AI and Legal Liability in Radiology

What impact will artificial intelligence have on the legal liability of the radiologists who use it? A new study in NEJM AI suggests that medical malpractice juries may pass harsher judgment on radiologists when they make mistakes that disagree with AI findings.

AI is viewed as a technology that can save radiologists time while also helping them make more accurate diagnoses.

• But there’s a dark side to AI as well – what happens when AI findings aren’t correct, or when radiologists disagree with AI only to discover it was right all along?

In the new study, a research team led by Michael Bernstein, PhD, of Brown University queried 1.3k U.S. adults on their attitudes toward radiologists’ legal liability in two clinical use cases for AI – identifying brain bleeds and detecting lung cancers.

• Participants were asked if they felt radiologists met their duty of care to patients across different scenarios, such as whether the AI and the radiologist agreed or disagreed on the original diagnosis. 

Responses were compared to a “no AI” control scenario in which respondents assessed legal liability if radiologists hadn’t used AI at all, with researchers finding …

• If radiologists disagreed with AI, more respondents found radiologists liable …
  • Brain bleeds: 73% found radiologist liable (vs. 50% with no AI)
  • Lung cancer: 79% found radiologist liable (vs. 64% with no AI)

• If both radiologists and AI missed the diagnosis, there was no statistically significant difference …
  • Brain bleeds: (50% vs. 56% with no AI, p=0.33)
  • Lung cancer: (64% vs. 65% with no AI, p=0.77)

• Respondents were less likely to side with plaintiffs when given information about standard AI error rates …
  • When AI agreed with the radiologist diagnosis:
    • Brain bleeds: (73% plaintiff agreement fell to 49%)
    • Lung cancer: (79% fell to 73%)
  • When AI disagreed with the radiologist diagnosis:
    • Brain bleeds: (50% plaintiff agreement fell to 34%)
    • Lung cancer: (64% fell to 56%)

The Takeaway

The new study offers a fascinating look at AI’s future in radiology from a medico-legal perspective. But there’s one question the researchers didn’t address: If AI-supported image interpretation eventually becomes the standard of care, will radiologists be found liable for not using it at all? Stay tuned.