Human-centered design and evaluation of AI-empowered clinical decision support systems: a systematic review

IntroductionArtificial intelligence (AI) technologies are increasingly applied to empower clinical decision support systems (CDSS), providing patient-specific recommendations to improve clinical work. Equally important to technical advancement is human, social, and contextual factors that impact the successful implementation and user adoption of AI-empowered CDSS (AI-CDSS). With the growing interest in human-centered design and evaluation of such tools, it is critical to synthesize the knowledge and experiences reported in prior work and shed light on future work.MethodsFollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review to gain an in-depth understanding of how AI-empowered CDSS was used, designed, and evaluated, and how clinician users perceived such systems. We performed literature search in five databases for articles published between the years 2011 and 2022. A total of 19874 articles were retrieved and screened, with 20 articles included for in-depth analysis.ResultsThe reviewed studies assessed different aspects of AI-CDSS, including effectiveness (e.g., improved patient evaluation and work efficiency), user needs (e.g., informational and technological needs), user experience (e.g., satisfaction, trust, usability, workload, and understandability), and other dimensions (e.g., the impact of AI-CDSS on workflow and patient-provider relationship). Despite the promising nature of AI-CDSS, our findings highlighted six major challenges of implementing such systems, including technical limitation, workflow misalignment, attitudinal barriers, informational barriers, usability issues, and environmental barriers. These sociotechnical challenges prevent the effective use of AI-based CDSS interventions in clinical settings.DiscussionOur study highlights the paucity of studies examining the user needs, perceptions, and experiences of AI-CDSS. Based on the findings, we discuss design implications and future research directions

Anticipatory Stress Increases Deontological Inclinations: The Mediating Role of Emotional Valence

Previous studies have explored the differences in moral judgments under normal situations and acute stress using the Trier Social Stress Test (TSST). The present study examined whether anticipatory stress (i.e., induced by an anticipated speech) could elicit similar effects and further explored the mediation of emotional responses between acute stress and moral judgments with a process-dissociation approach. Fifty-three undergraduate students (20 males and 33 females) were randomly assigned to the stress and control groups. In the first stage, they were instructed to prepare a public speech (the stress group) or just recall events during the previous vacation (the control group). In the second stage, they reported emotional valence and arousal for each moral dilemma in a set of 12 moral dilemmas, followed by judgments on moral acceptability of the agent’s action. The manipulation check confirmed that anticipatory stress was reliably induced, as indicated in both self-reported and physiological data. The traditional dilemma analysis revealed that participants in the stress group would make fewer utilitarian judgments than those in the control group. The process dissociation (PD) analyses further revealed that the stress group exhibited higher deontological inclinations than the control group, but no significant differences in utilitarian inclinations. Emotional valence played a mediating role in the association between stress and deontological inclinations. To sum up, our study extended the investigation of the relationship between acute stress and moral judgment to anticipatory stress, clarified its distinct impact on deontological and utilitarian inclinations, and revealed the mediating effect of emotional valence

A Dimensionless Parameter Analysis of a Cylindrical Tube Electromagnetic Vibration Energy Harvester and Its Oscillator Nonlinearity Effect

This paper investigates a single degree of freedom oscillator in a cylindrical tube vibration energy harvester which is applicable in a low-frequency range. A duffing-type nonlinear dynamic differential equation of the oscillator was developed for the nonlinear analysis and solved by using the harmonic balance method in order to widen energy harvesting frequency bandwidth. The exploitation of nonlinear spring force interactions of the oscillator to enhance the generator’s performance is also presented in this paper. The dimensionless harvested power formula of the nonlinear mass-spring-damper system was derived, and a parameter study was conducted for the design optimization of the harvester. The main contribution of this paper is to establish a dimensionless performance analysis method of a nonlinear electromagnetic vibration energy harvester system and to disclose the effects of the parameters and nonlinearity of the system on the harvesting performance

Effects of Different Processing Methods on the Antioxidant Activity of 6 Cultivars of Foxtail Millet

The total phenolic content (TPC) of millet was whole > dehulled > cooked > steamed and the bound phenolic content (BPC) was the main form. Compared with dehulled millet, the TPC, TFC, and phenolic acid contents were decreased significantly (P < 0.05). The retention rate of TPC of steamed millet ranged from 47% to 55% and cooked millet ranged from 55% to 79%. Additionally, the mean cinnamic acid content of cooked millet was 1.29 times as much as steamed millet. The antioxidant activity of millet was whole > dehulled > cooked > steamed. Therefore, cooked millet was a good choice for human

Chronic Stress and Moral Decision-Making: An Exploration With the CNI Model

Stress is prevalent in our daily life, and people often make moral decision-making in a stressful state. Several studies indicated the influence of acute stress on moral decision-making and behavior. The present study extended the investigation to chronic stress, and employed a new approach, the CNI model, to add new insights regarding the mechanism underlying the association between chronic stress and moral decision-making. A total of 197 undergraduates completed the Perceived Stress Scale and made moral decision-making on a series of deliberately designed moral dilemmas. The results indicated that higher chronic stress was related to more deontological moral choices. The process-dissociation analyses revealed that chronic stress was marginally significantly associated with deontological inclinations but not with utilitarian inclinations. And the CNI model analyses suggested that the high-stress group (above the median) showed a stronger general preference for inaction than the low-stress group (below the median) did, but there were no significant differences in sensitivity to consequences or sensitivity to moral norms between the two groups. Finally, the implications of the findings were discussed