Medical AI studies measure satisfaction far more than trust or safety
A Nature Health systematic review of 330 medical-AI studies found that patient factors are rarely integrated across the full AI lifecycle and are heavily concentrated in late validation. Among the papers reviewed, 70.6 percent assessed patient satisfaction and 69.4 percent perceived benefits, but only 16.7 percent examined trust and 10.9 percent safety. Patient factors were assessed during validation in 89.4 percent of cases, while only 3.9 percent incorporated them during design and development. The analysis covers reported studies rather than new patient-level data, and the included research spans different applications and methods, so the percentages should not be treated as a single performance score for medical AI. The pattern is still consequential. A patient can report a satisfying interaction without understanding the system, trusting the institution that uses it, or being protected from error and harm. If trust, safety, usability, adherence, privacy, and patient characteristics arrive only after a model is built, the product may optimize for a population and workflow that never existed outside the laboratory.
