为生成式AI在医疗中的应用建立全球协同监管新范式
Regulatory Science Innovation for Generative AI and Large Language Models in Health and Medicine: A Global Call for Action
- 提出适应生成式AI特性的动态监管框架,突破传统医疗器械生命周期模式
- 强调通过监管沙盒和迭代验证,在真实场景中测试治理方案
- 呼吁跨学科合作,防范模型偏见加剧全球健康不平等
生成式人工智能(GenAI)与大型语言模型(LLMs)在医疗领域的融合带来巨大机遇与挑战,亟需创新的监管科学应对。尽管其可广泛应用于临床流程自动化与个性化诊断,但非确定性输出、多功能性及复杂集成特性,使得现有基于全产品生命周期(TPLC)的医疗器械监管框架面临困境。本文探讨了TPLC方法在面向GenAI与LLM医疗设备监管中的局限性,倡导开展全球协作的监管科学研究,以推动自适应政策与监管沙盒等创新机制的发展,实现在真实世界环境中测试与优化治理方案。国际协调(如国际医疗器械监管机构论坛)对于管理LLM对全球健康的影响至关重要,尤其可缓解由模型固有偏见引发的健康不平等风险。通过整合多学科专业能力,采用数据驱动、持续迭代的方法,并关注多元人群需求,全球监管科学研究将支撑大型语言模型在医疗领域负责任且公平的进步。
原文摘要 · Abstract (English)
The integration of generative AI (GenAI) and large language models (LLMs) in healthcare presents both unprecedented opportunities and challenges, necessitating innovative regulatory approaches. GenAI and LLMs offer broad applications, from automating clinical workflows to personalizing diagnostics. However, the non-deterministic outputs, broad functionalities and complex integration of GenAI and LLMs challenge existing medical device regulatory frameworks, including the total product life cycle (TPLC) approach. Here we discuss the constraints of the TPLC approach to GenAI and LLM-based medical device regulation, and advocate for global collaboration in regulatory science research. This serves as the foundation for developing innovative approaches including adaptive policies and regulatory sandboxes, to test and refine governance in real-world settings. International harmonization, as seen with the International Medical Device Regulators Forum, is essential to manage implications of LLM on global health, including risks of widening health inequities driven by inherent model biases. By engaging multidisciplinary expertise, prioritizing iterative, data-driven approaches, and focusing on the needs of diverse populations, global regulatory science research enables the responsible and equitable advancement of LLM innovations in healthcare.
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