SEM model analysis of diabetic patients’ acceptance of artificial intelligence for diabetic retinopathy

Aims: This study aimed to investigate diabetic patients’ acceptance of artificial intelligence (AI) devices for diabetic retinopathy screening and the related influencing factors. Methods: An integrated model was proposed, and structural equation modeling was used to evaluate items and construct reliability and validity via confirmatory factor analysis. The model’s path effects, significance, goodness of fit, and mediation and moderation effects were analyzed. Results: Intention to Use (IU) is significantly affected by Subjective Norms (SN), Resistance Bias (RB), and Uniqueness Neglect (UN). Perceived Usefulness (PU) and Perceived Ease of Use (PEOU) were significant mediators between IU and other variables. The moderating effect of trust (TR) is non-significant on the path of PU to IU. Conclusions: The significant positive impact of SN may be caused by China’s collectivist and authoritarian cultures. Both PU and PEOU had a significant mediation effect, which suggests that impressions influence acceptance. Although the moderating effect of TR was not significant, the unstandardized factor loading remained positive in this study. We presume that this may be due to an insufficient sample size, and the public was unfamiliar with AI medical devices. © The Author(s) 2025.