Artificial Intelligence in Spanish Gastroenterology: high expectations, limited integration. A national survey

Background: Artificial intelligence (AI) has emerged as a disruptive innovation in medicine, yet its adoption within gastroenterology remains limited and poorly characterized. We aimed to examine knowledge, practical applications, perceived barriers, and expectations regarding AI among gastroenterology specialists in Spain. Methods: We conducted a cross-sectional observational study using a structured online survey distributed by the Spanish Society of Digestive Pathology (SEPD) in 2025. The questionnaire collected sociodemographic data, patterns of AI use, perceptions, and educational needs. Descriptive statistics and multivariable models were applied. Results: Among 283 respondents (mean age 44.6 +/- 9.7 years), 87.5% acknowledged AI as a transformative tool, but only 60.2% (95% CI: 54.3-66.1%) reported using it, mostly outside institutional frameworks. Notably, 80.2% of users initiated AI use within the past year. Independent predictors of frequent use included previous training (OR=2.44), employment in university hospitals (OR=2.14), and younger age (OR=1.36 per 5-year decrease). Main barriers were lack of training (61%), absence of institutional strategies (46%), and ethical concerns (50%). While 93.8% agreed that AI training programmes are necessary, only 18.4% had received formal training. Conclusions: A substantial gap exists between the favorable perception of AI and its actual integration into clinical practice within Spanish gastroenterology. The rapid adoption outside institutional frameworks underscores the urgent need for accredited training programmes and governance standards led by scientific societies.

💡 Research Summary

This paper reports the results of a nationwide cross‑sectional survey conducted by the Spanish Society of Digestive Pathology (SEPD) between February and April 2025 to assess the knowledge, use, perceived barriers, and educational needs regarding artificial intelligence (AI) among gastroenterology specialists in Spain. Out of 2,857 eligible SEPD members, 283 gastroenterologists responded (response rate 9.9%). The mean age of respondents was 44.6 ± 9.7 years, 59 % were women, and more than half worked in university hospitals.

A striking majority (87.5 %) regarded AI as a transformative tool for gastroenterology, yet only 60.2 % (95 % CI 54.3‑66.1 %) reported actually using AI in clinical practice. Use was predominantly outside formal institutional frameworks; 80.2 % of users had started employing AI within the previous year, indicating a rapid “grass‑roots” uptake. Frequency analysis showed that 38.2 % used AI at least weekly and 28.7 % daily. The most common applications were automated imaging analysis (82.2 %), text‑based clinical reporting assistants (80.6 %), and decision‑support systems (70.5 %).

Multivariable logistic regression identified three independent predictors of frequent AI use (defined as ≥ once per week): prior AI training (OR = 2.44, 95 % CI 1.22‑4.88), employment in a university hospital (OR = 2.14, 95 % CI 1.33‑3.45), and younger age (OR = 1.36 per 5‑year decrease, 95 % CI 1.12‑1.64). Sex, subspecialty, and geographic region were not significant predictors.

The main barriers reported were lack of training (61 %), absence of an institutional AI strategy (46 %), and ethical/legal concerns (50 %). Despite 93.8 % of respondents endorsing the need for AI training programmes, only 18.4 % had received any formal training, highlighting a substantial education gap.

Qualitative analysis of 186 open‑text responses revealed that participants most desired training focused on clinical diagnosis (56.2 %), predictive modelling (22.7 %), and teaching/research methods (18.8 %). They also called on scientific societies to assume a leadership role in providing accreditation, guidelines, standards, and ethical frameworks. Almost all respondents (94.9 %) were willing to dedicate at least one hour per week to AI education, with 49.5 % ready to commit two or more hours.

The authors conclude that a pronounced gap exists between the favorable perception of AI and its actual integration into Spanish gastroenterology practice. The rapid, largely unsupervised adoption underscores the urgency for accredited training programmes, clear governance, and coordinated strategies led by professional societies and university hospitals. Implementing such measures is deemed essential to ensure patient safety, data protection, and the sustainable clinical impact of AI across the national healthcare system.