arXiv:2504.19179cs.AI2025-04被引 39

为医疗AI可信性落地提供可操作框架,解决临床采纳中的信任难题。

A Design Framework for operationalizing Trustworthy Artificial Intelligence in Healthcare: Requirements, Tradeoffs and Challenges for its Clinical Adoption

  • 构建通用医疗AI可信性设计框架,覆盖筛查到治疗全流程
  • 识别出多类关键需求,明确技术与伦理间的权衡关系
  • 以心血管病为例,验证框架实用性并揭示应用障碍

人工智能在疾病诊断、预后和患者护理方面潜力巨大,得益于影像、组学、生物信号和电子健康记录等数字医疗数据的积累以及计算能力的进步,部分AI模型已接近专家水平。然而,其临床广泛应用仍受限于技术之外的挑战,如伦理争议、监管壁垒和信任缺失。为此,医疗AI系统需遵循可信人工智能(TAI)原则,包括人类控制与监督、算法鲁棒性、隐私与数据治理、透明性、避免偏见歧视及责任可追溯。但医疗流程复杂(如筛查、诊断、预后、治疗)且利益相关方多样(医生、患者、机构、监管者),使得TAI原则落地困难。本文提出一个设计框架,帮助开发者将TAI原则融入医疗AI系统。针对各环节关键利益相关方,提出一套不依赖特定疾病的通用要求,并分析实际应用中可能产生的挑战与权衡。以高发且活跃于AI创新的心血管疾病为例,展示TAI原则的应用现状与主要障碍。

原文摘要 · Abstract (English)

Artificial Intelligence (AI) holds great promise for transforming healthcare, particularly in disease diagnosis, prognosis, and patient care. The increasing availability of digital medical data, such as images, omics, biosignals, and electronic health records, combined with advances in computing, has enabled AI models to approach expert-level performance. However, widespread clinical adoption remains limited, primarily due to challenges beyond technical performance, including ethical concerns, regulatory barriers, and lack of trust. To address these issues, AI systems must align with the principles of Trustworthy AI (TAI), which emphasize human agency and oversight, algorithmic robustness, privacy and data governance, transparency, bias and discrimination avoidance, and accountability. Yet, the complexity of healthcare processes (e.g., screening, diagnosis, prognosis, and treatment) and the diversity of stakeholders (clinicians, patients, providers, regulators) complicate the integration of TAI principles. To bridge the gap between TAI theory and practical implementation, this paper proposes a design framework to support developers in embedding TAI principles into medical AI systems. Thus, for each stakeholder identified across various healthcare processes, we propose a disease-agnostic collection of requirements that medical AI systems should incorporate to adhere to the principles of TAI. Additionally, we examine the challenges and tradeoffs that may arise when applying these principles in practice. To ground the discussion, we focus on cardiovascular diseases, a field marked by both high prevalence and active AI innovation, and demonstrate how TAI principles have been applied and where key obstacles persist.

可信AI医疗AI设计框架

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