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Trust and accuracy in AI: Optometrists favor multimodal AI systems over unimodal for glaucoma diagnosis in collaborative environment

2025· article· en· W4414608322 on OpenAlexafffund
Faisal Ghaffar, Nadine Furtado, Catherine M. Burns

Bibliographic record

VenueComputers in Biology and Medicine · 2025
Typearticle
Languageen
FieldMedicine
TopicArtificial Intelligence in Healthcare and Education
Canadian institutionsUniversity of Waterloo
FundersUniversity of WaterlooNatural Sciences and Engineering Research Council of CanadaCanada Research Chairs
KeywordsGlaucomaConsistency (knowledge bases)Modality (human–computer interaction)Mental modelDecision support system

Abstract

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BACKGROUND: User trust and decision accuracy are crucial for the successful collaboration of humans and Artificial Intelligence (AI) systems, especially in clinical settings such as glaucoma diagnosis. Both trust and accuracy are influenced by the data modality used by AI systems, which directly impacts the effectiveness of human-AI collaboration. OBJECTIVE: The objective of this study is to discover the modality of an AI system that aligns best with an optometrist's mental model. This was achieved by comparing trust levels between unimodal and multimodal AI systems used for glaucoma diagnosis. Additionally, we explore the impact of modality on various targets of user trust and user performance. METHODS: We conducted a within-subject study with 20 optometrists, who were presented with both unimodal and multimodal AI mock-up systems specifically designed for glaucoma diagnosis. Trust was measured across five key targets using a 5 point Likert scale questionnaires. Statistical analysis was performed to assess trust differences between the unimodal and multimodal AI systems. Optometrist performance was evaluated based on the alignment of their decisions with those of the unimodal and multimodal AI systems. RESULTS: The results showed that the multimodal system had a higher average trust rating of 3.98 on a Likert scale, indicating greater trust compared to the unimodal system, which had an average trust rating of 3.00. This difference was statistically significant (p<.001), with further analysis revealing significant variation across all trust targets (p<.001). Additionally, optometrists demonstrated higher F1 scores with the multimodal system (43.1%) compared to the unimodal system (37.3%), while accuracy remained comparable between the two systems (63.0% for multimodal and 63.3% for unimodal). However, major differences across these metrics were observed in relation to optometrist's expertise. CONCLUSIONS: Multimodal AI systems, which use the same data modality as optometrists and align more closely with their mental models and decision-making processes, result in higher user trust and improved diagnostic performance. Therefore, for effective human-AI collaboration in healthcare, specifically for glaucoma diagnosis, AI systems should be designed to utilize the same data sources as the human counterparts, ensuring consistency and improving both trust and decision accuracy.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.007
metaresearch head score (Gemma)0.065
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.007
Threshold uncertainty score0.037

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0070.065
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.001
Bibliometrics0.0010.000
Science and technology studies0.0010.001
Scholarly communication0.0020.002
Open science0.0000.002
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0030.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.042
GPT teacher head0.439
Teacher spread0.397 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations2
Published2025
Admission routes2
Has abstractyes

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