# Trust in AI-Supported Screening in General Practice Among Urban and Rural Citizens: Cross-Sectional Study

## TL;DR

This study explores trust in AI-based disease screening among urban and rural citizens in Germany, finding mixed attitudes and significant concerns about AI's role in healthcare.

## Contribution

The study provides new insights into public trust in AI-supported early detection measures in general practice, comparing urban and rural populations.

## Key findings

- Approximately 44% of respondents viewed AI-based screening as a sign of modern medicine.
- Trust in AI-based diagnoses was predicted most strongly by a positive attitude toward AI in medicine.
- Trust in physician diagnoses was higher than trust in AI applications by about sixfold.

## Abstract

The early detection of diseases is one of the tasks of general practice. Artificial intelligence (AI)–based technologies could be useful for identifying diseases at an early stage in general practices. As approximately 90% of the population regularly consults a general practitioner during one year, this could increase the percentage of citizens who take part in meaningful screening measures.

This study aimed to evaluate the level of trust among citizens in rural and urban areas in AI-supported early detection measures in general practice.

This cross-sectional study was conducted in the federal state of Schleswig-Holstein, Germany, from November 2023 to December 2023, on the topic of early detection measures with AI in general practice care, among other things. For this purpose, 5000 adult residents of rural areas (Ostholstein, Pinneberg, and Nordfriesland) and urban areas (the city of Kiel) were invited to take part in the survey. Data analysis was carried out using descriptive statistics, subgroup analysis, and linear and stepwise regression analysis to identify the factors that influenced trust in AI-based diagnoses.

Most respondents (787/1790, 44.0%) considered the introduction of an AI-based screening measure to be a sign of modern medicine. Moreover, 21.7% (n=388) of respondents feared that the introduction of such services could lead to a deterioration in the physician-patient relationship. The role of AI in future care was rated as very important by 35.4% (n=634) of respondents. The stepwise regression analysis showed that a positive attitude toward AI in medicine was the strongest predictor (ß=0.420) of trust in AI-based diagnoses. In contrast, trust in physician diagnoses was associated with lower age (ß=–0.111) and shorter waiting times for test results (ß=0.077).

Trust in general practitioner–based diagnoses was approximately 6 times greater than trust in AI applications. Despite concerns about their impact on the physician-patient relationship, approximately one-third of participants believed that the role of AI in health care will grow.