Patient Perspectives on Artificial Intelligence in Gastroenterology: A Multicenter Survey of Knowledge, Concerns, and Beliefs

Background and Aims: Artificial intelligence (AI) is being increasingly integrated into gastroenterology (GI) through image-based diagnostic and clinical decision support tools. While clinician perspectives have been reported, little is known about patient understanding and attitudes towards AI. This study aimed to evaluate patient knowledge, concerns, and beliefs regarding the use of AI in GI care. Methods: A multicenter, cross-sectional survey of adult patients presenting to GI clinics and endoscopy units in Ontario (Canada), Missouri, and Florida (United States) was conducted. Participants completed a 25-item questionnaire assessing AI familiarity, trust, concerns, and beliefs about physician vs AI roles. Demographic and socioeconomic data were also collected. Likert-based responses were analyzed using Kruskal-Wallis and post hoc Dunn tests to evaluate associations across subgroups. Results: Among 265 invited participants, 230 (87%) completed the survey. 59% were female, and mean age was 50 years. While 60% reported limited AI knowledge, 61% believed AI could complement physician care. Trust in AI was moderate and significantly associated with higher levels of education, income, employment, and by region (p<0.01). Concerns about reliability (60%), data privacy (47%), and healthcare costs (45%) were common, particularly among racial minorities and individuals with lower education or income (p<0.05). Notably, 93% felt that physicians should retain final clinical decision-making authority, and 74% emphasized the importance of being informed when AI is used in their care. Conclusions: Patients in GI settings generally support AI as an assistive tool but prioritize physician oversight and transparency. Addressing knowledge gaps and demographic disparities is essential for equitable AI adoption in clinical gastroenterology.