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To provide a practical and methodologically grounded overview of explainable machine learning (XML) approaches in healthcare, with emphasis on their interpretation and application in clinical research and decision support. By moving beyond traditional predictive models, this primer aims to foster trust, transparency, and informed clinical decision-making, ultimately bridging the gap between data science and medical practice.

Predictive artificial intelligence (AI) promises to transform care delivery, enhance patient safety, and improve health outcomes. Realizing these benefits will require careful design, implementation, and monitoring strategies to avoid unintended consequences, including automation bias (i.e., erroneously favoring recommendations from automated systems). Automation bias is particularly concerning due to the variability of AI performance across time and populations, leading to predictions that may be variably incorrect, uncertain, or unfair.

Generative artificial intelligence (AI) chatbots built on large language models are rapidly entering mental-health care, offering human-like support without meeting evidentiary standards for safety or effectiveness.

To evaluate and compare the performance of large language models (LLMs) in identifying contributing factors (CFs) underlying patient safety incident investigations.

Alert fatigue is defined as alert dismissals due to excessive or irrelevant alerts and is frequently cited as a barrier to clinical decision support system use and impact. However, the criteria for determining the presence or absence of alert fatigue are poorly defined. The objective of this systematic review of systematic reviews was to identify operationalized definitions and measures of alert fatigue or alert-related metrics.

Health systems undertaking electronic health record (EHR) transitions often struggle to prepare and support clinicians in learning and using the new system. We evaluated a national peer coaching program-the National EHRM Supplemental Staffing Unit (NESSU)-designed to support clinicians during the U.S. Department of Veterans Affairs' (VA's) transition to a new EHR. Our goal was to assess NESSU's reach, perceived usefulness, and association with key EHR user outcomes, and to characterize [...]

We evaluated the quality and adoption of a large language model (LLM)-based summarization tool for ongoing hospital care.

Prediction models are increasingly used in healthcare for risk stratification and personalized care. Many models are developed using machine learning, which requires tuning hyperparameters to maximize performance based on a chosen loss function metric. In healthcare, the area under the receiver operating characteristic curve (AUROC) is commonly used for this purpose, but it may not always be the most appropriate choice for every clinical application. We empirically characterize whether the [...]

Ambient artificial intelligence (AI) documentation is increasingly used to draft clinical notes from patient-provider conversations, but how clinicians revise and finalize these drafts is not well understood. This qualitative content analysis study characterizes real-world edits to AI-generated drafts and identifies opportunities for improvement of AI design and the implementation process.

To assess whether large language model (LLM)-based clinical trial screening judgments vary by patient sociodemographic characteristics.