Evidence map›Paper›PMID 40658189›Full record

ArticleEuropean radiology experimental2025

Is a score enough? Pitfalls and solutions for AI severity scores.

Michael H Bernstein, Marly van Assen, Michael A Bruno, Elizabeth A Krupinski, Carlo De Cecco, Grayson L Baird

Abstract read
In one paragraph

Article in European radiology experimental, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. AI model for automatic spinopelvic and spinal alignment parameters measurement from EOS.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Michael H BernsteinDepartment of Diagnostic Imaging, Brown Radiology Human Factors Lab, Rhode Island Hospital, Warren Alpert School of Medicine of Brown University, Providence, RI, USA. Michael_Bernstein@brown.edu.ORCID http://orcid.org/0000-0001-7221-0697
Marly van AssenDepartment of Radiology and Imaging Sciences, Emory University, School of Medicine, Atlanta, GA, USA.
Michael A BrunoPenn State College of Medicine, The Milton S. Hershey Medical Center, Penn State Health, Hershey, PA, USA.
Elizabeth A KrupinskiDepartment of Radiology and Imaging Sciences, Emory University, School of Medicine, Atlanta, GA, USA.
Carlo De CeccoDepartment of Radiology and Imaging Sciences, Emory University, School of Medicine, Atlanta, GA, USA.
Grayson L BairdDepartment of Diagnostic Imaging, Brown Radiology Human Factors Lab, Rhode Island Hospital, Warren Alpert School of Medicine of Brown University, Providence, RI, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Severity scores, which often refer to the likelihood or probability of a pathology, are commonly provided by artificial intelligence (AI) tools in radiology. However, little attention has been given to the use of these AI scores, and there is a lack of transparency into how they are generated. In this comment, we draw on key principles from psychological science and statistics to elucidate six human factors limitations of AI scores that undermine their utility: (1) variability across AI systems; (2) variability within AI systems; (3) variability between radiologists; (4) variability within radiologists; (5) unknown distribution of AI scores; and (6) perceptual challenges. We hypothesize that these limitations can be mitigated by providing the false discovery rate and false omission rate for each score as a threshold. We discuss how this hypothesis could be empirically tested. KEY POINTS: The radiologist-AI interaction has not been given sufficient attention. The utility of AI scores is limited by six key human factors limitations. We propose a hypothesis for how to mitigate these limitations by using false discovery rate and false omission rate.

Indexed as

Artificial IntelligenceRadiologySeverity of Illness IndexHumansArtificial intelligenceBiasCognitionRadiologyReproducibility of results

Identifiers

PMID40658189
PMCPMC12259500

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.