Generalizability assessment of AI models across hospitals in a low-middle and high income country.

Journal: Nature communications
PMID:

Abstract

The integration of artificial intelligence (AI) into healthcare systems within low-middle income countries (LMICs) has emerged as a central focus for various initiatives aiming to improve healthcare access and delivery quality. In contrast to high-income countries (HICs), which often possess the resources and infrastructure to adopt innovative healthcare technologies, LMICs confront resource limitations such as insufficient funding, outdated infrastructure, limited digital data, and a shortage of technical expertise. Consequently, many algorithms initially trained on data from non-LMIC settings are now being employed in LMIC contexts. However, the effectiveness of these systems in LMICs can be compromised when the unique local contexts and requirements are not adequately considered. In this study, we evaluate the feasibility of utilizing models developed in the United Kingdom (a HIC) within hospitals in Vietnam (a LMIC). Consequently, we present and discuss practical methodologies aimed at improving model performance, emphasizing the critical importance of tailoring solutions to the distinct healthcare systems found in LMICs. Our findings emphasize the necessity for collaborative initiatives and solutions that are sensitive to the local context in order to effectively tackle the healthcare challenges that are unique to these regions.

Authors

  • Jenny Yang
    Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, England. jenny.yang@eng.ox.ac.uk.
  • Nguyen Thanh Dung
    Hospital for Tropical Diseases, Ho Chi Minh, Vietnam.
  • Pham Ngoc Thach
    National Hospital for Tropical Diseases, Hanoi, Vietnam.
  • Nguyen Thanh Phong
    Hospital for Tropical Diseases, Ho Chi Minh, Vietnam.
  • Vu Dinh Phu
    National Hospital for Tropical Diseases, Hanoi, Vietnam.
  • Khiem Dong Phu
    National Hospital for Tropical Diseases, Hanoi, Vietnam.
  • Lam Minh Yen
    Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam.
  • Doan Bui Xuan Thy
    Oxford University Clinical Research Unit, Ho Chi Minh, Vietnam.
  • Andrew A S Soltan
    Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, United Kingdom.
  • Louise Thwaites
    Oxford University Clinical Research Unit, Ho Chi Minh City and Hanoi, Vietnam.
  • David A Clifton