Evidence map›Paper›PMID 42712319›Full record

ArticleBMJ digital health & AI2025

Importance of model governance in clinical AI models: case study on the relevance of data drift detection.

Joris P van der Vorst, Jim M Smit, Davy van de Sande, Björn van der Ster, Freek Daams, Renske Schasfoort, Diederik Gommers, Cornelis Verhoef, Dirk J Grünhagen, Michel E van Genderen and 1 more

Abstract read
In one paragraph

Article in BMJ digital health & AI, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Joris P van der VorstDepartment of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.ORCID 0009-0001-0025-2406
Jim M SmitErasmus MC Datahub, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
Davy van de SandeErasmus MC Datahub, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
Björn van der SterErasmus MC Datahub, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
Freek DaamsDepartment of Surgery, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands.
Renske SchasfoortDepartment of Surgery, Treant Care Group, Emmen, The Netherlands.
Diederik GommersErasmus MC Datahub, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
Cornelis VerhoefDepartment of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
Dirk J GrünhagenDepartment of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
Michel E van GenderenErasmus MC Datahub, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
Denise E HillingDepartment of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.ORCID 0000-0002-5875-6164

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: To evaluate the use of data drift detection into an artificial intelligence (AI) governance framework to ensure the safe clinical deployment of an AI model that predicts safe patient discharge after gastrointestinal and oncological surgery. Despite the potential of AI in healthcare, clinical implementation remains limited. Mature AI governance is critical for safe and effective deployment, particularly in dynamic healthcare settings, where patient populations and treatment protocols evolve over time and data drift can occur. This case study illustrates the value of proactive model and data monitoring. Methods and analysis: A retrospective evaluation of an AI model that predicts safe discharge after gastrointestinal or oncological surgery was performed using data collected from two centres between June 2017 and October 2022, encompassing 6822 admissions. Data from June 2017 to January 2020 were used for model development, while data from January 2020 to October 2022 were used for temporal validation. Three candidate classification models (random forest, logistic regression and extreme gradient boosting (XGBoost)) were compared based on area under the receiver operating characteristic curve and Brier score. Data drift was monitored using univariate methods (Jensen-Shannon distance and Kolmogorov-Smirnov tests) and a multivariate approach (principal component analysis (PCA) reconstruction error). Results: Following cross-validation, XGBoost was selected for temporal validation, achieving stable performance over the validation period, with an area under the curve of 0.82 and a Brier score of 0.158. Univariate data drift monitoring detected a significant shift in respiratory rate starting in January 2022, primarily attributed to changes at one hospital. Multivariate analysis using PCA reconstruction error flagged potential data drift in three non-sequential months, with the highest reconstruction error observed in March 2021. Two anomalies were attributed to data entry errors in saturation and heart rate values, while another alert was linked to an unusually long patient length of stay. Conclusion: By tracking both model performance and data drift, this study identified shifts in data distributions and data quality issues in a clinical AI model. These findings underscore the need for robust model and data governance measures to ensure responsible AI deployment.

Indexed as

Artificial intelligenceClinical GovernanceDecision Support Systems, ClinicalGeneral Surgery

Identifiers

PMID42712319
PMCPMC13528359

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.