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Do Treatment Choices by Artificial Intelligence Correspond to Reality? Retrospective Comparative Research with Necrotizing Enterocolitis as a Use Case

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  • Rosa Verhoeven

    (Department of Surgery, Division of Pediatric Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
    Department of Neonatology, Beatrix Children’s Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands)

  • Stella Mulia

    (Councyl B.V., Delft, The Netherlands)

  • Elisabeth M. W. Kooi

    (Department of Neonatology, Beatrix Children’s Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands)

  • Jan B. F. Hulscher

    (Department of Surgery, Division of Pediatric Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands)

Abstract

Background In cases of surgical necrotizing enterocolitis (NEC), the choice between laparotomy (LAP) or comfort care (CC) presents a complex, ethical dilemma. A behavioral artificial intelligence technology (BAIT) decision aid was trained on expert knowledge, providing an output as “ x percentage of experts advise laparotomy for this patient.†This retrospective study aims to compare this output to clinical practice. Design Variables required for the decision aid were collected of preterm patients with NEC for whom the decision of LAP or CC had been made. These data were used in 2 BAIT model versions: one center specific, built on the input of experts from the same center as the patients, and a nationwide version, incorporating the input of additional experts. The Mann–Whitney U test compared the model output for the 2 groups (LAP/CC). In addition, model output was classified as advice for LAP or CC, after which the chi-square test assessed correspondence with observed decisions. Results Forty patients were included in the study (20 LAP). Model output ( x percentage of experts advising LAP) was higher in the LAP group than in the CC group (median 95.1% v. 46.1% in the center-specific version and 97.3% v. 67.5% in the nationwide version, both P  

Suggested Citation

  • Rosa Verhoeven & Stella Mulia & Elisabeth M. W. Kooi & Jan B. F. Hulscher, 2025. "Do Treatment Choices by Artificial Intelligence Correspond to Reality? Retrospective Comparative Research with Necrotizing Enterocolitis as a Use Case," Medical Decision Making, , vol. 45(4), pages 449-461, May.
    • Handle: RePEc:sae:medema:v:45:y:2025:i:4:p:449-461
    DOI: 10.1177/0272989X251324530
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