Baseline AI Economic Literacy and Enacted Adoption of Artificial Intelligence Tools by Oncology and Critical Care Professionals

We examined whether baseline artificial intelligence (AI) economic literacy was associated with sustained use of oncology AI tools. This prospective cohort included 96 oncology and critical care professionals at two centres in Timișoara, Romania, followed for 12 months after institutional roll-out. Participants were classified by AI Economic Literacy Index (AIELI) scores as high (≥14) or low (<14). Sustained use required log-verified activity in at least two of the final three months. Analyses included regression, inverse probability of treatment weighting and exploratory indirect-association analysis through return-on-investment (ROI) confidence. Among 91 completers, sustained use occurred in 29/53 high-literacy participants (54.7%) and 7/38 low-literacy participants (18.4%; risk ratio 2.97, 95% confidence interval 1.46–6.06). The weighted risk ratio was 2.24 (1.15–4.34), and the profession-stratified risk ratio was 2.80 (1.36–5.76). Median time to first use was 5.8 months in the high-literacy group and was not reached in the low-literacy group. Nine participants (eight high-literacy, one low-literacy) had recorded use before the baseline assessment; in a delayed-entry analysis restricted to the 87 participants unused at assessment, the crude hazard ratio for subsequent first use was 2.98 (1.62–5.48) and the crude risk ratio for sustained use after excluding prior users was 3.01 (1.36–6.64); the corresponding covariate-adjusted estimates were less precise (hazard ratio 1.81, 0.89–3.69; risk ratio 2.19, 0.99–4.86) and their confidence intervals included the null. Roll-out-based time-to-first-use comparisons are descriptive because they include events preceding measurement. Sustained use increased across literacy bands. An indirect association through ROI confidence was observed but was not interpretable as causal mediation. Higher baseline economic literacy was associated with earlier and more sustained recorded AI-tool use, although opportunity for use differed by profession, and the adjusted timing-corrected estimates leave the independent contribution of literacy uncertain. Larger multicentre studies should evaluate whether literacy training improves adoption and whether adoption translates into clinical or economic benefit.