<p class="COSSI-corpsdetexte" style="text-align:justify; text-indent:0px; -webkit-text-stroke-width:0px"><span style="font-size:medium"><span style="font-family:Arial, sans-serif"><span style="color:black"><span style="font-style:normal"><span style="font-variant-caps:normal"><span style="font-weight:400"><span style="letter-spacing:normal"><span style="orphans:auto"><span style="text-transform:none"><span style="white-space:normal"><span style="widows:auto"><span style="word-spacing:0px"><span style="text-decoration:none"><span style="background:white">En mati&egrave;re de diagnostic m&eacute;dical, de nombreux discours techno-utopiques mettent en avant la possibilit&eacute; de d&eacute;l&eacute;guer &laquo; aux machines dites intelligentes &raquo; le travail d&rsquo;analyse. Dans le domaine du traitement du cancer, c&rsquo;est m&ecirc;me une am&eacute;lioration de sa finesse pour un meilleur traitement et une augmentation des taux de survie dont il est question. Mais concr&egrave;tement qu&rsquo;acceptent les m&eacute;decins de d&eacute;l&eacute;guer &agrave; la &laquo; machine &raquo; lors d&rsquo;un diagnostic ? Quels sont les &laquo; scripts &raquo; (Akrich, 1995) que ces technologies supportent dans leurs algorithmes&nbsp;? Comment se constitue la confiance envers une IA ? Pour r&eacute;pondre &agrave; ces questions, nous nous appuierons sur une recherche men&eacute;e en 2020 et 2024 dans un cabinet d&rsquo;analyse m&eacute;dicale dans le domaine du diagnostic du cancer de la prostate (</span>Collet, Durampart, Heiser, Picard, 2021<span style="background:white">).&nbsp;</span></span></span></span></span></span></span></span></span></span></span></span></span></span></p> <p style="text-indent:0px; -webkit-text-stroke-width:0px; text-align:justify">&nbsp;</p> <p style="text-indent:0px; -webkit-text-stroke-width:0px; text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri, sans-serif"><span style="caret-color:#000000"><span style="color:#000000"><span style="font-style:normal"><span style="font-variant-caps:normal"><span style="font-weight:400"><span style="letter-spacing:normal"><span style="orphans:auto"><span style="text-transform:none"><span style="white-space:normal"><span style="widows:auto"><span style="word-spacing:0px"><span style="text-decoration:none"><span style="background:white"><span style="font-family:Arial, sans-serif"><span style="color:black">1. Le terrain</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p> <p style="text-indent:0px; -webkit-text-stroke-width:0px; text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri, sans-serif"><span style="caret-color:#000000"><span style="color:#000000"><span style="font-style:normal"><span style="font-variant-caps:normal"><span style="font-weight:400"><span style="letter-spacing:normal"><span style="orphans:auto"><span style="text-transform:none"><span style="white-space:normal"><span style="widows:auto"><span style="word-spacing:0px"><span style="text-decoration:none"><span style="font-family:Arial, sans-serif"><span style="color:black">MEDIPATH est laboratoire d&rsquo;analyse m&eacute;dicale dans le diagnostic anatomo-cytopathologique et plus particuli&egrave;rement du cancer. Cette Soci&eacute;t&eacute; d&rsquo;Exercice Lib&eacute;ral par Action Simplifi&eacute;e (SELAS) s&rsquo;est rapproch&eacute;e en 2019 de l&rsquo;entreprise IBEX-Medical Analytics pour d&eacute;velopper un partenariat de recherche afin d&rsquo;&eacute;laborer un logiciel d&rsquo;aide au diagnostic anatomopathologique sur biopsies prostatiques ayant pour objectif une utilisation en premi&egrave;re lecture. Le but &eacute;tait alors de pouvoir doter les m&eacute;decins d&rsquo;un outil moderne et fiable (propagation et efficience de l&rsquo;IA en imagerie m&eacute;dicale), adapt&eacute; (bas&eacute; sur les besoins des m&eacute;decins), ainsi que performant (gain de temps pour le m&eacute;decin dans l&rsquo;analyse des biopsies en identifiant les biopsies anormales).&nbsp;</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p> <p style="text-indent:0px; -webkit-text-stroke-width:0px; text-align:justify">&nbsp;</p> <p style="text-indent:0px; -webkit-text-stroke-width:0px; text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri, sans-serif"><span style="caret-color:#000000"><span style="color:#000000"><span style="font-style:normal"><span style="font-variant-caps:normal"><span style="font-weight:400"><span style="letter-spacing:normal"><span style="orphans:auto"><span style="text-transform:none"><span style="white-space:normal"><span style="widows:auto"><span style="word-spacing:0px"><span style="text-decoration:none"><span style="background:white"><span style="font-family:Arial, sans-serif"><span style="color:black">2. La m&eacute;thode</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p> <p class="texte" style="text-indent:0px; -webkit-text-stroke-width:0px; text-align:justify; margin-top:16px; margin-bottom:16px"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;, serif"><span style="caret-color:#000000"><span style="color:#000000"><span style="font-style:normal"><span style="font-variant-caps:normal"><span style="font-weight:400"><span style="letter-spacing:normal"><span style="orphans:auto"><span style="text-transform:none"><span style="white-space:normal"><span style="widows:auto"><span style="word-spacing:0px"><span style="text-decoration:none"><span style="font-family:Arial, sans-serif"><span style="color:black">La m&eacute;thode d&#39;observation employ&eacute;e a &eacute;t&eacute; celle de la restitution subjective en situation (Schmitt et Aubert, 2017). Lors de la premi&egrave;re captation en Janvier 2020, nous avons cherch&eacute; &agrave; comprendre le m&eacute;tier d&rsquo;anatomophalogiste et le v&eacute;cu des m&eacute;decins de MEDIPATH avant l&rsquo;introduction de la nouvelle solution logicielle. Puis, pendant la phase de d&eacute;ploiement de celle-ci, lors de la p&eacute;riode de confinement en France, nous avons d&ucirc; enregistrer l&rsquo;activit&eacute; &agrave; l&rsquo;&eacute;cran via le dispositif de captation et d&rsquo;enregistrement &agrave; distance Zoom. Apr&egrave;s cela, une troisi&egrave;me phase a &eacute;t&eacute; organis&eacute;e sous la forme d&rsquo;un</span></span>&nbsp;<em><span style="font-family:Arial, sans-serif">focus group</span></em>&nbsp;<span style="font-family:Arial, sans-serif"><span style="color:black">avec tous les m&eacute;decins. Enfin, en f&eacute;vrier 2024, nous avons men&eacute; des entretiens avec les deux coordinateurs R&amp;D du groupe MEDIPATH pour compl&eacute;ter nos analyses suite au d&eacute;ploiement de la solution dans l&rsquo;entreprise.</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p> <p class="texte" style="text-indent:0px; -webkit-text-stroke-width:0px; text-align:justify; margin-top:16px; margin-bottom:16px">&nbsp;</p> <p style="text-indent:0px; -webkit-text-stroke-width:0px; text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri, sans-serif"><span style="caret-color:#000000"><span style="color:#000000"><span style="font-style:normal"><span style="font-variant-caps:normal"><span style="font-weight:400"><span style="letter-spacing:normal"><span style="orphans:auto"><span style="text-transform:none"><span style="white-space:normal"><span style="widows:auto"><span style="word-spacing:0px"><span style="text-decoration:none"><span style="background:white"><span style="font-family:Arial, sans-serif"><span style="color:black">3. Les r&eacute;sultats</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p> <p style="text-indent:0px; -webkit-text-stroke-width:0px; text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri, sans-serif"><span style="caret-color:#000000"><span style="color:#000000"><span style="font-style:normal"><span style="font-variant-caps:normal"><span style="font-weight:400"><span style="letter-spacing:normal"><span style="orphans:auto"><span style="text-transform:none"><span style="white-space:normal"><span style="widows:auto"><span style="word-spacing:0px"><span style="text-decoration:none"><span style="background:white"><span style="font-family:Arial, sans-serif"><span style="color:black">Des observations des pratiques, il ressort que le logiciel prolonge les habitudes de travail des m&eacute;decins pathologistes et que le cours de l&rsquo;action avec l&rsquo;IA n&rsquo;est pas en rupture totale avec le cours de l&rsquo;action sans IA m&ecirc;me si leur mode de r&eacute;flexion est beaucoup moins inductif, voire abductif, pour tendre vers une h&eacute;g&eacute;monie de l&#39;hypoth&eacute;tico-d&eacute;ductif.&nbsp;</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p> <p style="text-indent:0px; -webkit-text-stroke-width:0px; text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri, sans-serif"><span style="caret-color:#000000"><span style="color:#000000"><span style="font-style:normal"><span style="font-variant-caps:normal"><span style="font-weight:400"><span style="letter-spacing:normal"><span style="orphans:auto"><span style="text-transform:none"><span style="white-space:normal"><span style="widows:auto"><span style="word-spacing:0px"><span style="text-decoration:none"><span style="background:white"><span style="font-family:Arial, sans-serif"><span style="color:black">Le</span></span></span><span style="font-family:Arial, sans-serif"><span style="color:black">&nbsp;retour r&eacute;flexif &agrave; l&rsquo;occasion du</span></span>&nbsp;<em><span style="font-family:Arial, sans-serif">focus group</span></em><span style="font-family:Arial, sans-serif"><span style="color:black">, montre que les m&eacute;decins d&eacute;veloppent de nouvelles croyances sur l&rsquo;IA dans leur contexte de travail. Selon eux, l&rsquo;IA permet de simplifier leurs activit&eacute;s cognitives en situation d&rsquo;analyse de cas simples du fait d&rsquo;un changement du processus de pens&eacute;e. Alors, se profile pour ces cas une activit&eacute; intellectuelle moins intense car, comme ils le disent, ils ne sont plus oblig&eacute;s de tout regarder. C&rsquo;est sur ce gain que se joue la confiance envers l&rsquo;IA. Par contre, pour les cas les plus compliqu&eacute;s, &agrave; savoir ceux o&ugrave; l&rsquo;IA n&rsquo;exprime pas de certitudes, l&rsquo;activit&eacute; reste tout autant compliqu&eacute;e et stressante.</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p> <p style="text-indent:0px; -webkit-text-stroke-width:0px; text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri, sans-serif"><span style="caret-color:#000000"><span style="color:#000000"><span style="font-style:normal"><span style="font-variant-caps:normal"><span style="font-weight:400"><span style="letter-spacing:normal"><span style="orphans:auto"><span style="text-transform:none"><span style="white-space:normal"><span style="widows:auto"><span style="word-spacing:0px"><span style="text-decoration:none"><span style="font-family:Arial, sans-serif"><span style="color:black">Enfin, les entretiens plus r&eacute;cents montrent que les&nbsp;<span style="background:white">habitudes se transforment lentement ainsi que l&rsquo;environnement&nbsp;: des situations hybrides de co-pr&eacute;sence entre microscope et ordinateur existent. Mais il est impossible de savoir si d&rsquo;autres fa&ccedil;ons de produire un diagnostic se sont d&eacute;velopp&eacute;es, ce qui n&eacute;cessite une autre phase d&rsquo;&eacute;tude. Un manque a surtout &eacute;merg&eacute; : l&rsquo;automatisation du compte-rendu d&rsquo;analyse. Par ailleurs des &laquo;&nbsp;r&eacute;fractaires&nbsp;&raquo; (terme utilis&eacute; par les coordinateurs) trouvent couteux la transformation des routines et de l&rsquo;environnement de travail (les 2 &eacute;crans). Chez eux, plus que sur les autres sont mis &agrave; l&rsquo;&eacute;preuve tous les imaginaires et les fantasmes qui se cristallisent autour de l&rsquo;exp&eacute;rimentation puis l&rsquo;appropriation : r&eacute;duction du r&ocirc;le de l&rsquo;humain, standardisation de l&rsquo;activit&eacute;, d&eacute;naturation du diagnostic &hellip;.&nbsp;</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p> <p style="text-indent:0px; -webkit-text-stroke-width:0px; text-align:justify">&nbsp;</p> <p style="text-indent:0px; -webkit-text-stroke-width:0px; text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri, sans-serif"><span style="caret-color:#000000"><span style="color:#000000"><span style="font-style:normal"><span style="font-variant-caps:normal"><span style="font-weight:400"><span style="letter-spacing:normal"><span style="orphans:auto"><span style="text-transform:none"><span style="white-space:normal"><span style="widows:auto"><span style="word-spacing:0px"><span style="text-decoration:none"><span style="background:white"><span style="font-family:Arial, sans-serif"><span style="color:black">4. Conclusion</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p> <p style="text-indent:0px; -webkit-text-stroke-width:0px; text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri, sans-serif"><span style="caret-color:#000000"><span style="color:#000000"><span style="font-style:normal"><span style="font-variant-caps:normal"><span style="font-weight:400"><span style="letter-spacing:normal"><span style="orphans:auto"><span style="text-transform:none"><span style="white-space:normal"><span style="widows:auto"><span style="word-spacing:0px"><span style="text-decoration:none"><span style="font-family:Arial, sans-serif"><span style="color:black">La confiance envers l&rsquo;IA ne se joue pas uniquement autour de la qualit&eacute; des interfaces ou de l&rsquo;hybridation (Mallein, Toussaint, 1994) avec les pratiques existantes mais &eacute;galement sur la confrontation des imaginaires avec la r&eacute;alit&eacute; des &laquo;&nbsp;arts&nbsp;&raquo; de diagnostiquer support&eacute;s par l&rsquo;environnement de travail. Ce qui nous am&egrave;ne &agrave; conclure que l&rsquo;exp&eacute;rience est une notion f&eacute;conde pour penser ce que les gens font avec des formes objectales et s&eacute;miotiques&nbsp;: ils vivent une exp&eacute;rience (sentiment subjectif impliqu&eacute; par l&rsquo;&eacute;preuve des technologies au quotidien) par qu&rsquo;ils ont une exp&eacute;rience (comme comp&eacute;tence &agrave; partir d&rsquo;un patrimoine cognitif acquis qui se transforme), qu&rsquo;ils mettent &agrave; l&rsquo;&eacute;preuve tant au niveau pratique qu&rsquo;imaginaire (temps d&rsquo;exp&eacute;rimentations, d&eacute;but d&rsquo;appropriation).</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p> <p style="text-indent:0px; -webkit-text-stroke-width:0px; text-align:justify">&nbsp;</p> <p style="text-indent:0px; -webkit-text-stroke-width:0px; text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri, sans-serif"><span style="caret-color:#000000"><span style="color:#000000"><span style="font-style:normal"><span style="font-variant-caps:normal"><span style="font-weight:400"><span style="letter-spacing:normal"><span style="orphans:auto"><span style="text-transform:none"><span style="white-space:normal"><span style="widows:auto"><span style="word-spacing:0px"><span style="text-decoration:none"><span lang="EN-US" style="font-family:Arial, sans-serif">Bibliographie</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p> <p style="text-indent:0px; -webkit-text-stroke-width:0px; text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri, sans-serif"><span style="caret-color:#000000"><span style="color:#000000"><span style="font-style:normal"><span style="font-variant-caps:normal"><span style="font-weight:400"><span style="letter-spacing:normal"><span style="orphans:auto"><span style="text-transform:none"><span style="white-space:normal"><span style="widows:auto"><span style="word-spacing:0px"><span style="text-decoration:none"><span lang="EN-US" style="font-family:Arial, sans-serif">Akrich, M. (1995). User Representations: Practices, Methods and Sociology. Rip, A., Misa, T.J. &amp; Schot, J. (Eds.)&nbsp;<i>Managing Technology in Society. The Approach of Constructive Technology Assessment</i>, Pinter Publisher, London/ New York, 167-184.</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p> <p style="text-indent:0px; -webkit-text-stroke-width:0px; text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri, sans-serif"><span style="caret-color:#000000"><span style="color:#000000"><span style="font-style:normal"><span style="font-variant-caps:normal"><span style="font-weight:400"><span style="letter-spacing:normal"><span style="orphans:auto"><span style="text-transform:none"><span style="white-space:normal"><span style="widows:auto"><span style="word-spacing:0px"><span style="text-decoration:none"><span lang="EN-US" style="font-family:Arial, sans-serif">Collet, L., Durampart, M., Heiser, L. Picard, L. (2021<span style="background:white"><span style="color:black">).&nbsp;</span></span></span><span style="font-family:Arial, sans-serif"><span style="color:black">Enjeux exp&eacute;rientiels de l&#39;utilisation de l&#39;IA en anatomopathologie&rdquo;&nbsp;</span></span><em><span style="font-family:Arial, sans-serif">Communiquer</span></em>&nbsp;<span style="background:white"><span style="font-family:Arial, sans-serif"><span style="color:black">[Online], 33&nbsp;|&nbsp;2021, Online since&nbsp;</span></span></span><span style="font-family:Arial, sans-serif"><span style="color:black">21 December 2021<span style="background:white">, connection on&nbsp;</span>14 May 2024<span style="background:white">.&nbsp;</span></span></span><span lang="EN-US" style="font-family:Arial, sans-serif"><span style="color:black">URL<span style="background:white">: http://journals. openedition.org/communiquer/8819;&nbsp;</span>DOI<span style="background:white">: https://doi.org/10.4000/communiquer.8819.</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p> <p style="text-indent:0px; -webkit-text-stroke-width:0px; text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri, sans-serif"><span style="caret-color:#000000"><span style="color:#000000"><span style="font-style:normal"><span style="font-variant-caps:normal"><span style="font-weight:400"><span style="letter-spacing:normal"><span style="orphans:auto"><span style="text-transform:none"><span style="white-space:normal"><span style="widows:auto"><span style="word-spacing:0px"><span style="text-decoration:none"><span style="font-family:Arial, sans-serif">Mallein, P., Toussaint., Y (1994).</span>&nbsp;<i>L&rsquo;int&eacute;gration sociale des technologies d&rsquo;information et de communication. Une sociologie des usages.</i>&nbsp;<span style="font-family:Arial, sans-serif">Technologies de l&rsquo;information et soci&eacute;t&eacute; no. 4. p. 315-335.</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p> <p style="text-indent:0px; -webkit-text-stroke-width:0px; text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri, sans-serif"><span style="caret-color:#000000"><span style="color:#000000"><span style="font-style:normal"><span style="font-variant-caps:normal"><span style="font-weight:400"><span style="letter-spacing:normal"><span style="orphans:auto"><span style="text-transform:none"><span style="white-space:normal"><span style="widows:auto"><span style="word-spacing:0px"><span style="text-decoration:none"><span style="background:white"><span style="font-family:Arial, sans-serif"><span style="color:black">Schmitt, D. et Aubert, O. (2017).&nbsp;</span></span></span><span lang="EN-US" style="background:white"><span style="font-family:Arial, sans-serif"><span style="color:black">REMIND: A method to understand the micro-dynamics of the museum visitors experience.&nbsp;</span></span></span><span style="background:white"><span style="font-family:Arial, sans-serif"><span style="color:black">Revue des Interactions Humaines M&eacute;diatis&eacute;es (RIHM) = Journal of Human Mediated Interactions, 17(2), 43‑70.</span></span></span><span style="font-family:Arial, sans-serif"><span style="color:black">&nbsp;<span style="background:white">DOI :&nbsp;</span></span></span><span style="font-family:Arial, sans-serif">10.4000/ocim.1440</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p>