zarin, W., O’Brien, K., Colquhoun, H., Kastner, M., Levac, D., Ng, C., Sharpe, J. P., Wilson, K., et al. (2016) · BMC Medical Research Methodology · doi:10.1186/s12874-016-0116-4 · Cited by 2,250 · see citing works
Christodoulou, E., Ma, J., Collins, G. S., Steyerberg, E. W., Verbakel, J. Y., & Van Calster, B. (2019) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2019.02.004 · Cited by 2,119 · see citing works
Miotto, R., Li, L., Kidd, B. A., & Dudley, J. T. (2016) · Scientific Reports · doi:10.1038/srep26094 · Cited by 1,710 · see citing works
Arndt, B. G., Beasley, J. W., Watkinson, M. D., Temte, J. L., Tuan, W.-J., Sinsky, C. A., & Gilchrist, V. J. (2017) · The Annals of Family Medicine · doi:10.1370/afm.2121 · Cited by 972 · cited 1× · see citing works
“6,32,33 These examples predominantly come from referral care settings, not from primary care, where the spectrum of illness is wider, and clinicians have fewer diagnostic instruments or tests available.”
BackgroundWhat do we need to build explainable AI systems for the medical domain?
Holzinger, A., Biemann, C., Pattichis, C. S., & Kell, D. B. (2017) · arXiv · doi:10.48550/arxiv.1712.09923 · Cited by 636 · see citing works
GREENHALGH, T., POTTS, H. W. W., WONG, G., BARK, P., & SWINGLEHURST, D. (2009) · The Milbank Quarterly · doi:10.1111/j.1468-0009.2009.00578.x · Cited by 541 · see citing works
Shortliffe, E. H., Davis, R., Axline, S. G., Buchanan, B. G., Green, C. C., & Cohen, S. N. (1975) · Computers and Biomedical Research · doi:10.1016/0010-4809(75)90009-9 · Cited by 493 · cited 1× · see citing works
“24,26 Although met with initial enthusiasm, rule-centric methods faltered when faced with increasing complexity.”
BackgroundGreenhalgh, T., Hinder, S., Stramer, K., Bratan, T., & Russell, J. (2010) · BMJ · doi:10.1136/bmj.c5814 · Cited by 343 · see citing works
de Graaf, L. E., Gerhards, S. A. H., Arntz, A., Riper, H., Metsemakers, J. F. M., Evers, S. M. A. A., Severens, J. L., Widdershoven, G., & Huibers, M. J. H. (2009) · British Journal of Psychiatry · doi:10.1192/bjp.bp.108.054429 · Cited by 190 · see citing works
Craske, M. G., Rose, R. D., Lang, A., Welch, S. S., Campbell-Sills, L., Sullivan, G., Sherbourne, C., Bystritsky, A., Stein, M. B., & Roy-Byrne, P. P. (2009) · Depression and Anxiety · doi:10.1002/da.20542 · Cited by 170 · see citing works
de Graaf, L. E., Hollon, S. D., & Huibers, M. J. H. (2010) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0018324 · Cited by 51 · see citing works
Flagged first, then by citations
Research works printed but not linked: 50
- Jiang F, Jiang Y, Zhi H, et al. Artificial intelligence in healthcare: past, present and future. Stroke Vasc Neurol. 2017; 2(4): 230-243.
- Beam AL, Kohane IS. Big data and machine learning in health care. JAMA. 2018; 319(13): 1317.
- Rajkomar A, Dean J, Kohane I. Machine learning in medicine. N Engl J Med. 2019; 380(14): 1347-1358.
- Topol E. The Topol Review. Preparing the Healthcare Workforce to Deliver the Digital Future. London, UK: NHS Health Education Eng- land; 2019.
- Moore SF, Hamilton W, Llewellyn DJ. Harnessing the power of intelligent machines to enhance primary care. Br J Gen Pract. 2018; 68(666): 6-7.
- Starfield B. Primary care and its relationship to health. In: Primary Care. Balancing Health Needs, Services, and Technology. New York, NY: Oxford University Press, Inc; 1998.
- Huang M, Gibson C, Terry A. Measuring electronic health record use in primary care: a scoping review. Appl Clin Inform. 2018; 09(01): 15-33.
- Terry AL, Stewart M. How does Canada stack up? A bibliometric analysis of the primary healthcare electronic medical record litera- ture. Inform Prim Care. 2012; 20: 233-240.
- Kringos DS, Boerma WG, Hutchinson A, van der Zee J, Groenewe- gen PP. The breadth of primary care: a systematic literature review of its core dimensions. BMC Health Serv Res. 2010; 10: 65.
- Friedman C, Elhadad N. Natural language processing in health care and biomedicine. In: Shortliffe EH, Cimino JJ, eds. Biomedical Infor- matics. London, England: Springer London; 2014: 255-284.
- Yu K-H, Beam AL, Kohane IS. Artificial intelligence in healthcare. Nat Biomed Eng. 2018; 2(10): 719-731.
- Hinton G. Deep learning -A technology with the potential to trans- form health care. JAMA. 2018; 320(11): 1101-1102.
- Lin SY, Mahoney MR, Sinsky CA. Ten ways artificial intelligence will transform primary care. J Gen Intern Med. 2019; 34(8): 1626-1630.
- Talukder AK. Big data analytics advances in health intelligence, public health, and evidence-based precision medicine. In: Reddy PK, Sureka A, Chakravarthy S, Bhalla S, eds. Big Data Analytics. Vol 10721. Cham, Switzerland: Springer International Publishing; 2017: 243-253.
- Wiens J, Shenoy ES. Machine learning for healthcare: on the verge of a major shift in healthcare epidemiology. Clin Infect Dis. 2018; 66(1): 149-153.
- Terry AL, Ryan BL, McKay S, et al. Towards optimal electronic medi- cal record use: perspectives of advanced users. Fam Pract. 2018; 35(5): 607-611.
- Russell S, Norvig P. Chapter 1: Introduction. In: Artificial Intelligence: A Modern Approach. 3rd ed. Cedar Rapids, IA: Pearson Education Inc; 2010: 1-33.
- Turing A. Computing machinery and intelligence. Mind. 1950; 49: 433-460.
- Alanazi HO, Abdullah AH, Qureshi KN. A critical review for develop- ing accurate and dynamic predictive models using machine learning methods in medicine and health care. J Med Syst. 2017; 41(4): 69.
- Miotto R, Wang F, Wang S, Jiang X, Dudley JT. Deep learning for healthcare: review, opportunities and challenges. Brief Bioinform. 2018; 19(6): 1236-1246.
- Collier R. Electronic health records contributing to physician burn- out. CMAJ. 2017; 189(45): E1405-E1406.
- Levac D, Colquhoun H, O'Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010; 5: 69.
- Covidence Systematic Review Software. Melbourne, Australia: Veritas Health Innovation. http: //www.covidence.org. Accessed Jul 8, 2019.
- Cucciare MA, Curran GM, Craske MG, et al. Assessing fidelity of cognitive behavioral therapy in rural VA clinics: design of a random- ized implementation effectiveness (hybrid type III) trial. Implement Sci. 2016; 11: 65.
- de Graaf LE, Gerhards SAH, Arntz A, et al. One-year follow-up results of unsupported online computerized cognitive behavioural therapy for depression in primary care: A randomized trial. J Behav Ther Exp Psychiatry. 2011; 42(1): 89-95.
- Chang EK, Yu CY, Clarke R, et al. Defining a patient population with cirrhosis: an automated algorithm with natural language process- ing. J Clin Gastroenterol. 2016; 50(10): 889-894.
- Widmer G, Horn W, Nagele B. Automatic knowledge base refine- ment: Learning from examples and deep knowledge in rheumatol- ogy. Artif Intell Med. 1993; 5(3): 225-243.
- Michalowski M, Michalowski W, Wilk S, O'Sullivan D, Carrier M. AFGuide system to support personalized management of atrial fibrillation. In: Joint Workshop on Health Intelligence. https: //aaai.org/ ocs/index.php/WS/AAAIW17/paper/view/15215. Published Mar 21, 2017. Accessed Jul 8, 2019.
- Flores CD, Fonseca JM, Bez MR, Respício A, Coelho H. Method for building a medical training simulator with Bayesian networks: SimDeCS. In: 2nd KES International Conference on Innovation in Medi- cine and Healthcare. Vol 207. San Sebastian, Spain: Studies in Health Technology and Informatics; 2014: 102-114.
- Astilean A, Avram C, Folea S, Silvasan I, Petreus D. Fuzzy Petri nets based decision support system for ambulatory treatment of non- severe acute diseases. In: 2010 IEEE International Conference on Auto- mation, Quality and Testing, Robotics (AQTR). Cluj-Napoca, Romania: IEEE; 2010: 1-6.
- Dominguez-Morales JP, Jimenez-Fernandez AF, Dominguez-Morales MJ, Jimenez-Moreno G. Deep neural networks for the recognition and classification of heart murmurs using neuromorphic auditory sensors. IEEE Trans Biomed Circuits Syst. 2018; 12(1): 24-34.
- Zamora M, Baradad M, Amado E, et al. Characterizing chronic disease and polymedication prescription patterns from electronic health records. In: 2015 IEEE International Conference on Data Science and Advanced Analytics (DSAA). Campus des Cordeliers, Paris, France: IEEE; 2015: 1-9.
- Orient JM. Evaluation of abdominal pain: clinicians' performance compared with three protocols. South Med J. 1986; 79(7): 793-799.
- Sumner W II, Truszczynski M, Marek VW. Simulating patients with parallel health state networks. Proceedings/AMIA. Annual Symposium AMIA Symposium. 1998: 438-442.
- Sumner W II, Xu JZ, Roussel G, Hagen MD. Modeling relief. AMIA. Annual Symposium proceedings / AMIA Symposium AMIA Symposium. 2007: 706-710.
- Sumner W II, Xu JZ. Modeling fatigue. Proceedings / AMIA. Annual Symposium AMIA Symposium. 2002: 747-751.
- Sumner W, Hagen MD, Rovinelli R. The item generation methodol- ogy of an empiric simulation project. Adv Health Sci Educ Theory Pract. 1999; 4(1): 49-66.
- Zhuang ZY, Churilov L, Sikaris K. Uncovering the patterns in pathol- ogy ordering by Australian general practitioners: a data mining perspective. In: Proceedings of the 39th Annual Hawaii International Conference on System Sciences (HICSS '06). Kauia, HI: IEEE; 2006: 5(92c): 1-10.
- Zhuang ZY, Amarasiri R, Churilov L, Alahakoon D, Sikaris K. Explor- ing the clinical notes of pathology ordering by Australian general practitioners: a text mining perspective. In: Proceedings of the 40th Annual Hawaii International Conference on System Sciences (HICSS '07). Waikoloa, HI: IEEE; 2007: 1(136a): 1-10.
- Zhuang ZY, Churilov L, Burstein F, Sikaris K. Combining data min- ing and case-based reasoning for intelligent decision support for pathology ordering by general practitioners. Eur J Oper Res. 2009; 195(3): 662-675.
- Zhuang ZY, Wilkin CL, Ceglowski A. A framework for an intelligent decision support system: A case in pathology test ordering. Decis Support Syst. 2013; 55(2): 476-487.
- Voracek D. NASA innovation framework and center innovation fund. Presented at: Edwards Technical Symposium; September 10, 2018;
- Gupta A, Thorpe C, Bhattacharyya O, Zwarenstein M. Promoting development and uptake of health innovations: the nose to tail tool. F1000 Res. 2016; 5: 361.
- Hao K. We analyzed 16,625 papers to figure out where AI is headed next. MIT Technology Review; 2019. https: //www.technology review.com/s/612768/we-analyzed-16625-papers-to-figure-out- where-ai-is-headed-next/. Accessed Mar 15, 2019.
- SJR. Scimago journal and country rank. https: //www.scimagojr.com/ countryrank.php. Accessed May 31, 2019.
- Conte ML, Liu J, Schnell S, Omary MB. Globalization and chang- ing trends of biomedical research output. JCI Insight. 2017; 2(12): e95206.
- Hajjar F, Saint-Lary O, Cadwallader J-S, et al. Development of pri- mary care research in North America, Europe, and Australia from 1974 to 2017. Ann Fam Med. 2019;17(1):49-51.
- Sturgiss E, van Boven K. Datasets collected in general practice: an international comparison using the example of obesity. Aust Health Rev. 2018; 42(5): 563-567.
- Smeets HM, Kortekaas MF, Rutten FH, et al. Routine primary care data for scientific research, quality of care programs and educa- tional purposes: the Julius General Practitioners' Network (JGPN). BMC Health Serv Res. 2018; 18: 875.
- Verghese A, Shah NH, Harrington RA. What this computer needs is a physician: humanism and artificial intelligence. JAMA. 2018; 319(1): 19-20.
Cited by
Sorted by citations
Artificial Intelligence Applications in Health Care Practice: Scoping Review
Sharma, M., Savage, C., Nair, M., Larsson, I., Svedberg, P., & Nygren, J. M. (2022) · Journal of Medical Internet Research · doi:10.2196/40238 · Cited by 198 · see citing works
The role of artificial intelligence in enhancing clinical nursing care: A scoping review
Ng, Z. Q. P., Ling, L. Y. J., Chew, H. S. J., & Lau, Y. (2022) · Journal of Nursing Management · doi:10.1111/jonm.13425 · Cited by 184 · see citing works
Schubert, T., Oosterlinck, T., Stevens, R. D., Maxwell, P. H., & van der Schaar, M. (2025) · eClinicalMedicine · doi:10.1016/j.eclinm.2024.102968 · Cited by 103 · see citing works
Allen, M. R., Webb, S., Mandvi, A., Frieden, M., Tai-Seale, M., & Kallenberg, G. (2024) · BMC Primary Care · doi:10.1186/s12875-024-02282-y · Cited by 100 · see citing works
Hwang, G.-J., Tang, K.-Y., & Tu, Y.-F. (2024) · Interactive Learning Environments · doi:10.1080/10494820.2022.2086579 · Cited by 87 · see citing works
Lu, X., Yang, C., Liang, L., Hu, G., Zhong, Z., & Jiang, Z. (2024) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocae243 · Cited by 77 · see citing works
“82 Despite the potential for AI to revolutionize clinical trials, it still encounters numerous challenges, with unstructured data being a significant obstacle.”
BackgroundHurt, R. T., Stephenson, C. R., Gilman, E. A., Aakre, C. A., Croghan, I. T., Mundi, M. S., Ghosh, K., & Edakkanambeth Varayil, J. (2025) · Journal of Primary Care & Community Health · doi:10.1177/21501319251332215 · Cited by 78 · see citing works
The application and use of artificial intelligence in cancer nursing: A systematic review
O'Connor, S., Vercell, A., Wong, D., Yorke, J., Fallatah, F. A., Cave, L., & Anny Chen, L.-Y. (2024) · European Journal of Oncology Nursing · doi:10.1016/j.ejon.2024.102510 · Cited by 51 · see citing works
Rushlow, D. R., Croghan, I. T., Inselman, J. W., Thacher, T. D., Friedman, P. A., Yao, X., Pellikka, P. A., Lopez-Jimenez, F., Bernard, M. E., Barry, B. A., et al. (2022) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2022.04.008 · Cited by 33 · see citing works
Young, R. A., Martin, C. M., Sturmberg, J. P., Hall, S., Bazemore, A., Kakadiaris, I. A., & Lin, S. (2024) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2023.230219r1 · Cited by 17 · see citing works
Yan, X., Wang, Z., Chen, O., & Guo, Y. (2026) · Nurse Education Today · doi:10.1016/j.nedt.2026.107217 · Cited by 4 · see citing works
- Authors
- Kueper, J. K., Terry, A. L., Zwarenstein, M., & Lizotte, D. J.
- Affiliations
- Western University (CA)
- Corresponding author
- Kueper, Jacqueline K.
- Venue
- The Annals of Family Medicine
- Publisher
- Annals of Family Medicine
- Published
- 2020-05
- Volume
- 18
- Issue
- 3
- Pages
- 250-258
- ISSN
- 1544-1709 (ISSN-L)
- 1544-1717
- PMC
- PMC7213996
- OpenAlex
- W3022437576
- Cited by
- 143
- References
- 16
- Citations by year
- 2026: 24 · 2025: 37 · 2024: 27 · 2023: 17 · 2022: 18 · 2021: 16 · 2020: 4
- FWCI
- 1.05
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- The Annals of Family Medicine (publishedVersion)
- medRxiv (acceptedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Health Sciences › Health Professions › Health Information Management › Artificial Intelligence in Healthcare
- Physical Sciences › Computer Science › Artificial Intelligence › Machine Learning in Healthcare
- Keywords
- artificial intelligence, primary care, machine learning, expert systems, clinical decision support, diagnostic support, treatment guidelines, chronic disease, end-user involvement, interdisciplinary research, research maturity
- MeSH terms
- Interdisciplinary Research, Artificial Intelligence, Humans, Primary Health Care
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review