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A Framework for the Oversight and Local Deployment of Safe and High-quality Prediction Models

Abstract

Artificial intelligence/machine learning models are being rapidly developed and used in clinical practice. However, many models are deployed without a clear understanding of clinical or operational impact and frequently lack monitoring plans that can detect potential safety signals. There is a lack of consensus in establishing governance to deploy, pilot, and monitor algorithms within operational healthcare delivery workflows. Here, we describe a governance framework that combines current regulatory best practices and lifecycle management of predictive models being used for clinical care. Since January 2021, we have successfully added models to our governance portfolio and are currently managing 52 models.

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References
1.
Sendak M, Gao M, Brajer N, Balu S . Presenting machine learning model information to clinical end users with model facts labels. NPJ Digit Med. 2020; 3:41. PMC: 7090057. DOI: 10.1038/s41746-020-0253-3. View

2.
Watson J, Hutyra C, Clancy S, Chandiramani A, Bedoya A, Ilangovan K . Overcoming barriers to the adoption and implementation of predictive modeling and machine learning in clinical care: what can we learn from US academic medical centers?. JAMIA Open. 2020; 3(2):167-172. PMC: 7382631. DOI: 10.1093/jamiaopen/ooz046. View

3.
Kawamanto K, Flynn M, Kukhareva P, ElHalta D, Hess R, Gregory T . A Pragmatic Guide to Establishing Clinical Decision Support Governance and Addressing Decision Support Fatigue: a Case Study. AMIA Annu Symp Proc. 2019; 2018:624-633. PMC: 6371304. View

4.
Pencina M, Goldstein B, DAgostino R . Prediction Models - Development, Evaluation, and Clinical Application. N Engl J Med. 2020; 382(17):1583-1586. DOI: 10.1056/NEJMp2000589. View

5.
Bedoya A, Clement M, Phelan M, Steorts R, OBrien C, Goldstein B . Minimal Impact of Implemented Early Warning Score and Best Practice Alert for Patient Deterioration. Crit Care Med. 2018; 47(1):49-55. PMC: 6298839. DOI: 10.1097/CCM.0000000000003439. View