针对罕见事件识别的AI模型,提出评估框架与实用检查清单。
Critical appraisal of artificial intelligence for rare-event recognition: principles and pharmacovigilance case studies
- 构建结构化案例审查法,补足统计评估不足
- 实证显示误报成本敏感目标提升模型实际价值
- 适用于药监、金融等罕见事件高风险领域
许多高风险场景下的AI应用聚焦低发生率事件,其表面准确率可能掩盖真实价值有限的问题。本文系统梳理了罕见事件识别中需关注的关键环节:问题定义、测试集设计、流行率感知的统计评估、模型鲁棒性分析及与人工流程的融合。提出结构化案例审查(SCLE)方法以补充性能评估,并提供采购或开发模型的完整检查清单。在药物警戒领域通过三项研究验证:基于规则提取妊娠相关报告;结合机器学习与概率记录链接进行重复检测;利用大语言模型自动去除人名信息。揭示罕见事件设置中的典型陷阱,如不合理的类别平衡导致乐观偏差,测试集中缺乏难例正样本;并证明成本敏感目标能有效对齐模型表现与实际业务价值。虽以药监实践为基础,但原则可推广至正例稀缺且错误代价不对称的其他领域。
原文摘要 · Abstract (English)
Many high-stakes AI applications target low-prevalence events, where apparent accuracy can conceal limited real-world value. Relevant AI models range from expert-defined rules and traditional machine learning to generative LLMs constrained for classification. We outline key considerations for critical appraisal of AI in rare-event recognition, including problem framing and test set design, prevalence-aware statistical evaluation, robustness assessment, and integration into human workflows. In addition, we propose an approach to structured case-level examination (SCLE), to complement statistical performance evaluation, and a comprehensive checklist to guide procurement or development of AI models for rare-event recognition. We instantiate the framework in pharmacovigilance, drawing on three studies: rule-based retrieval of pregnancy-related reports; duplicate detection combining machine learning with probabilistic record linkage; and automated redaction of person names using an LLM. We highlight pitfalls specific to the rare-event setting including optimism from unrealistic class balance and lack of difficult positive controls in test sets - and show how cost-sensitive targets align model performance with operational value. While grounded in pharmacovigilance practice, the principles generalize to domains where positives are scarce and error costs may be asymmetric.
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