Sustainable deployment of clinical prediction tools—a 360° approach to model maintenance

Abstract

Background: As the enthusiasm for integrating artificial intelligence (AI) into clinical care grows, so has our understanding of the challenges associated with deploying impactful and sustainable clinical AI models. Complex dataset shifts resulting from evolving clinical environments strain the longevity of AI models as predictive accuracy and associated utility deteriorate over time. Objective: Responsible practice thus necessitates the lifecycle of AI models be extended to include ongoing monitoring and maintenance strategies within health system algorithmovigilance programs. We describe a framework encompassing a 360° continuum of preventive, preemptive, responsive, and reactive approaches to address model monitoring and maintenance from critically different angles. Discussion: We describe the complementary advantages and limitations of these four approaches and highlight the importance of such a coordinated strategy to help ensure the promise of clinical AI is not short-lived.