Artificial intelligence algorithms in health care: is the current Food and Drug Administration regulation sufficient?
File(s)ai-2023-1-e42940.pdf (302.6 KB)
Published version
Author(s)
Type
Journal Article
Abstract
Given the growing use of machine learning (ML) technologies in health care, regulatory bodies face unique challenges in governing their clinical use. Under the regulatory framework of the Food and Drug Administration, approved ML algorithms are practically locked, preventing their adaptation in the ever-changing clinical environment, defeating the unique adaptive trait of ML technology in learning from real-world feedback. At the same time, regulations must enforce a strict level of patient safety to mitigate risk at a systemic level. Given that ML algorithms often support, or at times replace, the role of medical professionals, we have proposed a novel regulatory pathway analogous to the regulation of medical professionals, encompassing the life cycle of an algorithm from inception, development to clinical implementation, and continual clinical adaptation. We then discuss in-depth technical and nontechnical challenges to its implementation and offer potential solutions to unleash the full potential of ML technology in health care while ensuring quality, equity, and safety. References for this article were identified through searches of PubMed with the search terms “Artificial intelligence,” “Machine learning,” and “regulation” from June 25, 2017, until June 25, 2022. Articles were also identified through searches of the reference list of the articles. Only papers published in English were reviewed. The final reference list was generated based on originality and relevance to the broad scope of this paper.
Date Issued
2023
Date Acceptance
2022-12-28
Citation
JMIR AI, 2023, 2
ISSN
2817-1705
Publisher
JMIR Publications
Journal / Book Title
JMIR AI
Volume
2
Copyright Statement
©Meghavi Mashar, Shreya Chawla, Fangyue Chen, Baker Lubwama, Kyle Patel, Mihir A Kelshiker, Patrik Bachtiger, Nicholas
S Peters. Originally published in JMIR AI (https://ai.jmir.org), 16.01.2023. This is an open-access article distributed under the
terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted
use, distribution, and reproduction in any medium, provided the original work, first published in JMIR AI, is properly cited. The
complete bibliographic information, a link to the original publication on https://www.ai.jmir.org/, as well as this copyright and
license information must be included.
S Peters. Originally published in JMIR AI (https://ai.jmir.org), 16.01.2023. This is an open-access article distributed under the
terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted
use, distribution, and reproduction in any medium, provided the original work, first published in JMIR AI, is properly cited. The
complete bibliographic information, a link to the original publication on https://www.ai.jmir.org/, as well as this copyright and
license information must be included.
License URL
Identifier
http://dx.doi.org/10.2196/42940
Publication Status
Published
Article Number
e42940
Date Publish Online
2023-01-16