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

Rosa Verhoeven, Stella Mulia, Elisabeth M. W. Kooi and Jan B. F. Hulscher
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Rosa Verhoeven: Department of Surgery, Division of Pediatric Surgery, 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

Medical Decision Making, 2025, vol. 45, issue 4, 449-461

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  

Keywords: necrotizing enterocolitis; artificial intelligence; decision support; decision making; end-of-life decision; comfort care; retrospective comparison (search for similar items in EconPapers)
Date: 2025
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:45:y:2025:i:4:p:449-461

DOI: 10.1177/0272989X251324530

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