Broadening the HTA of medical AI: A review of the literature to inform a tailored approach

IF 3.4 3区 医学 Q1 HEALTH POLICY & SERVICES
Bart-Jan Boverhof , W. Ken Redekop , Jacob J. Visser , Carin A. Uyl-de Groot , Maureen P.M.H. Rutten-van Mölken
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Abstract

Objectives

As current health technology assessment (HTA) frameworks do not provide specific guidance on the assessment of medical artificial intelligence (AI), this study aimed to propose a conceptual framework for a broad HTA of medical AI.

Methods

A systematic literature review and a targeted search of policy documents was conducted to distill the relevant medical AI assessment elements. Three exemplary cases were selected to illustrate various elements: (1) An application supporting radiologists in stroke-care (2) A natural language processing application for clinical data abstraction (3) An ICU-discharge decision-making application.

Results

A total of 31 policy documents and 9 academic publications were selected, from which a list of 29 issues was distilled. The issues were grouped by four focus areas: (1) Technology & Performance, (2) Human & Organizational, (3) Legal & Ethical and (4) Transparency & Usability. Each assessment element was extensively discussed in the test, and the elements clinical effectiveness, clinical workflow, workforce, interoperability, fairness and explainability were further highlighted through the exemplary cases.

Conclusion

The current methodology of HTA requires extension to make it suitable for a broad evaluation of medical AI technologies. The 29-item assessment list that we propose needs a tailored approach for distinct types of medical AI, since the conceptualisation of the issues differs across applications.

拓宽医疗人工智能的 HTA:文献综述为量身定制的方法提供依据
目标 由于目前的卫生技术评估(HTA)框架没有为医疗人工智能(AI)的评估提供具体指导,本研究旨在为广泛的医疗人工智能 HTA 提出一个概念框架。方法 通过系统的文献回顾和有针对性的政策文件搜索,提炼出相关的医疗人工智能评估要素。我们选择了三个典型案例来说明各种要素:(结果共选择了 31 份政策文件和 9 份学术出版物,从中提炼出 29 个问题。这些问题按四个重点领域分组:(1) 技术与性能;(2) 人力与组织;(3) 法律与道德;(4) 透明度与可用性。每个评估要素都在测试中进行了广泛讨论,并通过示范案例进一步强调了临床有效性、临床工作流程、劳动力、互操作性、公平性和可解释性等要素。我们提出的 29 项评估清单需要针对不同类型的医疗人工智能采用量身定制的方法,因为不同应用的问题概念各不相同。
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来源期刊
Health Policy and Technology
Health Policy and Technology Medicine-Health Policy
CiteScore
9.20
自引率
3.30%
发文量
78
审稿时长
88 days
期刊介绍: Health Policy and Technology (HPT), is the official journal of the Fellowship of Postgraduate Medicine (FPM), a cross-disciplinary journal, which focuses on past, present and future health policy and the role of technology in clinical and non-clinical national and international health environments. HPT provides a further excellent way for the FPM to continue to make important national and international contributions to development of policy and practice within medicine and related disciplines. The aim of HPT is to publish relevant, timely and accessible articles and commentaries to support policy-makers, health professionals, health technology providers, patient groups and academia interested in health policy and technology. Topics covered by HPT will include: - Health technology, including drug discovery, diagnostics, medicines, devices, therapeutic delivery and eHealth systems - Cross-national comparisons on health policy using evidence-based approaches - National studies on health policy to determine the outcomes of technology-driven initiatives - Cross-border eHealth including health tourism - The digital divide in mobility, access and affordability of healthcare - Health technology assessment (HTA) methods and tools for evaluating the effectiveness of clinical and non-clinical health technologies - Health and eHealth indicators and benchmarks (measure/metrics) for understanding the adoption and diffusion of health technologies - Health and eHealth models and frameworks to support policy-makers and other stakeholders in decision-making - Stakeholder engagement with health technologies (clinical and patient/citizen buy-in) - Regulation and health economics
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