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Artificial intelligence (AI) is seen as a strategic lever to improve access, quality, and efficiency of care and services and to build learning and value-based health systems. Many studies have examined the technical performance of AI within an experimental context. These studies provide limited insights into the issues that its use in a real-world context of care and services raises. To help decision makers address these issues in a systemic and holistic manner, this viewpoint paper relies on the health technology assessment core model to contrast the expectations of the health sector toward the use of AI with the risks that should be mitigated for its responsible deployment. The analysis adopts the perspective of payers (ie, health system organizations and agencies) because of their central role in regulating, financing, and reimbursing novel technologies. This paper suggests that AI-based systems should be seen as a health system transformation lever, rather than a discrete set of technological devices. Their use could bring significant changes and impacts at several levels: technological, clinical, human and cognitive (patient and clinician), professional and organizational, economic, legal, and ethical. The assessment of AI’s value proposition should thus go beyond technical performance and cost logic by performing a holistic analysis of its value in a real-world context of care and services. To guide AI development, generate knowledge, and draw lessons that can be translated into action, the right political, regulatory, organizational, clinical, and technological conditions for innovation should be created as a first step.

Assessing behavioural consistency is crucial to understand the evolution of personality traits. In the present study we examined the short-and long-term repeatability and stability of two unrelated personality traits-exploratory tendencies and struggling rate-using captive female zebra finches (Taeniopygia guttata). We performed two experimental sessions of behavioural tests with a seven-month interval, which represents up to one quarter of a zebra finch's life expectancy. We showed that, overall, exploratory tendencies and struggling rate were significantly repeatable in the short-term. However, only exploratory tendencies were repeatable in the long-term. We found inter-individual differences in short-term stability of exploratory tendencies, but not struggling rate, providing evidence for differences in intra-individual variability. In the long-term, struggling rate significantly decreased between the two experimental sessions, whereas exploratory tendencies remained stable. Finally, the amount of inter-individual variation measured at both sessions did not differ. Our results suggest that short-and long-term repeatability and stability of personality may vary between individuals, depending on the behavioural trait under scrutiny. As a consequence, deducing personality from measures realized earlier in a subject's life should be performed with caution. We discuss the implications of inter-and intra-individual variation in personality consistency on individual fitness. AbstractAssessing behavioural consistency is crucial to understand the evolution of personality traits. In the present study, we examined the short-and long-term repeatability and stability of two unrelated personality traitsexploratory tendencies and struggling rate -using captive female zebra finches (Taeniopygia guttata). We performed two experimental sessions of behavioural tests with a 7-mo interval, which represents up to one quarter of a zebra finch's life expectancy. We showed that, overall, exploratory tendencies and struggling rate were significantly repeatable in the short term. However, only exploratory tendencies were repeatable in the long term. We found interindividual differences in short-term stability of exploratory tendencies, but not struggling rate, providing evidence for differences in intraindividual variability. In the long term, struggling rate significantly decreased between the two experimental sessions, whereas exploratory tendencies remained stable. Finally, the amount of interindividual variation measured at both sessions did not differ. Our results suggest that short-and long-term repeatability and stability of personality may vary between individuals, depending on the behavioural trait under scrutiny. As a consequence, deducing personality from measures realized earlier in a subject's life should be performed with caution. We discuss the implications of inter-and intraindividual variation in personality consistency on individual fitness.