Endoscopist and Patients' Values and Preferences on Artificial Intelligence in Endoscopy: An Intercontinental Opinion Survey by the World Endoscopy Organization

BACKGROUND AND AIMS: Artificial intelligence (AI) is increasingly integrated into gastrointestinal (GI) endoscopy, yet limited data exist on how patients and endoscopists perceive its use. This study aimed to evaluate users' values and preferences regarding AI in endoscopy to support effective implementation and inform guideline development. METHODS: As part of the World Endoscopy Organization (WEO) AI committee initiatives, two structured international surveys were conducted-one for patients and one for practicing endoscopists. Thirteen AI-related statements were presented to patients via an established online platform, while 23 statements were shared with endoscopists through professional networks. Responses were captured using 5-point Likert scales and analyzed with non-parametric tests, including subgroup comparisons by age, gender, and endoscopic experience. RESULTS: A total of 1237 patients and 476 endoscopists participated. Most patients supported AI in image analysis (75.5%) but emphasized the need for endoscopist oversight (92.3%). Among endoscopists, 90.3% believed AI improves endoscopy quality, and 85.3% believed it benefits outcomes. Concerns were raised about liability (47%), operator dependency (34.8%), and procedure time (49%). Most respondents felt primary responsibility for AI-related errors should rest with the endoscopist. Younger and male patients reported greater trust in AI. CONCLUSIONS: Patients and endoscopists are generally supportive of AI in GI endoscopy, especially as an adjunct to human expertise. However, key concerns-including accountability, trust, and clinical integration-must be addressed to ensure responsible and effective adoption.