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XR-DT: Extended Reality-Enhanced Digital Twin for Agentic Mobile Robots

arXiv:2512.05270v1 Announce Type: cross Abstract: As mobile robots increasingly operate alongside humans in shared workspaces, ensuring safe, efficient, and interpretable Human-Robot Interaction (HRI) has become a pressing challenge. While substantial progress has been devoted to human behavior prediction, limited attention has been paid to how humans perceive, interpret, and trust robots' inferences, impeding deployment in safety-critical and socially embedded environments. This paper presents XR-DT, an eXtended Reality-enhanced Digital Twin framework for agentic mobile robots, that bridges physical and virtual spaces to enable bi-directional understanding between humans and robots. Our hierarchical XR-DT architecture integrates virtual-, augmented-, and mixed-reality layers, fusing real-time sensor data, simulated environments in the Unity game engine, and human feedback captured through wearable AR devices. Within this framework, we design an agentic mobile robot system with a unified diffusion policy for context-aware task adaptation. We further propose a chain-of-thought prompting mechanism that allows multimodal large language models to reason over human instructions and environmental context, while leveraging an AutoGen-based multi-agent coordination layer to enhance robustness and collaboration in dynamic tasks. Initial experimental results demonstrate accurate human and robot trajectory prediction, validating the XR-DT framework's effectiveness in HRI tasks. By embedding human intention, environmental dynamics, and robot cognition into the XR-DT framework, our system enables interpretable, trustworthy, and adaptive HRI.

The AI Productivity Index (APEX)

arXiv:2509.25721v4 Announce Type: replace-cross Abstract: We present an extended version of the AI Productivity Index (APEX-v1-extended), a benchmark for assessing whether frontier models are capable of performing economically valuable tasks in four jobs: investment banking associate, management consultant, big law associate, and primary care physician (MD). This technical report details the extensions to APEX-v1, including an increase in the held-out evaluation set from n = 50 to n = 100 cases per job (n = 400 total) and updates to the grading methodology. We present a new leaderboard, where GPT5 (Thinking = High) remains the top performing model with a score of 67.0%. APEX-v1-extended shows that frontier models still have substantial limitations when performing typical professional tasks. To support further research, we are open sourcing n = 25 non-benchmark example cases per role (n = 100 total) along with our evaluation harness.

Chinese Discharge Drug Recommendation in Metabolic Diseases with Large Language Models

arXiv:2510.21084v2 Announce Type: replace-cross Abstract: Intelligent drug recommendation based on Electronic Health Records (EHRs) is critical for improving the quality and efficiency of clinical decision-making. By leveraging large-scale patient data, drug recommendation systems can assist physicians in selecting the most appropriate medications according to a patient's medical history, diagnoses, laboratory results, and comorbidities. Recent advances in large language models (LLMs) have shown remarkable capabilities in complex reasoning and medical text understanding, making them promising tools for drug recommendation tasks. However, the application of LLMs for Chinese clinical medication recommendation remains largely unexplored. In this work, we conduct a systematic investigation of LLM-based methodologies for Chinese discharge medication recommendation. We evaluate several representative LLM families (GLM, Llama, Qwen) under a unified methodological framework including zero-shot prompting, in-context learning, chain-of-thought prompting, and supervised fine-tuning using LoRA. We analyze model behavior across reasoning styles, error patterns, domain adaptation mechanisms, and robustness. Experimental results show that while supervised fine-tuning improves model performance, there remains substantial room for improvement, with the best model achieving the F1 score of 0.5648 and Jaccard score of 0.4477. Our findings highlight both the potential and limitations of LLMs for Chinese drug recommendation.

Critical Appraisal Tools for Evaluating Artificial Intelligence in Clinical Studies: Scoping Review

Background: Health research that uses predictive and/or generative AI is rapidly growing. Just as in traditional clinical studies, the way in which AI studies are conducted can introduce systematic errors. Transmission of this AI evidence into clinical practice and research needs critical appraisal tools for clinical decision makers and researchers. Objective: To identify existing tools for critical appraisal of clinical studies that use artificial intelligence (AI) and examine the concepts and domains these tools explore. Methods: Inclusion criteria in PCC framework P: (population) Artificial intelligence clinical studies. C (Concept): tools for critical appraisal and associated constructs such as: quality, reporting, validity, risk of bias, and applicability. C (context): in clinical practice context. In addition, bias classification and Chatbot assessment studies were included. We searched in medical and engineering databases (MEDLINE, EMBASE, CINAHL, PsycINFO and IEEE). We included clinical primary research with tools for critical appraisal. Classic reviews and systematic reviews were included in first phase of screening. They were excluded in the secondary phase, after identifying new tools by forward snowballing. We excluded non-human, computer and mathematical research, and letters, opinion papers and editorials. We used Rayyan for screening. Data extraction was done by two observers and discrepancies were solved by discussion. The protocol was previously registered in OSF (https://doi.org/10.17605/OSF.IO/ETYDS). We adhered to the PRISMA extension for Scoping reviews and to the PRISMA-Search extension for Reporting Literature in Systematic Reviews. Results: We retrieved 4393 unique records for screening. After excluding 3803 records, 119 were selected for full-text screening. From these, 59 were excluded. After inclusion of 10 studies via other methods, a total of 70 records were finally included. 46 of them were reporting guidelines (15 tools for critical appraisal, 2 for quality of study and 2 for risk of bias). Nine papers ware focused on bias classification or mitigation. We found 15 Chatbots assessment studies or systematic reviews of Chatbots studies (6 and 9 respectively) which are a very heterogeneous group. Conclusions: The results picture a landscape of the evidence tools where reporting tools predominate, followed by critical appraisal and risk of bias tools, and few tools for risk of bias. The mismatch of bias in AI and epidemiology should be considered for critical appraisal, especially regarding fairness and the mitigation bias in the AI. Finally, Chatbot assessment studies is a vast and evolving field in which progress in design, reporting and critical appraisal is necessary and urgent. Clinical Trial: https://doi.org/10.17605/OSF.IO/ETYDS

Molecular stratification of esophageal adenocarcinoma: implications for prognosis and treatment strategy

Oncogene, Published online: 08 December 2025; doi:10.1038/s41388-025-03650-3

Molecular stratification of esophageal adenocarcinoma: implications for prognosis and treatment strategy

AI-driven transfer learning and classical molecular dynamics for strategic therapeutic repurposing and rational design of antiviral peptides targeting monkeypox virus DNA polymerase

Comput Biol Med. 2025 Dec 7;200:111372. doi: 10.1016/j.compbiomed.2025.111372. Online ahead of print.

ABSTRACT

The emergence of monkeypox virus (MPXV) as a global health threat has necessitated the rapid identification of novel antiviral therapeutics. Currently, no FDA-approved drugs are specifically designed against the disease. We used an in-house deep learning pharmacophore model for screening a library of 1974 FDA-approved drugs targeting the active site of MPXV DNA polymerase. Three drugs exhibited the strongest binding affinities, outperforming the control drug, Cidofovir diphosphate, and forming stable interactions with key active site residues. Among them, Paromomycin emerged as the most favourable drug, demonstrating stable, persistent, and adaptable interactions in molecular dynamics simulation. In parallel, we developed a novel automated peptide-generating AI pipeline that integrates active-site residues with knowledge-guided amino acid selection to generate and evaluate synthetic peptides. Cysteine-Phenylalanine-Cysteine (CFC), together with a panel of candidates, emerged through rational balancing of physicochemical properties and drug-likeness for accelerated therapeutic discovery. Synthetic peptides were evaluated to further understand the binding efficacies with DNA polymerase. CFC peptide demonstrated strong binding affinity (-8.08 kcal/mol) through stable interactions with key catalytic residues ASP549, ARG634 and LYS661, while MMGBSA analysis confirmed favourable binding energy (-33.02 kcal/mol). Consistent results in MD simulations indicate functional binding without destabilisation. Although ADMET predictions for CFC revealed limitations in permeability and oral bioavailability, its favourable binding profile and reduced predicted toxicity support its potential as a novel antiviral lead.

PMID:41360016 | DOI:10.1016/j.compbiomed.2025.111372

AI Deception: Risks, Dynamics, and Controls

arXiv:2511.22619v2 Announce Type: replace Abstract: As intelligence increases, so does its shadow. AI deception, in which systems induce false beliefs to secure self-beneficial outcomes, has evolved from a speculative concern to an empirically demonstrated risk across language models, AI agents, and emerging frontier systems. This project provides a comprehensive and up-to-date overview of the AI deception field, covering its core concepts, methodologies, genesis, and potential mitigations. First, we identify a formal definition of AI deception, grounded in signaling theory from studies of animal deception. We then review existing empirical studies and associated risks, highlighting deception as a sociotechnical safety challenge. We organize the landscape of AI deception research as a deception cycle, consisting of two key components: deception emergence and deception treatment. Deception emergence reveals the mechanisms underlying AI deception: systems with sufficient capability and incentive potential inevitably engage in deceptive behaviors when triggered by external conditions. Deception treatment, in turn, focuses on detecting and addressing such behaviors. On deception emergence, we analyze incentive foundations across three hierarchical levels and identify three essential capability preconditions required for deception. We further examine contextual triggers, including supervision gaps, distributional shifts, and environmental pressures. On deception treatment, we conclude detection methods covering benchmarks and evaluation protocols in static and interactive settings. Building on the three core factors of deception emergence, we outline potential mitigation strategies and propose auditing approaches that integrate technical, community, and governance efforts to address sociotechnical challenges and future AI risks. To support ongoing work in this area, we release a living resource at www.deceptionsurvey.com.

PaperDebugger: A Plugin-Based Multi-Agent System for In-Editor Academic Writing, Review, and Editing

arXiv:2512.02589v1 Announce Type: new Abstract: Large language models are increasingly embedded into academic writing workflows, yet existing assistants remain external to the editor, preventing deep interaction with document state, structure, and revision history. This separation makes it impossible to support agentic, context-aware operations directly within LaTeX editors such as Overleaf. We present PaperDebugger, an in-editor, multi-agent, and plugin-based academic writing assistant that brings LLM-driven reasoning directly into the writing environment. Enabling such in-editor interaction is technically non-trivial: it requires reliable bidirectional synchronization with the editor, fine-grained version control and patching, secure state management, multi-agent scheduling, and extensible communication with external tools. PaperDebugger addresses these challenges through a Chrome-approved extension, a Kubernetes-native orchestration layer, and a Model Context Protocol (MCP) toolchain that integrates literature search, reference lookup, document scoring, and revision pipelines. Our demo showcases a fully integrated workflow, including localized edits, structured reviews, parallel agent execution, and diff-based updates, encapsulated within a minimal-intrusion user interface (UI). Early aggregated analytics demonstrate active user engagement and validate the practicality of an editor-native, agentic writing assistant. More details about this demo and video could be found at https://github.com/PaperDebugger/PaperDebugger.

AutoSurvey2: Empowering Researchers with Next Level Automated Literature Surveys

arXiv:2510.26012v3 Announce Type: replace Abstract: The rapid growth of research literature, particularly in large language models (LLMs), has made producing comprehensive and current survey papers increasingly difficult. This paper introduces autosurvey2, a multi-stage pipeline that automates survey generation through retrieval-augmented synthesis and structured evaluation. The system integrates parallel section generation, iterative refinement, and real-time retrieval of recent publications to ensure both topical completeness and factual accuracy. Quality is assessed using a multi-LLM evaluation framework that measures coverage, structure, and relevance in alignment with expert review standards. Experimental results demonstrate that autosurvey2 consistently outperforms existing retrieval-based and automated baselines, achieving higher scores in structural coherence and topical relevance while maintaining strong citation fidelity. By combining retrieval, reasoning, and automated evaluation into a unified framework, autosurvey2 provides a scalable and reproducible solution for generating long-form academic surveys and contributes a solid foundation for future research on automated scholarly writing. All code and resources are available at https://github.com/annihi1ation/auto_research.

Whole-genome landscapes of 1,364 breast cancers

Nature, Published online: 03 December 2025; doi:10.1038/s41586-025-09812-3

Whole-genome and transcriptome analysis of 1,364 cases of breast cancer from South Korea broadens our understanding of breast cancer biology and reveals genomic features that connect tumour biology with treatment responses and clinical outcomes.

SelfAI: Building a Self-Training AI System with LLM Agents

arXiv:2512.00403v1 Announce Type: cross Abstract: Recent work on autonomous scientific discovery has leveraged LLM-based agents to integrate problem specification, experiment planning, and execution into end-to-end systems. However, these frameworks are often confined to narrow application domains, offer limited real-time interaction with researchers, and lack principled mechanisms for determining when to halt exploration, resulting in inefficiencies, reproducibility challenges, and under-utilized human expertise. To address these gaps, we propose \textit{SelfAI}, a general multi-agent platform that combines a User Agent for translating high-level research objectives into standardized experimental configurations, a Cognitive Agent powered by LLMs with optimal stopping criteria to iteratively refine hyperparameter searches, and an Experiment Manager responsible for orchestrating parallel, fault-tolerant training workflows across heterogeneous hardware while maintaining a structured knowledge base for continuous feedback. We further introduce two novel evaluation metrics, Score and $\text{AUP}_D$, to quantify discovery efficiency and search diversity. Across regression, NLP, computer vision, scientific computing, medical imaging, and drug discovery benchmarks, SelfAI consistently achieves strong performance and reduces redundant trials compared to classical Bayesian optimization and LLM-based baselines, while enabling seamless interaction with human researchers.

Human Decision-making is Susceptible to AI-driven Manipulation

arXiv:2502.07663v3 Announce Type: replace Abstract: AI systems are increasingly intertwined with daily life, assisting users with various tasks and guiding decision-making. This integration introduces risks of AI-driven manipulation, where such systems may exploit users' cognitive biases and emotional vulnerabilities to steer them toward harmful outcomes. Through a randomized between-subjects experiment with 233 participants, we examined human susceptibility to such manipulation in financial (e.g., purchases) and emotional (e.g., conflict resolution) decision-making contexts. Participants interacted with one of three AI agents: a neutral agent (NA) optimizing for user benefit without explicit influence, a manipulative agent (MA) designed to covertly influence beliefs and behaviors, or a strategy-enhanced manipulative agent (SEMA) equipped with established psychological tactics, allowing it to select and apply them adaptively during interactions to reach its hidden objectives. By analyzing participants' preference ratings, we found significant susceptibility to AI-driven manipulation. Particularly across both decision-making domains, interacting with the manipulative agents significantly increased the odds of rating hidden incentives higher than optimal options (Financial, MA: OR=5.24, SEMA: OR=7.96; Emotional, MA: OR=5.52, SEMA: OR=5.71) compared to the NA group. Notably, we found no clear evidence that employing psychological strategies (SEMA) was overall more effective than simple manipulative objectives (MA) on our primary outcomes. Hence, AI-driven manipulation could become widespread even without requiring sophisticated tactics and expertise. While our findings are preliminary and derived from hypothetical, low-stakes scenarios, we highlight a critical vulnerability in human-AI interactions, emphasizing the need for ethical safeguards and regulatory frameworks to protect human autonomy.

Uni-X: Mitigating Modality Conflict with a Two-End-Separated Architecture for Unified Multimodal Models

arXiv:2509.24365v2 Announce Type: replace-cross Abstract: Unified Multimodal Models (UMMs) built on shared autoregressive (AR) transformers are attractive for their architectural simplicity. However, we identify a critical limitation: when trained on multimodal inputs, modality-shared transformers suffer from severe gradient conflicts between vision and text, particularly in shallow and deep layers. We trace this issue to the fundamentally different low-level statistical properties of images and text, while noting that conflicts diminish in middle layers where representations become more abstract and semantically aligned. To overcome this challenge, we propose Uni-X, a two-end-separated, middle-shared architecture. Uni-X dedicates its initial and final layers to modality-specific processing, while maintaining shared parameters in the middle layers for high-level semantic fusion. This X-shaped design not only eliminates gradient conflicts at both ends but also further alleviates residual conflicts in the shared layers. Extensive experiments validate the effectiveness of Uni-X. Under identical training conditions, Uni-X achieves superior training efficiency compared to strong baselines. When scaled to 3B parameters with larger training data, Uni-X matches or surpasses 7B AR-based UMMs, achieving a GenEval score of 82 for image generation alongside strong performance in text and vision understanding tasks. These results establish Uni-X as a parameter-efficient and scalable foundation for future unified multimodal modeling. Our code is available at https://github.com/CURRENTF/Uni-X

The AI Productivity Index (APEX)

arXiv:2509.25721v3 Announce Type: replace-cross Abstract: We present an extended version of the AI Productivity Index (APEX-v1-extended), a benchmark for assessing whether frontier models are capable of performing economically valuable tasks in four jobs: investment banking associate, management consultant, big law associate, and primary care physician (MD). This technical report details the extensions to APEX-v1, including an increase in the held-out evaluation set from n = 50 to n = 100 cases per job (n = 400 total) and updates to the grading methodology. We present a new leaderboard, where GPT5 (Thinking = High) remains the top performing model with a score of 67.0%. APEX-v1-extended shows that frontier models still have substantial limitations when performing typical professional tasks. To support further research, we are open sourcing n = 25 non-benchmark example cases per role (n = 100 total) along with our evaluation harness.

Single-Cell Multi-Omics in Type 2 Diabetes Mellitus: Revealing Cellular Heterogeneity and Mechanistic Insights

Int J Mol Sci. 2025 Nov 13;26(22):11005. doi: 10.3390/ijms262211005.

ABSTRACT

Type 2 diabetes mellitus (T2DM) is a prevalent and complex metabolic disorder characterized by insulin resistance, progressive β-cell dysfunction, and severe systemic complications. Advances in single-cell multi-omics-transcriptomics, chromatin accessibility profiling, and integrative analyses-have offered unprecedented insights into the cellular heterogeneity and regulatory networks of pancreatic islets. We highlight recent discoveries in islet cell heterogeneity and β-cell pathophysiology, with a particular focus on dysfunction and dedifferentiation. We further underscore the computational frameworks that enable these discoveries, spanning data preprocessing, multi-omics integration, and machine learning-driven analyses, which collectively enable the dissection of disease-relevant cell subpopulations and the reconstruction of developmental and regulatory trajectories. We also examine how impaired signaling within islets and chronic adipose inflammation contribute to T2DM pathogenesis. Finally, we discuss key challenges in clinical translation-including limited population diversity in single-cell atlases and the interpretability of computational models-and propose future directions toward precision diagnostics and therapeutic innovation in T2DM.

PMID:41303487 | PMC:PMC12652634 | DOI:10.3390/ijms262211005

Cognitive bias in LLM reasoning compromises interpretation of clinical oncology notes

arXiv:2511.20680v1 Announce Type: cross Abstract: Despite high performance on clinical benchmarks, large language models may reach correct conclusions through faulty reasoning, a failure mode with safety implications for oncology decision support that is not captured by accuracy-based evaluation. In this two-cohort retrospective study, we developed a hierarchical taxonomy of reasoning errors from GPT-4 chain-of-thought responses to real oncology notes and tested its clinical relevance. Using breast and pancreatic cancer notes from the CORAL dataset, we annotated 600 reasoning traces to define a three-tier taxonomy mapping computational failures to cognitive bias frameworks. We validated the taxonomy on 822 responses from prostate cancer consult notes spanning localized through metastatic disease, simulating extraction, analysis, and clinical recommendation tasks. Reasoning errors occurred in 23 percent of interpretations and dominated overall errors, with confirmation bias and anchoring bias most common. Reasoning failures were associated with guideline-discordant and potentially harmful recommendations, particularly in advanced disease management. Automated evaluators using state-of-the-art language models detected error presence but could not reliably classify subtypes. These findings show that large language models may provide fluent but clinically unsafe recommendations when reasoning is flawed. The taxonomy provides a generalizable framework for evaluating and improving reasoning fidelity before clinical deployment.

How Do Companies Manage the Environmental Sustainability of AI? An Interview Study About Green AI Efforts and Regulations

arXiv:2505.07317v2 Announce Type: replace-cross Abstract: With the ever-growing adoption of artificial intelligence (AI), AI-based software and its negative impact on the environment are no longer negligible, and studying and mitigating this impact has become a critical area of research. However, it is currently unclear which role environmental sustainability plays during AI adoption in industry and how AI regulations influence Green AI practices and decision-making in industry. We therefore aim to investigate the Green AI perception and management of industry practitioners. To this end, we conducted a total of 11 interviews with participants from 10 different organizations that adopted AI-based software. The interviews explored three main themes: AI adoption, current efforts in mitigating the negative environmental impact of AI, and the influence of the EU AI Act and the Corporate Sustainability Reporting Directive (CSRD). Our findings indicate that 9 of 11 participants prioritized business efficiency during AI adoption, with minimal consideration of environmental sustainability. Monitoring and mitigation of AI's environmental impact were very limited. Only one participant monitored negative environmental effects. Regarding applied mitigation practices, six participants reported no actions, with the others sporadically mentioning techniques like prompt engineering, relying on smaller models, or not overusing AI. Awareness and compliance with the EU AI Act are low, with only one participant reporting on its influence, while the CSRD drove sustainability reporting efforts primarily in larger companies. All in all, our findings reflect a lack of urgency and priority for sustainable AI among these companies. We suggest that current regulations are not very effective, which has implications for policymakers. Additionally, there is a need to raise industry awareness, but also to provide user-friendly techniques and tools for Green AI practices.

scGALA advances graph link prediction-based cell alignment for comprehensive data integration and harmonization

Nat Commun. 2025 Nov 26. doi: 10.1038/s41467-025-66644-5. Online ahead of print.

ABSTRACT

Single-cell technologies have transformed our understanding of cellular heterogeneity through multimodal data acquisition. However, robust cell alignment remains a major challenge for data integration and harmonization, including batch correction, label transfer, and multi-omics integration. Many existing methods constrain alignment based on rigid feature-wise distance metrics, limiting their ability to capture accurate cell correspondence across diverse cell populations and conditions. We introduce scGALA, a graph-based learning framework that redefines cell alignment by combining graph attention networks with a score-driven, task-independent optimization strategy. scGALA constructs enriched graphs of cell-cell relationships by integrating gene expression profiles with auxiliary information, such as spatial coordinates, and iteratively refines alignment via self-supervised graph link prediction, where a deep neural network is trained to identify and reinforce high-confidence correspondences across datasets. In extensive benchmarks, scGALA identifies over 25 percent more high-confidence alignments without compromising accuracy. By improving the core step of cell alignment, scGALA serves as a versatile enhancer for a wide range of single-cell data integration tasks.

PMID:41298467 | DOI:10.1038/s41467-025-66644-5

Clinician-Directed Large Language Model Software Generation for Therapeutic Interventions in Physical Rehabilitation

arXiv:2511.18274v1 Announce Type: cross Abstract: Digital health interventions are increasingly used in physical and occupational therapy to deliver home exercise programs via sensor equipped devices such as smartphones, enabling remote monitoring of adherence and performance. However, digital interventions are typically programmed as software before clinical encounters as libraries of parametrized exercise modules targeting broad patient populations. At the point of care, clinicians can only select modules and adjust a narrow set of parameters like repetitions, so patient specific needs that emerge during encounters, such as distinct movement limitations, and home environments, are rarely reflected in the software. We evaluated a digital intervention paradigm that uses large language models (LLMs) to translate clinicians' exercise prescriptions into intervention software. In a prospective single arm feasibility study with 20 licensed physical and occupational therapists and a standardized patient, clinicians created 40 individualized upper extremity programs (398 instructions) that were automatically translated into executable software. Our results show a 45% increase in the proportion of personalized prescriptions that can be implemented as software compared with a template based benchmark, with unanimous consensus among therapists on ease of use. The LLM generated software correctly delivered 99.78% (397/398) of instructions as prescribed and monitored performance with 88.4% (352/398) accuracy, with 90% (18/20) of therapists judged it safe to interact with patients, and 75% (15/20) expressed willingness to adopt it. To our knowledge, this is the first prospective evaluation of clinician directed intervention software generation with LLMs in healthcare, demonstrating feasibility and motivating larger trials to assess clinical effectiveness and safety in real patient populations.

AI-Assisted Cardiovascular Risk Assessment by General Practitioners in Resource-Constrained Indonesian Settings Using a Conceptual Prototype: Randomized Controlled Study

Background: Preventive strategies integrated with digital health and artificial intelligence (AI), have significant potential to mitigate the global burden of atherosclerotic cardiovascular disease (ASCVD). AI-enabled clinical decision support (CDS) systems increasingly provide patient-specific insights beyond traditional risk factors. Despite these advances, their capacity to enhance clinical decision-making in resource-constrained settings remains largely unexplored. Objective: We conducted a randomised controlled study to assess the effect of AI-based CDS on 10-year ASCVD risk assessment and management in primary prevention. Methods: In a three-way within-subject randomised design, doctors completed nine clinical vignettes representative of primary care presentations in a resource-constrained outpatient setting. For each vignette, participants assessed 10-year ASCVD risk and made management decisions using either a conceptual prototype of AI-based CDS, automated CDS, or no decision support. The conceptual prototype represented contemporary risk calculators based on traditional machine learning models (e.g., random forest, neural networks, logistic regression) that incorporate additional predictors alongside traditional risk factors. Primary outcomes were correct risk assessment and patient management (prescription of aspirin, statins, and anti-hypertensives; referral for advanced examinations). Decision-making time and perceptions about AI utility were also measured. Results: 102 doctors from all seven geographical regions of Indonesia participated. Most participants were 26–35 years (83%), 56% male, with a median of six years of clinical experience (IQR=4.75). AI-based CDS improved risk assessment by 27% (2(2, n=102) = 48.875, P<.001 compared to unassisted or one additional correct risk classification for every patients where doctors use ai needed treat nnt="3.7;" ci the prescription of statins also improved by n="102)=" p in pairwise comparisons assisted with ai-based cds correctly assessed significantly more cases adjusted and prescribed appropriate statin often medium effect size r=".35)" control. ai-assisted required less time marginal means sec vs f however improvements aspirin anti-hypertensives did not reach statistical significance. no improvement was observed referral decisions. participants generally viewed positively agreeing strongly that they would follow its recommendations indicating it if given access. believed could enhance efficiency assessment particularly high-volume primary care settings while noting need verify against clinical guidelines each patient. conclusions: coupled reduced decision-making highlight potential utility ascvd resource-constrained efficient healthcare resources is crucial. further research ascertain whether this online study translate real-world low-resource settings.>
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