AI assistance may lead to loss of skills in health professionals

Routine use of AI reduced health professionals’ abilities to detect precancerous growths without the technology, according to researchers.

An observational study, published in The Lancet Gastroenterology & Hepatology journal on 13 August 2025, assessed how endoscopists (health professionals who perform colonoscopies) who regularly used AI to help perform colonoscopy were able to perform without its use.

Colonoscopy enables detection and removal of precancerous growths (adenomas), leading to prevention of bowel cancer.

Numerous trials have shown that the use of AI increases the detection of adenomas, but this is the first study to suggest that AI could lead to a reduction in health professionals’ skills. 

The study of more than 1,400 colonoscopies found the rate at which experienced endoscopists detected adenomas in non-AI assisted colonoscopies decreased by 20% several months after the routine introduction of AI.

Study author Dr Marcin Romańczyk, of the Academy of Silesia, said: “Our results are concerning given the adoption of AI in medicine is rapidly spreading. 

“We urgently need more research into the impact of AI on health professional’s skills across different medical fields. 

“We need to find out which factors may cause or contribute to problems when healthcare professionals and AI systems don’t work well together, and to develop ways to fix or improve these interactions.” 

The study took place at four colonoscopy centres in Poland between September 2021 and March 2022. 

Regular AI use was introduced at the centres at the end of 2021 after which colonoscopies were randomly done either with or without AI assistance. 

During this time 1,443 colonoscopies were conducted without AI; 795 before the introduction of regular AI use and 648 after AI implementation. 

The colonoscopies were performed by 19 experienced endoscopists who had conducted more than 2,000 colonoscopies each. 

The average rate of adenoma detection at non-AI assisted colonoscopies significantly decreased from 28.4% before AI exposure to 22.4% after AI exposure, corresponding to a 20% relative and 6% absolute reduction in adenoma detection rate. 

In the AI-assisted colonoscopies there was a 25.3% adenoma detection rate.

Study author Prof Yuichi Mori, of the University of Oslo, said: “These results pose an interesting question about previous randomised controlled trials which found AI-assisted colonoscopy enabled a higher adenoma detection rate than non-AI assisted colonoscopy. 

“It could be the case that non-AI assisted colonoscopy assessed in these trials is different from standard non-AI assisted colonoscopy as the endoscopists in the trials may have been negatively affected by continuous AI exposure.” 

The authors acknowledge that the observational nature of the study means that factors other than the implementation of AI use may have influenced the findings.

Also, as the study was conducted with experienced endoscopists this may limit its generalisation to less experienced health professionals. 

Commenting on the study, Dr Omer Ahmad of the University College London, said that the findings “temper the current enthusiasm for rapid adoption of AI based technologies” and highlight the importance of “carefully considering possible unintended clinical consequences”. 

He added: “Although AI continues to offer great promise to enhance clinical outcomes, we must also safeguard against the quiet erosion of fundamental skills required for high-quality endoscopy.”