Recommendations on compiling test datasets for evaluating artificial intelligence solutions in pathology.

Journal: Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
Published Date:

Abstract

Artificial intelligence (AI) solutions that automatically extract information from digital histology images have shown great promise for improving pathological diagnosis. Prior to routine use, it is important to evaluate their predictive performance and obtain regulatory approval. This assessment requires appropriate test datasets. However, compiling such datasets is challenging and specific recommendations are missing. A committee of various stakeholders, including commercial AI developers, pathologists, and researchers, discussed key aspects and conducted extensive literature reviews on test datasets in pathology. Here, we summarize the results and derive general recommendations on compiling test datasets. We address several questions: Which and how many images are needed? How to deal with low-prevalence subsets? How can potential bias be detected? How should datasets be reported? What are the regulatory requirements in different countries? The recommendations are intended to help AI developers demonstrate the utility of their products and to help pathologists and regulatory agencies verify reported performance measures. Further research is needed to formulate criteria for sufficiently representative test datasets so that AI solutions can operate with less user intervention and better support diagnostic workflows in the future.

Authors

  • André Homeyer
    Fraunhofer MEVIS, Am Fallturm 1, 28359, Bremen, Germany. Electronic address: andre.homeyer@mevis.fraunhofer.de.
  • Christian Geißler
    Technische Universität Berlin, DAI-Labor, Ernst-Reuter-Platz 7, 10587 Berlin, Germany.
  • Lars Ole Schwen
    Fraunhofer Institute for Digital Medicine MEVIS, Max-von-Laue-Straße 2, 28359, Bremen, Germany.
  • Falk Zakrzewski
    Institute of Pathology, Carl Gustav Carus University Hospital Dresden (UKD), TU Dresden (TUD), Fetscherstrasse 74, 01307, Dresden, Germany.
  • Theodore Evans
    Technische Universität Berlin, DAI-Labor, Ernst-Reuter-Platz 7, 10587, Berlin, Germany.
  • Klaus Strohmenger
    Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Pathology, Charitéplatz 1, 10117 Berlin, Germany.
  • Max Westphal
  • Roman David Bülow
    Institute of Pathology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
  • Michaela Kargl
    Medical University Graz, Graz, Austria.
  • Aray Karjauv
    Technische Universität Berlin, DAI-Labor, Ernst-Reuter-Platz 7, 10587, Berlin, Germany.
  • Isidre Munné-Bertran
    MoticEurope, S.L.U., C. Les Corts, 12 Poligono Industrial, 08349, Barcelona, Spain.
  • Carl Orge Retzlaff
    Human-Centered AI Lab, Institute of Forest Engineering, Department of Forest and Soil Sciences, University of Natural Resources and Life Sciences Vienna, 1190 Wien, Austria.
  • Adrià Romero-López
    Lakera AI AG, Zelgstrasse 7, 8003, Zürich, Switzerland.
  • Tomasz Sołtysiński
    QuIP GmbH, Reinhardtstraße 1, 10117 Berlin, Germany.
  • Markus Plass
    Medical University of Graz, Graz, Austria.
  • Rita Carvalho
    Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Pathology, Charitéplatz 1, 10117, Berlin, Germany.
  • Peter Steinbach
    Helmholtz-Zentrum Dresden Rossendorf, Bautzner Landstraße 400, 01328, Dresden, Germany.
  • Yu-Chia Lan
    Institute of Pathology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
  • Nassim Bouteldja
    Institute of Medical Informatics, University of Lübeck, Germany.
  • David Haber
    Lakera AI AG, Zelgstrasse 7, 8003, Zürich, Switzerland.
  • Mateo Rojas-Carulla
    Lakera AI AG, Zelgstrasse 7, 8003, Zürich, Switzerland.
  • Alireza Vafaei Sadr
  • Matthias Kraft
    Lakera AI AG, Zelgstrasse 7, 8003, Zürich, Switzerland.
  • Daniel Krüger
    Olympus Soft Imaging Solutions GmbH, Johann-Krane-Weg 39, 48149, Münster, Germany.
  • Rutger Fick
    TRIBVN Healthcare, Paris, France.
  • Tobias Lang
    Mindpeak, Hamburg, Germany. tobias.lang@mindpeak.ai.
  • Peter Boor
    Institute of Pathology, University Hospital Aachen, RWTH Aachen University, Aachen, Germany.
  • Heimo Müller
    Medical University of Graz, Graz, Austria.
  • Peter Hufnagl
    Department of Digital Pathology and IT, Institute of Pathology, Charité University Hospital, Berlin, Germany.
  • Norman Zerbe
    Department of Digital Pathology and IT, Institute of Pathology, Charité University Hospital, Berlin, Germany.