Patient perspectives on artificial intelligence in healthcare: A global scoping review of benefits, ethical concerns, and implementation strategies.

Abstract

The integration of artificial intelligence (AI) into healthcare offers opportunities for improving patient care, yet successful implementation relies on patient acceptance. Understanding how patients perceive AI technologies in healthcare is critical for developing strategies that address their concerns while leveraging perceived benefits. This scoping review, the first comprehensive synthesis of patient concerns across diverse healthcare contexts, aims to systematically identify and synthesize evidence regarding patients' perceptions of AI in healthcare, including perceived benefits, concerns, and factors influencing acceptance. Following PRISMA-ScR (PRISMA for scoping reviews) guidelines, a comprehensive search was conducted across Scopus, PubMed, and Web of Science for empirical studies published between January 2014 and June 2024. The review identified 38 studies meeting eligibility criteria. Data extraction focused on study characteristics, AI applications, healthcare domains, and patient-reported perceptions organized into thematic categories. The scoping review identified 38 studies across 18 countries, with over 75% of patients expressing notable benefits of AI in healthcare, including improved diagnostic accuracy (particularly in medical imaging), enhanced efficiency, time savings, and personalized care. However, approximately 50-70% of patients had substantial concerns about the loss of human connection in healthcare delivery, reliability, and safety uncertainties, privacy and data security risks, and issues with trust, transparency, and patient autonomy. Acceptance factors clustered into demographic factors (age, education, digital literacy), health condition specifics, clinical involvement models, and organizational/systemic factors. An integrated framework illustrating the multifaceted nature of patient acceptance of AI in healthcare is proposed. Patient acceptance of AI encompasses a complex interplay of individual characteristics, technology design features, healthcare contextual factors and systemic considerations. The insights of this scoping review call for human-centric AI design and regulatory frameworks prioritizing patient autonomy. Successful implementation strategies should maintain human oversight, ensure transparent communication about AI capabilities and limitations, tailor approaches to specific contexts, and engage patients as stakeholders in development and implementation. Future research should explore diverse cultural contexts and develop interventions to enhance patient education and engagement with healthcare AI.