Hallucination vs interpretation: rethinking accuracy and precision in AI-assisted data extraction for knowledge synthesis

TL;DR

This study evaluates AI-assisted data extraction in literature reviews, highlighting that AI variability is mainly due to interpretive differences rather than hallucinations, and proposes methods to improve reliability.

Contribution

It introduces a platform using large language models for data extraction and compares AI to human responses, revealing insights into AI accuracy and interpretability in knowledge synthesis.

Findings

AI is highly consistent with humans on explicit questions

Interpretive differences account for most AI-human discordance

AI inaccuracies are rare compared to human errors

Abstract

Knowledge syntheses (literature reviews) are essential to health professions education (HPE), consolidating findings to advance theory and practice. However, they are labor-intensive, especially during data extraction. Artificial Intelligence (AI)-assisted extraction promises efficiency but raises concerns about accuracy, making it critical to distinguish AI 'hallucinations' (fabricated content) from legitimate interpretive differences. We developed an extraction platform using large language models (LLMs) to automate data extraction and compared AI to human responses across 187 publications and 17 extraction questions from a published scoping review. AI-human, human-human, and AI-AI consistencies were measured using interrater reliability (categorical) and thematic similarity ratings (open-ended). Errors were identified by comparing extracted responses to source publications. AI was highly consistent with humans for concrete, explicitly stated questions (e.g., title, aims) and lower for questions requiring subjective interpretation or absent in text (e.g., Kirkpatrick's outcomes, study rationale). Human-human consistency was not higher than AI-human and showed the same question-dependent variability. Discordant AI-human responses (769/3179 = 24.2%) were mostly due to interpretive differences (18.3%); AI inaccuracies were rare (1.51%), while humans were nearly three times more likely to state inaccuracies (4.37%). Findings suggest AI variability depends more on interpretability than hallucination. Repeating AI extraction can identify interpretive complexity or ambiguity, refining processes before human review. AI can be a transparent, trustworthy partner in knowledge synthesis, though caution is needed to preserve critical human insights.