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Updated: Mar 16, 2026

Evidence-based Knowledge Synthesis and Hypothesis Validation: Navigating Biomedical Knowledge Bases via Explainable AI and Agentic Systems
Published on: June 13, 2025
1Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
This review examines how automated decision support tools can lead to human errors. While often seen as a problem only during multitasking, the authors find that over-reliance on technology also occurs during complex, single-task diagnostic work.
Area of Science:
Background:
No prior work had resolved whether over-reliance on automated systems is restricted to multitasking environments. Prior research has shown that decision support tools can inadvertently introduce novel error types. That uncertainty drove this investigation into the broader literature beyond human factors engineering. It was already known that users sometimes neglect manual information verification when using digital aids. This gap motivated a cross-disciplinary comparison between clinical and industrial settings. Researchers previously assumed that vigilance decreases primarily when individuals manage multiple concurrent demands. However, the prevalence of these errors in specialized diagnostic settings remained poorly understood. This study addresses the discrepancy between established theoretical models and observed performance in complex decision-making tasks.
Purpose Of The Study:
The aim of this review is to compare human factors and health care literature regarding the association of bias with multitasking. This study addresses the uncertainty surrounding whether over-reliance on technology is restricted to complex, concurrent environments. The researchers seek to clarify the role of task complexity in decision-making errors. No prior work had resolved how these errors manifest across different professional domains. This investigation explores whether diagnostic tasks are more prone to failure than monitoring tasks. The authors intend to evaluate the prevalence of these issues in studies where manual verification is possible. They hope to determine if cognitive load is a more significant predictor than multitasking. This work provides a comprehensive synthesis of evidence to guide future system design and error mitigation strategies.
Main Methods:
Review approach involved searching nine major academic databases from 1983 through 2015. The investigators selected evaluations where automated tools assisted human performance and resulted in measurable errors. Participants had to possess the capability to verify system accuracy and execute tasks manually. The team identified and grouped various task types to facilitate cross-disciplinary comparisons. Each activity received a rating based on its specific verification complexity. The researchers noted the presence of multitasking alongside the type of automation employed. They synthesized findings from 40 studies, including six from the health care sector. This rigorous screening process ensured that only relevant performance data were included in the final analysis.
Main Results:
Key findings from the literature reveal that over-reliance on technology occurs in single tasks, contrary to established human factors theories. The researchers identified 40 relevant studies from an initial pool of 890 publications. Bias was frequently observed in diagnostic scenarios rather than simple monitoring activities. High verification complexity emerged as a consistent factor linked to these performance errors. The authors report that the literature is currently fragmented, with large discrepancies in reporting standards. Few studies provided statistical significance testing when compared to a control condition. Results suggest that cognitive load, rather than multitasking, is the primary driver of these decision failures. The data indicate that automated systems can introduce risks even when users are not managing concurrent demands.
Conclusions:
The authors propose that over-reliance on automated aids is not exclusively tied to multitasking scenarios. Synthesis and implications suggest that high verification complexity contributes significantly to user error rates. Evidence indicates that diagnostic tasks are particularly susceptible to these cognitive failures. The researchers note that the current body of literature remains highly fragmented across different fields. They highlight that few studies provide robust statistical comparisons against manual control conditions. Strategies for mitigation should prioritize the reduction of cognitive load during high-stakes decision processes. The findings imply that designers must account for task difficulty when implementing automated support systems. Future efforts should aim to standardize how these performance discrepancies are reported in scientific publications.
According to the authors, the phenomenon occurs during single-task diagnostic activities, contradicting the human factors view that it requires multitasking. The researchers propose that high verification complexity, rather than concurrent demands, drives this outcome.
The researchers utilized nine databases, including Medline, EMBASE, and Scopus, to identify relevant literature. They screened 890 papers, ultimately selecting 40 studies that met specific criteria regarding task execution and manual verification capabilities.
The authors suggest that high verification complexity is necessary for these errors to manifest in single-task environments. This contrasts with monitoring tasks, where lower complexity might allow for easier detection of automated system failures.
The researchers categorized tasks based on their type, the nature of the automation, and the presence of multitasking. This data allowed them to compare findings across human factors and health care literature.
The authors measured the degree of cognitive load experienced by participants during decision tasks. They observed that this load is associated with the occurrence of bias, unlike the previously assumed requirement for multitasking.
The researchers propose that strategies to minimize these errors should focus on reducing cognitive load. They argue this approach is more effective than simply addressing multitasking, given the prevalence of bias in single-task diagnostic settings.