Mapping Artificial Intelligence adoption in Hepatology Practice and Research: Challenges and Opportunities in MENA region

Mohamed El-Kassas^1,2*Rofida Khalifa³Mohammed A Medhat⁴Yusuf YILMAZ^5,6Ali Tumi^7,8Asma Labidi^5,9Maen Almattooq^10,11Faisal M Sanai^12,5Mohamed Elbadry^13,5Mohammed Omer Mohammed¹⁴Mohamed Abdelhakim Mahdy¹⁵Nermeen Abdeen¹⁶Hend Radwan¹⁷Walaa Abdelhamed¹⁸Majed Almaghrabi^19,20Mai Fared^21,5Abdel-Naser Elzouki^22,5Khalid A Alswat^23,5Khalid M Alnaamani^24,5

• ¹Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt
• ²Steatotic Liver Diseases Study Foundation in Middle East and North Africa (SLMENA), Cairo, Egypt
• ³3. Tropical Medicine Department, Faculty of Medicine, Minia University, Minya, Egypt., Minya, Egypt
• ⁴4. Tropical Medicine and Gastroenterology Department, Assiut University, Assiut, Egypt., Assiut, Egypt
• ⁵Steatotic Liver Diseases foundation in Middle East and North Africa, Cairo, Egypt
• ⁶5. Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Türkiye
• ⁷Steatotic Liver Disease foundation in Middle East and North Africa, Cairo, Egypt
• ⁸6. Medical Department, Central Hospital, Tripoli, Libya
• ⁹7. Department of Gastroenterology "A," Rabta Hospital,, Tunisia, Tunisia
• ¹⁰8. Gastroenterology and Hepatology Department, Jaber AlAhmad Hospital, Kuwait City, Kuwait., Kuwait City,, Kuwait
• ¹¹Steatotic Liver Diseases foundation in Middle East in North Africa, Cairo, Egypt
• ¹²9. Gastroenterology Section, Department of Medicine, King Abdulaziz Medical City, King Abdullah International Medical Research Center, Ministry of National Guard - Health Affairs, Jeddah, Saudi Arabia, Jeddah, Saudi Arabia
• ¹³1. Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt, Cairo, Egypt
• ¹⁴10. Department of Clinical Science, University of Sulaimani, Sulaimani, Iraq
• ¹⁵11. Gastroenterology and Hepatology Unit, Assiut University, Assuit, Egypt
• ¹⁶12. Tropical Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
• ¹⁷13. Internal Medicine Department, Medicine and Clinical Studies Research Institute, National Research center, Cairo, Egypt
• ¹⁸14. Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
• ¹⁹15. Gastroenterology Section, Department of Medicine, King, Abdulaziz Medical City, Jeddah, Saudi Arabia
• ²⁰16. King Abdullah International Medical Research Center and College of Medicine, King Saud bin Abdulaziz University for Health Science, Jeddah, Saudi Arabia
• ²¹Research Support Center,Helwan University, Cairo, Egypt
• ²²18. Department of Medicine, Hamad Medical Corporation and College of Medicine, Qatar University, Doha, Qatar
• ²³19. Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, Riyadh,, Riyadh, Saudi Arabia
• ²⁴20. Department of Medicine, Division of Gastroenterology and Hepatology, The Medical City for Military and Security Services, Muscat, Oman

Background: Artificial intelligence (AI) is increasingly relevant to hepatology, yet real-world adoption in the Middle East and North Africa (MENA) is uncertain. We assessed awareness, use, perceived value, barriers, and policy priorities among hepatology clinicians in the region. Methods: A cross-sectional online survey targeted hepatologists and gastroenterologists across 17 MENA countries. The survey assessed clinical and research applications of AI, perceived benefits, clinical and research use, barriers, ethical considerations, and institutional readiness. Descriptive statistics and thematic analysis were performed. Results: Of 285 invited professionals, 236 completed the survey (response rate: 82.8%). While 73.2% recognized the transformative potential of AI, only 14.4% used AI tools daily, primarily for imaging analysis and disease prediction. AI tools were used in research by 39.8% of respondents, mainly for data analysis, manuscript writing assistance, and predictive modeling. Major barriers included inadequate training (60.6%), limited AI tool access (53%), and insufficient infrastructure (53%). Ethical concerns focused on data privacy, diagnostic accuracy, and over-reliance on automation. Despite these challenges, 70.3% expressed strong interest in AI training. , and 43.6% anticipating routine clinical integration within 1–3 years. Conclusion: MENA hepatologists are optimistic about AI but report limited routine use and substantial readiness gaps. Priorities include scalable training, interoperable infrastructure and standards, clear governance with human-in-the-loop safeguards, and region-specific validation to enable safe, equitable implementation.