• Skip to main content
  • Skip to secondary menu
  • Skip to primary sidebar
  • Skip to footer
Montreal AI Ethics Institute

Montreal AI Ethics Institute

Democratizing AI ethics literacy

  • Articles
    • Public Policy
    • Privacy & Security
    • Human Rights
      • Ethics
      • JEDI (Justice, Equity, Diversity, Inclusion
    • Climate
    • Design
      • Emerging Technology
    • Application & Adoption
      • Health
      • Education
      • Government
        • Military
        • Public Works
      • Labour
    • Arts & Culture
      • Film & TV
      • Music
      • Pop Culture
      • Digital Art
  • Columns
    • AI Policy Corner
    • Recess
    • Tech Futures
  • The AI Ethics Brief
  • AI Literacy
    • Research Summaries
    • AI Ethics Living Dictionary
    • Learning Community
  • The State of AI Ethics Report
    • Volume 7 (November 2025)
    • Volume 6 (February 2022)
    • Volume 5 (July 2021)
    • Volume 4 (April 2021)
    • Volume 3 (Jan 2021)
    • Volume 2 (Oct 2020)
    • Volume 1 (June 2020)
  • About
    • Our Contributions Policy
    • Our Open Access Policy
    • Contact
    • Donate

Understanding the Effect of Counterfactual Explanations on Trust and Reliance on AI for Human-AI Collaborative Clinical Decision Making

September 21, 2023

šŸ”¬ Research Summary by Min Lee, an Assistant Professor in Computer Science at Singapore Management University, where he creates and evaluates interactive, human-centered AI systems for societal problems (e.g. health).

[Original paper by Min Hun Lee and Chong Jun Chew]


Overview: Although advanced artificial intelligence (AI) and machine learning (ML) models are increasingly being explored to assist various decision-making tasks (e.g., health, bail decisions), users might place too much trust even with ā€˜wrong’ AI outputs. This paper explores the effect of counterfactual explanations on users’ trust and reliance on AI during a clinical decision-making task.


Introduction

Advanced artificial intelligence (AI) and machine learning (ML) models are increasingly being considered to increase efficiency and reduce the cost of performing decision-making tasks from various types of organizations and domains (e.g., health, bail decisions, child welfare services, etc.). However, users might place too much trust in the AI/ML system and even agree with ā€˜wrong’ AI outputs, and they achieve worse performance than humans or AI/ML models alone.

Key Insights

What did we do? 

In this work, we contribute to an empirical study that analyzes the effect of AI explanations on users’ trust and reliance on AI during clinical decision-making. Specifically, we focus on the task of assessing post-stroke survivors’ quality of motion. We conducted a within-subject experiment with seven therapists and ten laypersons to compare the effect of counterfactual explanations with one of the widely used AI explanations, feature importance explanations.

  • Feature importance: describes the contribution/importance of each input feature (e.g., kinematic variablesā€Šā€”ā€Šjoint angle, distance between joints for the context of the study)
  • Counterfactual explanations: describe how the inputs can be modified to achieve an AI output in a certain way (e.g., how does a patient’s incorrect/abnormal motion need to be changed to become a normal motion?)

One potential reason for overreliance on AI might be that humans rarely involve analytical thinking on AI outputs. This work hypothesizes that reviewing counterfactual explanations will allow a user to think critically about changing AI inputs to update an AI output and improve the user’s analytical review of an AI output to reduce overreliance on AI.

What did we learn?

  • When ā€˜right’ AI outputs were presented, human+AI performance with both feature importance and counterfactual explanations increased than humans alone
  • When ā€˜wrong’ AI outputs were presented, human+AI performance with both feature importance and counterfactual explanations decreased than humans alone
  • Counterfactual explanations reduced overreliance on ā€˜wrong’ AI outputs by 21% compared to feature importance
  • Domain experts (i.e., therapists) had lower performance degradation and overreliance on ā€˜wrong’ AI outputs than laypersons while using both feature importance and counterfactual explanations
  • Both experts and laypersons expressed higher subjective usability scores of ā€˜usefulness,’ ā€˜less effort & frustration,’ ā€˜trust,’ and ā€˜usage intent’ on feature importance than counterfactual explanations.

Between the lines

Implications: Our work shows that providing AI explanations does not necessarily indicate improved human-AI collaborative decision-making. This work provides new insights into:

1) the potential of counterfactual explanations to improve analytical reviews on AI outputs and reduce overreliance on ā€˜wrong’ AI outputs with the cost of cognitive burdens.

2) a gap between users’ perceived benefits and actual trustworthiness/usefulness of an AI system (e.g., improving performance while relying on ā€˜right’ outcomes)

Please check our paper for the details of this work (link). If you are interested in further discussing this work or collaborating in this space, please contact Min Lee (link).

Citation Format: Min Hun Lee and Chong Jun Chew. 2023. Understanding the Effect of Counterfactual Explanations on Trust and Reliance on AI for Human-AI Collaborative Clinical Decision Making. Proc. ACM Hum.-Comput. Interact. 7, CSCW2, Article 369 (October 2023), 22 pages. https://doi.org/10.1145/3610218

Want quick summaries of the latest research & reporting in AI ethics delivered to your inbox? Subscribe to the AI Ethics Brief. We publish bi-weekly.

Primary Sidebar

šŸ” SEARCH

Spotlight

A rock embedded with intricate circuit board patterns, held delicately by pale hands drawn in a ghostly style. The contrast between the rough, metallic mineral and the sleek, artificial circuit board illustrates the relationship between raw natural resources and modern technological development. The hands evoke human involvement in the extraction and manufacturing processes.

Tech Futures: The Fossil Fuels Playbook for Big Tech: Part I

Close-up of a cat sleeping on a computer keyboard

Tech Futures: The threat of AI-generated code to the world’s digital infrastructure

The undying sun hangs in the sky, as people gather around signal towers, working through their digital devices.

Dreams and Realities in Modi’s AI Impact Summit

Illustration of a coral reef ecosystem

Tech Futures: Diversity of Thought and Experience: The UN’s Scientific Panel on AI

This image shows a large white, traditional, old building. The top half of the building represents the humanities (which is symbolised by the embedded text from classic literature which is faintly shown ontop the building). The bottom section of the building is embossed with mathematical formulas to represent the sciences. The middle layer of the image is heavily pixelated. On the steps at the front of the building there is a group of scholars, wearing formal suits and tie attire, who are standing around at the enternace talking and some of them are sitting on the steps. There are two stone, statute-like hands that are stretching the building apart from the left side. In the forefront of the image, there are 8 students - which can only be seen from the back. Their graduation gowns have bright blue hoods and they all look as though they are walking towards the old building which is in the background at a distance. There are a mix of students in the foreground.

Tech Futures: Co-opting Research and Education

related posts

  • Measuring Value Understanding in Language Models through Discriminator-Critique Gap

    Measuring Value Understanding in Language Models through Discriminator-Critique Gap

  • Research summary: Aligning Super Human AI with Human Behavior: Chess as a Model System

    Research summary: Aligning Super Human AI with Human Behavior: Chess as a Model System

  • Fair allocation of exposure in recommender systems

    Fair allocation of exposure in recommender systems

  • Achieving Fairness at No Utility Cost via Data Reweighing with Influence

    Achieving Fairness at No Utility Cost via Data Reweighing with Influence

  • Ubuntu’s Implications for Philosophical Ethics

    Ubuntu’s Implications for Philosophical Ethics

  • A Sequentially Fair Mechanism for Multiple Sensitive Attributes

    A Sequentially Fair Mechanism for Multiple Sensitive Attributes

  • Representation and Imagination for Preventing AI Harms

    Representation and Imagination for Preventing AI Harms

  • LLMCarbon: Modeling the end-to-end Carbon Footprint of Large Language Models

    LLMCarbon: Modeling the end-to-end Carbon Footprint of Large Language Models

  • Human-AI Collaboration in Decision-Making: Beyond Learning to Defer

    Human-AI Collaboration in Decision-Making: Beyond Learning to Defer

  • Editing Personality for LLMs

    Editing Personality for LLMs

Partners

  • Ā 
    U.S. Artificial Intelligence Safety Institute Consortium (AISIC) at NIST

  • Partnership on AI

  • The LF AI & Data Foundation

  • The AI Alliance

Footer


Articles

Columns

AI Literacy

The State of AI Ethics Report


 

About Us


Founded in 2018, the Montreal AI Ethics Institute (MAIEI) is an international non-profit organization equipping citizens concerned about artificial intelligence and its impact on society to take action.

Contact

Donate


  • Ā© 2025 MONTREAL AI ETHICS INSTITUTE.
  • This work is licensed under a Creative Commons Attribution 4.0 International License.
  • Learn more about our open access policy here.
  • Creative Commons License

    Save hours of work and stay on top of Responsible AI research and reporting with our bi-weekly email newsletter.