“AI might feel like magic at times, but mostly it's just powerful technology, and with any technology, it's a tool.” —Merlijn van Breugel

AI is no longer a future-tense possibility for allergists. It is already shaping diagnosis, prediction, documentation, patient communication, and the way clinicians think through complex decisions. But if AI can process more than we can, what still belongs to the clinician?

On this episode of The Allergist, Dr. Mariam Hanna is joined by Merlijn van Breugel, a data scientist and philosopher whose work focuses on AI in allergy and immunology. Together, they get into where AI may be most useful now and in the near future, including phenotyping asthma and eczema, supporting diagnosis in young children, combining genetic, environmental, wearable, and clinical data, and reducing the administrative work that pulls clinicians away from patient care. But the episode does not dodge the hard stuff: hallucinations, bias, validation, liability, overtrust, and the very human problem of changing behaviour in real clinics.

Key Points

• Allergy and immunology are not early adopters of AI, partly because the field relies on complex, heterogeneous data.
• AI is most promising when it helps reveal patterns clinicians struggle to synthesize on their own, such as asthma or eczema subtypes.
• Large language models can hallucinate, so clinicians need to stay critical even when an answer sounds polished and convincing.
• Decision-support tools should augment clinical judgment, not replace it.
• Bias in training data can create real harm if AI tools work better for some patient populations than others.
• The best use cases are significant, underserved problems where AI can do something that older tools could not.
• AI literacy will become a core skill for clinicians who want to use these tools safely and effectively.

For allergists, the message is not to fear the machine or blindly follow it. AI may help identify patterns, reduce administrative work, and open new research possibilities, but the clinician still brings the judgment, context, accountability, and critical eye. The future is not AI instead of allergists. It is allergists who understand how to use AI well.

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