Explainable AI as a Double-Edged Sword in Dermatology: The Impact on Clinicians versus The Public

Fuente: arXiv
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Main Authors: Xu, Xuhai, Hu, Haoyu, Zhang, Haoran, Wang, Will Ke, Wang, Reina, Soenksen, Luis R., Badri, Omar, Jafry, Sheharbano, Burger, Elise, Nwandu, Lotanna, Mehta, Apoorva, Duhaime, Erik P., Qasim, Asif, Lin, Hause, Pereira, Janis, Hershon, Jonathan, Mui, Paulius, Gru, Alejandro A., Elhadad, Noémie, Mamykina, Lena, Groh, Matthew, Tschandl, Philipp, Daneshjou, Roxana, Ghassemi, Marzyeh
Format: Preprint
Published: 2025
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author Xu, Xuhai
Hu, Haoyu
Zhang, Haoran
Wang, Will Ke
Wang, Reina
Soenksen, Luis R.
Badri, Omar
Jafry, Sheharbano
Burger, Elise
Nwandu, Lotanna
Mehta, Apoorva
Duhaime, Erik P.
Qasim, Asif
Lin, Hause
Pereira, Janis
Hershon, Jonathan
Mui, Paulius
Gru, Alejandro A.
Elhadad, Noémie
Mamykina, Lena
Groh, Matthew
Tschandl, Philipp
Daneshjou, Roxana
Ghassemi, Marzyeh
author_facet Xu, Xuhai
Hu, Haoyu
Zhang, Haoran
Wang, Will Ke
Wang, Reina
Soenksen, Luis R.
Badri, Omar
Jafry, Sheharbano
Burger, Elise
Nwandu, Lotanna
Mehta, Apoorva
Duhaime, Erik P.
Qasim, Asif
Lin, Hause
Pereira, Janis
Hershon, Jonathan
Mui, Paulius
Gru, Alejandro A.
Elhadad, Noémie
Mamykina, Lena
Groh, Matthew
Tschandl, Philipp
Daneshjou, Roxana
Ghassemi, Marzyeh
contents Artificial intelligence (AI) is increasingly permeating healthcare, from physician assistants to consumer applications. Since AI algorithm's opacity challenges human interaction, explainable AI (XAI) addresses this by providing AI decision-making insight, but evidence suggests XAI can paradoxically induce over-reliance or bias. We present results from two large-scale experiments (623 lay people; 153 primary care physicians, PCPs) combining a fairness-based diagnosis AI model and different XAI explanations to examine how XAI assistance, particularly multimodal large language models (LLMs), influences diagnostic performance. AI assistance balanced across skin tones improved accuracy and reduced diagnostic disparities. However, LLM explanations yielded divergent effects: lay users showed higher automation bias - accuracy boosted when AI was correct, reduced when AI erred - while experienced PCPs remained resilient, benefiting irrespective of AI accuracy. Presenting AI suggestions first also led to worse outcomes when the AI was incorrect for both groups. These findings highlight XAI's varying impact based on expertise and timing, underscoring LLMs as a "double-edged sword" in medical AI and informing future human-AI collaborative system design.
format Preprint
id arxiv_https___arxiv_org_abs_2512_12500
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Explainable AI as a Double-Edged Sword in Dermatology: The Impact on Clinicians versus The Public
Xu, Xuhai
Hu, Haoyu
Zhang, Haoran
Wang, Will Ke
Wang, Reina
Soenksen, Luis R.
Badri, Omar
Jafry, Sheharbano
Burger, Elise
Nwandu, Lotanna
Mehta, Apoorva
Duhaime, Erik P.
Qasim, Asif
Lin, Hause
Pereira, Janis
Hershon, Jonathan
Mui, Paulius
Gru, Alejandro A.
Elhadad, Noémie
Mamykina, Lena
Groh, Matthew
Tschandl, Philipp
Daneshjou, Roxana
Ghassemi, Marzyeh
Human-Computer Interaction
Artificial Intelligence
Artificial intelligence (AI) is increasingly permeating healthcare, from physician assistants to consumer applications. Since AI algorithm's opacity challenges human interaction, explainable AI (XAI) addresses this by providing AI decision-making insight, but evidence suggests XAI can paradoxically induce over-reliance or bias. We present results from two large-scale experiments (623 lay people; 153 primary care physicians, PCPs) combining a fairness-based diagnosis AI model and different XAI explanations to examine how XAI assistance, particularly multimodal large language models (LLMs), influences diagnostic performance. AI assistance balanced across skin tones improved accuracy and reduced diagnostic disparities. However, LLM explanations yielded divergent effects: lay users showed higher automation bias - accuracy boosted when AI was correct, reduced when AI erred - while experienced PCPs remained resilient, benefiting irrespective of AI accuracy. Presenting AI suggestions first also led to worse outcomes when the AI was incorrect for both groups. These findings highlight XAI's varying impact based on expertise and timing, underscoring LLMs as a "double-edged sword" in medical AI and informing future human-AI collaborative system design.
title Explainable AI as a Double-Edged Sword in Dermatology: The Impact on Clinicians versus The Public
topic Human-Computer Interaction
Artificial Intelligence
url https://arxiv.org/abs/2512.12500