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Danielle Perret

Publications and source records attributed to Danielle Perret.

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Examine Clinicians' Modification of Hedging Language in Ambient AI Documentation: A Comparative Study of AI Drafts and Final Notes

Ambient AI documentation systems generate clinical note drafts that clinicians frequently revise before signing off into electronic health records, yet how these edits alter hedging language remains unclear. We conducted paired analysis of clinician-edited portions of ambient AI drafts and final notes to examine (1) whether these edits change the prevalence of hedging language, (2) whether these edits exhibit a systematic shift toward greater certainty or uncertainty, and (3) whether these changes in hedging prevalence and directionality differ by ambient AI vendors and clinical specialties. Among 62,811 paired note sections, hedging terms were more often introduced into previously non-hedged text than removed from previously hedged text, and post-edit text contained more hedging mentions than pre-edit text. Directionality analyses showed a significant overall tendency toward greater uncertainty in hedging-related replacement edits. Vendor and specialty analyses revealed substantial heterogeneity in hedging prevalence, pre-to-post changes in hedging mentions, and directionality.

cs.HC

Understanding Stigmatizing Language in Clinical Documentation: A Paired Comparison of Ambient AI Drafts and Clinician Finalized Notes

Ambient artificial intelligence (AI) documentation tools are increasingly deployed to reduce clinician documentation burden, but their implications for biased language in clinical notes remain unclear. We conducted a large-scale comparison analysis of AI drafts and corresponding clinician finalized notes to quantify stigmatizing language changes pre- and post-editing. Using a lexicon-based natural language processing (NLP) pipeline, we measured (1) the prevalence of stigmatizing language in AI drafts, (2) the prevalence and term composition in final notes, and (3) the frequency of removal or introduction of stigmatizing terms. Across 66,297 paired note sections, 21.4% of AI draft sections contained at least one stigmatizing language mention, rising to 24.0% in clinician finalized versions. Introductions occurred more often than removals, suggesting clinician editing can be a net source of stigmatizing language entering the EHR with using Ambient AI.

cs.HC

Consumer-to-Clinical Language Shifts in Ambient AI Draft Notes and Clinician-Finalized Documentation: A Multi-level Analysis

Ambient AI generates draft clinical notes from patient-clinician conversations, often using lay or consumer-oriented phrasing to support patient understanding instead of standardized clinical terminology. How clinicians revise these drafts for professional documentation conventions remains unclear. We quantified clinician editing for consumer-to- clinical normalization using a dictionary-confirmed transformation framework. We analyzed 71,173 AI-draft and finalized-note section pairs from 34,726 encounters. Confirmed transformations were defined as replacing a consumer expression with its dictionary-mapped clinical equivalent in the same section. Editing significantly reduced terminology density across all sections (p < 0.001). The Assessment and Plan accounted for the largest transformation volume (59.3%). Our analysis identified 7,576 transformation events across 4,114 note sections (5.8%), representing 1.2% consumer-term deletions. Transformation intensity varied across individual clinicians (p < 0.001). Overall, clinician post-editing demonstrates consistent shifts from conversational phrasing toward standardized, section- appropriate clinical terminology, supporting section-aware ambient AI design.

cs.AI

When AI Writes Back: Ethical Considerations by Physicians on AI-Drafted Patient Message Replies

The increasing burden of responding to large volumes of patient messages has become a key factor contributing to physician burnout. Generative AI (GenAI) shows great promise to alleviate this burden by automatically drafting patient message replies. The ethical implications of this use have however not been fully explored. To address this knowledge gap, we conducted a semi-structured interview study with 21 physicians who participated in a GenAI pilot program. We found that notable ethical considerations expressed by the physician participants included human oversight as ethical safeguard, transparency and patient consent of AI use, patient misunderstanding of AI's role, and patient privacy and data security as prerequisites. Additionally, our findings suggest that the physicians believe the ethical responsibility of using GenAI in this context primarily lies with users, not with the technology. These findings may provide useful insights into guiding the future implementation of GenAI in clinical practice.

cs.CY

Ambient Listening in Clinical Practice: Evaluating EPIC Signal Data Before and After Implementation and Its Impact on Physician Workload

The widespread adoption of EHRs following the HITECH Act has increased the clinician documentation burden, contributing to burnout. Emerging technologies, such as ambient listening tools powered by generative AI, offer real-time, scribe-like documentation capabilities to reduce physician workload. This study evaluates the impact of ambient listening tools implemented at UCI Health by analyzing EPIC Signal data to assess changes in note length and time spent on notes. Results show significant reductions in note-taking time and an increase in note length, particularly during the first-month post-implementation. Findings highlight the potential of AI-powered documentation tools to improve clinical efficiency. Future research should explore adoption barriers, long-term trends, and user experiences to enhance the scalability and sustainability of ambient listening technology in clinical practice.

cs.HC