The Effects of Presenting AI Uncertainty Information on Pharmacists’ Trust in Automated Pill Recognition Technology: Exploratory Mixed Subjects Study

BackgroundDispensing errors significantly contribute to adverse drug events, resulting in substantial health care costs and patient harm. Automated pill verification technologies have been developed to aid pharmacists with medication dispensing. However, pharmacists’ trust in...

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Main Authors: Jin Yong Kim, Vincent D Marshall, Brigid Rowell, Qiyuan Chen, Yifan Zheng, John D Lee, Raed Al Kontar, Corey Lester, Xi Jessie Yang
Format: Article
Language:English
Published: JMIR Publications 2025-02-01
Series:JMIR Human Factors
Online Access:https://humanfactors.jmir.org/2025/1/e60273
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author Jin Yong Kim
Vincent D Marshall
Brigid Rowell
Qiyuan Chen
Yifan Zheng
John D Lee
Raed Al Kontar
Corey Lester
Xi Jessie Yang
author_facet Jin Yong Kim
Vincent D Marshall
Brigid Rowell
Qiyuan Chen
Yifan Zheng
John D Lee
Raed Al Kontar
Corey Lester
Xi Jessie Yang
author_sort Jin Yong Kim
collection DOAJ
description BackgroundDispensing errors significantly contribute to adverse drug events, resulting in substantial health care costs and patient harm. Automated pill verification technologies have been developed to aid pharmacists with medication dispensing. However, pharmacists’ trust in such automated technologies remains unexplored. ObjectiveThis study aims to investigate pharmacists’ trust in automated pill verification technology designed to support medication dispensing. MethodsThirty licensed pharmacists in the United States performed a web-based simulated pill verification task to determine whether an image of a filled medication bottle matched a known reference image. Participants completed a block of 100 verification trials without any help, and another block of 100 trials with the help of an imperfect artificial intelligence (AI) aid recommending acceptance or rejection of a filled medication bottle. The experiment used a mixed subjects design. The between-subjects factor was the AI aid type, with or without an AI uncertainty plot. The within-subjects factor was the four potential verification outcomes: (1) the AI rejects the incorrect drug, (2) the AI rejects the correct drug, (3) the AI approves the incorrect drug, and (4) the AI approves the correct drug. Participants’ trust in the AI system was measured. Mixed model (generalized linear models) tests were conducted with 2-tailed t tests to compare the means between the 2 AI aid types for each verification outcome. ResultsParticipants had an average trust propensity score of 72 (SD 18.08) out of 100, indicating a positive attitude toward trusting automated technologies. The introduction of an uncertainty plot to the AI aid significantly enhanced pharmacists’ end trust (t28=–1.854; P=.04). Trust dynamics were influenced by AI aid type and verification outcome. Specifically, pharmacists using the AI aid with the uncertainty plot had a significantly larger trust increment when the AI approved the correct drug (t78.98=3.93; P<.001) and a significantly larger trust decrement when the AI approved the incorrect drug (t2939.72=–4.78; P<.001). Intriguingly, the absence of the uncertainty plot led to an increase in trust when the AI correctly rejected an incorrect drug, whereas the presence of the plot resulted in a decrease in trust under the same circumstances (t509.77=–3.96; P<.001). A pronounced “negativity bias” was observed, where the degree of trust reduction when the AI made an error exceeded the trust gain when the AI made a correct decision (z=–11.30; P<.001). ConclusionsTo the best of our knowledge, this study is the first attempt to examine pharmacists’ trust in automated pill verification technology. Our findings reveal that pharmacists have a favorable disposition toward trusting automation. Moreover, providing uncertainty information about the AI’s recommendation significantly boosts pharmacists’ trust in AI aid, highlighting the importance of developing transparent AI systems within health care.
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spelling doaj-art-f39d62252c4a46c2b9699b9a016a9d382025-02-11T16:15:52ZengJMIR PublicationsJMIR Human Factors2292-94952025-02-0112e6027310.2196/60273The Effects of Presenting AI Uncertainty Information on Pharmacists’ Trust in Automated Pill Recognition Technology: Exploratory Mixed Subjects StudyJin Yong Kimhttps://orcid.org/0009-0002-1626-7204Vincent D Marshallhttps://orcid.org/0000-0002-2594-7407Brigid Rowellhttps://orcid.org/0000-0002-8469-899XQiyuan Chenhttps://orcid.org/0009-0006-4112-014XYifan Zhenghttps://orcid.org/0000-0002-6997-735XJohn D Leehttps://orcid.org/0000-0001-9808-2160Raed Al Kontarhttps://orcid.org/0000-0002-4546-324XCorey Lesterhttps://orcid.org/0000-0001-8774-793XXi Jessie Yanghttps://orcid.org/0000-0001-6071-0387 BackgroundDispensing errors significantly contribute to adverse drug events, resulting in substantial health care costs and patient harm. Automated pill verification technologies have been developed to aid pharmacists with medication dispensing. However, pharmacists’ trust in such automated technologies remains unexplored. ObjectiveThis study aims to investigate pharmacists’ trust in automated pill verification technology designed to support medication dispensing. MethodsThirty licensed pharmacists in the United States performed a web-based simulated pill verification task to determine whether an image of a filled medication bottle matched a known reference image. Participants completed a block of 100 verification trials without any help, and another block of 100 trials with the help of an imperfect artificial intelligence (AI) aid recommending acceptance or rejection of a filled medication bottle. The experiment used a mixed subjects design. The between-subjects factor was the AI aid type, with or without an AI uncertainty plot. The within-subjects factor was the four potential verification outcomes: (1) the AI rejects the incorrect drug, (2) the AI rejects the correct drug, (3) the AI approves the incorrect drug, and (4) the AI approves the correct drug. Participants’ trust in the AI system was measured. Mixed model (generalized linear models) tests were conducted with 2-tailed t tests to compare the means between the 2 AI aid types for each verification outcome. ResultsParticipants had an average trust propensity score of 72 (SD 18.08) out of 100, indicating a positive attitude toward trusting automated technologies. The introduction of an uncertainty plot to the AI aid significantly enhanced pharmacists’ end trust (t28=–1.854; P=.04). Trust dynamics were influenced by AI aid type and verification outcome. Specifically, pharmacists using the AI aid with the uncertainty plot had a significantly larger trust increment when the AI approved the correct drug (t78.98=3.93; P<.001) and a significantly larger trust decrement when the AI approved the incorrect drug (t2939.72=–4.78; P<.001). Intriguingly, the absence of the uncertainty plot led to an increase in trust when the AI correctly rejected an incorrect drug, whereas the presence of the plot resulted in a decrease in trust under the same circumstances (t509.77=–3.96; P<.001). A pronounced “negativity bias” was observed, where the degree of trust reduction when the AI made an error exceeded the trust gain when the AI made a correct decision (z=–11.30; P<.001). ConclusionsTo the best of our knowledge, this study is the first attempt to examine pharmacists’ trust in automated pill verification technology. Our findings reveal that pharmacists have a favorable disposition toward trusting automation. Moreover, providing uncertainty information about the AI’s recommendation significantly boosts pharmacists’ trust in AI aid, highlighting the importance of developing transparent AI systems within health care.https://humanfactors.jmir.org/2025/1/e60273
spellingShingle Jin Yong Kim
Vincent D Marshall
Brigid Rowell
Qiyuan Chen
Yifan Zheng
John D Lee
Raed Al Kontar
Corey Lester
Xi Jessie Yang
The Effects of Presenting AI Uncertainty Information on Pharmacists’ Trust in Automated Pill Recognition Technology: Exploratory Mixed Subjects Study
JMIR Human Factors
title The Effects of Presenting AI Uncertainty Information on Pharmacists’ Trust in Automated Pill Recognition Technology: Exploratory Mixed Subjects Study
title_full The Effects of Presenting AI Uncertainty Information on Pharmacists’ Trust in Automated Pill Recognition Technology: Exploratory Mixed Subjects Study
title_fullStr The Effects of Presenting AI Uncertainty Information on Pharmacists’ Trust in Automated Pill Recognition Technology: Exploratory Mixed Subjects Study
title_full_unstemmed The Effects of Presenting AI Uncertainty Information on Pharmacists’ Trust in Automated Pill Recognition Technology: Exploratory Mixed Subjects Study
title_short The Effects of Presenting AI Uncertainty Information on Pharmacists’ Trust in Automated Pill Recognition Technology: Exploratory Mixed Subjects Study
title_sort effects of presenting ai uncertainty information on pharmacists trust in automated pill recognition technology exploratory mixed subjects study
url https://humanfactors.jmir.org/2025/1/e60273
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