人工智能 (AI) 有潜力提高诊断准确性并改善治疗结果。然而，人工智能与临床工作流程和患者观点的整合仍不清楚。为了确定患者对人工智能的信任以及他们对依赖人工智能的泌尿科医生的看法，以及未来人工智能在患者诊断和治疗中的应用。我们进行了一项前瞻性试验，涉及接受诊断或治疗的患者。前列腺癌（PC）的治疗干预。患者被要求在磁共振成像、前列腺活检或根治性前列腺切除术之前完成一项调查。主要结果是患者对人工智能的信任。次要结果是 AI 在治疗环境中的选择以及 AI 和泌尿科医生的特征。分析了 466 名患者的数据。对技术的累积亲和力与对人工智能的信任呈正相关（相关系数 0.094；p = 0.04），而患者年龄、教育水平和对疾病的主观感知则不然（p > 0.05）。在沟通诊断时，医生对能力的信任度平均得分（±标准差）高于人工智能，因为他们在传达诊断时以个性化方式做出反应（4.51 ± 0.76 vs 3.38 ± 1.07；平均差 [MD] 1.130，95% 置信区间 [ CI] 1.010-1.250；t924 = 18.52，p < 0.001；Cohen's d = 1.040）并以可理解的方式解释信息（4.57 ± vs 3.18 ± 1.09；MD 1.392，95% CI 1.275-1.509；t921 = 27 .27，p < 0.001；科恩的 d = 1.216）。患者表示，与非医生控制的 AI 相比，他们对医生控制的 AI 做出的诊断有更高的信任度（4.31 ± 0.88 vs 1.75 ± 0.93；MD 2.561，95% CI 2.444-2.678；t925 = 42.89，p < 0.001 ；科恩的 d = 2.818）。在当前临床情况下，人工智能辅助医生（66.74%）比单独医生（29.61%）、人工智能控制医生（2.36%）和单独人工智能（0.64%）更受青睐。相信未来的诊断和治疗人工智能-基于的治疗依赖于与泌尿科医生的最佳集成作为人机界面，以利用人类和人工智能的能力。人工智能（AI）将在未来的前列腺癌诊断决策中发挥作用。目前，患者更喜欢人工智能辅助的泌尿科医生，而不是单独的泌尿科医生、单独的人工智能和人工智能控制的泌尿科医生。人工智能和泌尿科医生的具体特征可用于优化前列腺癌患者的诊断和治疗。版权所有 © 2023 欧洲泌尿外科协会。由 Elsevier B.V. 出版。保留所有权利。

Artificial intelligence (AI) has the potential to enhance diagnostic accuracy and improve treatment outcomes. However, AI integration into clinical workflows and patient perspectives remain unclear.To determine patients' trust in AI and their perception of urologists relying on AI, and future diagnostic and therapeutic AI applications for patients.A prospective trial was conducted involving patients who received diagnostic or therapeutic interventions for prostate cancer (PC).Patients were asked to complete a survey before magnetic resonance imaging, prostate biopsy, or radical prostatectomy.The primary outcome was patient trust in AI. Secondary outcomes were the choice of AI in treatment settings and traits attributed to AI and urologists.Data for 466 patients were analyzed. The cumulative affinity for technology was positively correlated with trust in AI (correlation coefficient 0.094; p = 0.04), whereas patient age, level of education, and subjective perception of illness were not (p > 0.05). The mean score (± standard deviation) for trust in capability was higher for physicians than for AI for responding in an individualized way when communicating a diagnosis (4.51 ± 0.76 vs 3.38 ± 1.07; mean difference [MD] 1.130, 95% confidence interval [CI] 1.010-1.250; t924 = 18.52, p < 0.001; Cohen's d = 1.040) and for explaining information in an understandable way (4.57 ± vs 3.18 ± 1.09; MD 1.392, 95% CI 1.275-1.509; t921 = 27.27, p < 0.001; Cohen's d = 1.216). Patients stated that they had higher trust in a diagnosis made by AI controlled by a physician versus AI not controlled by a physician (4.31 ± 0.88 vs 1.75 ± 0.93; MD 2.561, 95% CI 2.444-2.678; t925 = 42.89, p < 0.001; Cohen's d = 2.818). AI-assisted physicians (66.74%) were preferred over physicians alone (29.61%), physicians controlled by AI (2.36%), and AI alone (0.64%) for treatment in the current clinical scenario.Trust in future diagnostic and therapeutic AI-based treatment relies on optimal integration with urologists as the human-machine interface to leverage human and AI capabilities.Artificial intelligence (AI) will play a role in diagnostic decisions in prostate cancer in the future. At present, patients prefer AI-assisted urologists over urologists alone, AI alone, and AI-controlled urologists. Specific traits of AI and urologists could be used to optimize diagnosis and treatment for patients with prostate cancer.Copyright © 2023 European Association of Urology. Published by Elsevier B.V. All rights reserved.