Reassessing the evidence linking clinical leadership to AI deployment outcomes

Li et al. report that clinician last authorship is associated with greater “impact” in AI deployment trials. This commentary argues that current evidence is insufficient to attribute this to clinical leadership per se. Concerns include outcome definition in a literature where 88% of trials are positive, statistical instability from only 13 non-events, authorship as a noisy proxy for leadership, and structural confounding by trial design and geography.