Evidence map›Paper›PMID 41800155›Full record

ArticleDigital health

Public risk perception, institutional AI adoption, and diagnostic safety: An exploratory cross-level analysis using a tracer condition approach.

Zhichao Li, Mengxue Lyu, Jilin Huang

Abstract read
In one paragraph

Article in Digital health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

3 authors.

Zhichao LiSchool of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China.ORCID https://orcid.org/0000-0002-8734-6551
Mengxue LyuSchool of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China.ORCID https://orcid.org/0009-0001-2924-1698
Jilin HuangSchool of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China.ORCID https://orcid.org/0009-0006-6854-5535

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: To examine the cross-level sociotechnical linkages between societal risk perception of medical artificial intelligence, institutional adoption patterns, and clinical safety outcomes. Specifically, this study aims to explore how social pressure shapes hospital technology strategies and to rigorously assess the association between AI usage intensity and diagnostic errors using an acute imaging-dependent condition as a specific tracer. Methods: A cross-level analytical framework was constructed based on the Technology Acceptance Model and Institutional Theory. We integrated three heterogeneous data streams from the Federal District of Brazil: a stratified probability survey of residents (N = 4764), longitudinal hospital operational panels (1728 hospital-month observations), and a validating index of social media sentiment. A "Catchment Area Ecological Linkage" protocol was employed to merge micro-level psychometric data with meso-level organizational metrics. Structural Equation Modeling was employed to test the direct, mediating, and moderating effects among variables, with robustness and endogeneity checks conducted via time-lag analysis and double-validation. Moderators included public trust and hospital geographical remoteness. Results: Structural equation modeling revealed a significant negative association between aggregated public risk perception and hospital AI application frequency (β = -0.34, p < 0.001), consistent with the theory of "algorithmic aversion" at the institutional level. Within the specific context of the tracer condition, higher AI usage intensity was positively associated with misdiagnosis rates (β = 0.28, p < 0.001), suggesting a pattern of "automation bias" in time-sensitive acute triage. These inhibitory effects are attenuated by high public trust and geographical remoteness. Conclusion: Public risk perception functions as an institutional constraint that throttles technology deployment. While social pressure limits adoption, the uncritical reliance on AI in high-stakes acute settings may compromise diagnostic vigilance. This study highlights the necessity of using precise tracer conditions to evaluate digital health safety and suggests that governance must balance social legitimacy with rigorous clinical oversight.

Indexed as

algorithmic aversionArtificial intelligenceautomation biasdiagnostic safetysociotechnical systemstracer condition

Identifiers

PMID41800155
PMCPMC12966551

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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.