AGENT-O: A Semantic Agent Card Framework for Interoperable and Governed Healthcare AI Agents

AGENT-O is a modular ontology framework that defines a semantic Agent Card for representing health-oriented AI agent systems and supports assessment of reporting completeness in scientific publications. AGENT-O was developed as an OWL 2/RDF ontology covering runtime, models, workflow, tools, clinical use, evaluation, provenance, governance, and reporting assessment. Evaluation included ontology inventory, OWL-RL reasoning, three SHACL suites, 12 SPARQL competency queries, three cases, and model-assisted reporting-completeness assessment of 279 papers across five dimensions. The ontology contained 1,962 RDF triples and 1,922 Protege axioms, with 252 active classes, 198 active object properties, and 51 datatype properties. All SHACL suites conformed on example graphs, all competency queries returned prespecified evidence, and all 279 papers were scored. Incomplete reporting was highest for runtime/architecture (84.6%), governance/safety (82.8%), and provenance/reproducibility (78.1%), compared with evaluation (25.8%) and benchmark-process alignment (29.8%). AGENT-O supported semantic Agent Card representation and reporting assessment while revealing an evaluation-specification gap: evaluation and benchmark procedures were reported more consistently than runtime architecture, governance, and reproducibility. AGENT-O provides a reusable ontology, semantic Agent Card profile, and reporting-completeness workflow for structured reporting and gap identification, but does not assess agent quality or deployment readiness.

Algorithm Design and Physician Liability

A single clinical algorithm can deliver unequal accuracy across patient groups, and concern about such disparity has grown as artificial intelligence (AI) spreads through clinical decision-making. In response, a liability rule introduced in the United States holds healthcare providers responsible when their reliance on disparate algorithms contributes to erroneous clinical decisions. We examine how such liability considerations reshape (i) an AI firm's algorithm design decisions that drive group-specific accuracy and (ii) a physician's decisions to use AI in healthcare delivery. The AI firm designs an algorithm for two patient groups, and improving accuracy for the disadvantaged group is more costly. The physician (who remains the accountable decision-maker) then decides whether to consult AI, weighing the reduction in clinical uncertainty against expected liability exposure when AI errors disproportionately affect the disadvantaged group. We find the liability rule can induce disparate use of AI: the physician may reduce AI use overall and, over an intermediate range of liability, rely on AI less for disadvantaged patients. The effect is non-monotone. As liability increases, the physician's use of AI for disadvantaged patients first declines, then rises as the firm reallocates investment toward reducing disparity or switches to an equal-accuracy design. Mandating equal algorithmic accuracy across patient groups can then inadvertently harm both groups, because a uniform accuracy requirement distorts the firm's investment incentives and the physician's equilibrium AI-use decisions.

Public perceptions of AI-driven decision-making in healthcare: A structural equation modeling approach

Artificial intelligence (AI) is increasingly integrated into healthcare to support diagnostics, decision-making, and administrative processes. However, the successful implementation of AI depends not only on technical performance but also on public perceptions of its helpfulness, riskiness, and fairness. This study examines public perceptions of automated decision-making (ADM) in healthcare. Data were drawn from the first wave of an ongoing longitudinal survey panel. The final sample consisted of 3,915 respondents and was analyzed with structural equation modeling. Perceptions of ADM in healthcare as helpful, risky, and fair were treated as the dependent variables. AI literacy, familiarity with different forms of AI, confidence in clinicians' ability to distinguish AI- from human-generated content, use of conversational agents for health information, and use of traditional digital health information sources were included as exogenous. Greater familiarity with different forms of AI, higher confidence in the clinician's ability to recognize AI-generated content, and use of conversational agents for health information were associated with greater perceived helpfulness. Use of conversational agents was associated with lower perceived risk, whereas greater familiarity with AI and greater reliance on traditional health information sources were associated with higher perceived risk. Perceptions of ADM as fair were most strongly predicted by confidence in the clinician's ability, with additional small positive associations with AI familiarity, AI literacy, and use of conversational agents. Public perceptions of ADM in healthcare are shaped by technological familiarity, use of conversational agents, and confidence in human oversight. Overall, ADM's perceived helpfulness and fairness are driven more by trust in healthcare professionals than by trust in the technology itself.

A Personalized Computational Framework for Assessing the Sufficiency of Partially Observed Data in Healthcare AI models

Achieving early and timely diagnosis and treatment for disease is a major challenge. Recent applications of machine learning (ML) algorithms trained on patient data have shown promise in many different settings for predicting the patient health state. A challenge often faced when applying these ML algorithms is that at any given time, not all clinical variables (features) needed as input to perform prediction tasks are available. We define the concept of full-feature-capacity (FFC) to refer to prediction performance when such algorithms make use of all features on which they were trained. We then introduce Feature Sufficiency Analysis (FSA) - an analysis for determining whether a subset of all clinical features needed by an AI model is sufficient to achieve FFC. FSA estimates the underlying distributions of missing variables conditioned on features that are available. FSA provides a patient-specific assessment of whether the existing set of measured features achieves FFC. If yes, then there is no need to acquire further inputs and a ML-based prediction. We provide two case studies: prediction of need for postoperative prolonged ventilation in patients recovering from heart surgery; 10-year mortality prediction in an outpatient cohort. We also demonstrate that FSA also provides a clinically interpretable feature-ranking methodology based on prediction sufficiency, identifies intrinsically hard-to-predict patient populations, and has the potential to perform cost-aware optimization for clinical data acquisition. FSA provides a generic computational approach for determining whether incomplete clinical information is sufficient to support trustworthy AI-assisted clinical decision-making, thereby facilitating the prospective deployment of healthcare AI systems across diverse clinical settings.