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New standards released to ensure medical AI is safe and effective for everyone

Published on 31/10/2023

Research into the use of medical AI has been conducted in over 50 countries
Research into the use of medical AI has been conducted in over 50 countries

Healthcare professionals can harness artificial intelligence safely by following a new set of patient and industry-agreed standards.

An international initiative called STANDING Together has released new standards ensuring that medical artificial intelligence (AI) systems are developed with appropriate health datasets. These recommendations are the result of a two-year research study involving over 350 people from 58 countries, including patients, researchers, healthcare professionals, industry experts, and regulators.

STANDING Together is led by researchers at University Hospitals Birmingham NHS Foundation Trust, and the University of Birmingham. The research has been conducted with collaborators from over 30 institutions worldwide, including universities, the UK medicines regulator (the Medicines and Healthcare products Regulatory Agency, MHRA), patient groups and charities, and small and large health technology companies. The work has been funded by The Health Foundation and the NHS AI Lab and supported by the National Institute for Health and Care Research (NIHR).

The STANDING Together recommendations ensure that the full diversity of people, that AI systems will be used for, is represented in health datasets. This is imperative as AI systems are less likely to work well for people who aren’t properly represented in datasets – and may even be harmful. People who are in minority groups are particularly likely to be under-represented in datasets.

The recommendations provide guidance on collecting and reporting details such as age, sex, gender, race, ethnicity, and other important characteristics. They also recommend that any limitations of the dataset should be transparently reported to ensure that developers creating AI systems can choose the best data for their purpose. Guidance is also given on how to identify those who may be harmed when medical AI systems are used, allowing this risk to be reduced.

Lead researcher, Ophthalmology Specialist Trainee and Research Fellow at UHB, Dr Xiaoxuan Liu said: “AI models are underpinned by data, which captures a wealth of information. When dealing with health data, this information can unfortunately include existing health inequalities. These inequalities can come about in many ways, including underrepresentation of particular groups, or as a reflection of structural biases within wider society. It is vital that anyone using data to develop new innovations (including AI) are aware of any biases, and that they are accounted for. As we move towards an AI-enabled future, we can ensure these technologies don’t just work on average, but that they work for all.”

Dominic Cushnan, Director AI, Imaging & Deployment at the NHS AI Lab, said: “The lack of diversity and inclusivity in our current datasets are major challenges in our ability to ensure AI in health and care works for everyone. These standards are an important step towards transparent and common documentation of represented groups in our data, which can support the responsible and fair development and use of AI.”

The recommendations are available open access, to support the development of safe, effective, and equitable AI tools for healthcare.

About the National Institute for Health and Care Research

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

  • funding high quality, timely research that benefits the NHS, public health and social care
  • investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services
  • partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research
  • attracting, training and supporting the best researchers to tackle complex health and social care challenges
  • collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system
  • funding applied global health research and training to meet the needs of the poorest people in low and middle income countries

NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.

The NHS AI Lab, the NIHR, and the Health Foundation have awarded in total £1.4m to four projects, including STANDING Together.

Organisations working with University Hospitals Birmingham NHS Trust and the University of Birmingham on STANDING Together include the Medicines and Healthcare products Regulatory Agency (MHRA), Massachusetts Institute of Technology, Health Data Research UK, Genomics England, Oxford University Hospitals NHS Foundation Trust, and The Hospital for Sick Children (Sickkids, Toronto).

About The University of Birmingham

The University of Birmingham is ranked amongst the world’s top 100 institutions. Its work brings people from across the world to Birmingham, including researchers, teachers and more than 8,000 international students from over 150 countries.

The University of Birmingham is a founding member of Birmingham Health Partners (BHP), a strategic alliance which transcends organisational boundaries to rapidly translate healthcare research findings into new diagnostics, drugs and devices for patients. Birmingham Health Partners is a strategic alliance between seven organisations who collaborate to bring healthcare innovations through to clinical application:

  • University of Birmingham
  • University Hospitals Birmingham NHS Foundation Trust
  • Birmingham Women's and Children's Hospitals NHS Foundation Trust
  • Aston University
  • The Royal Orthopaedic Hospital NHS Foundation Trust
  • Sandwell and West Birmingham Hospitals NHS Trust
  • West Midlands Academic Health Science Network

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