How Do Radiologists Currently Monitor AI in Radiology and What Challenges Do They Face? An Interview Study and Qualitative Analysis

Artificial intelligence (AI) in radiology is becoming increasingly prevalent; however, there is not a clear picture of how AI is being monitored today and how this should practically be done given the inherent risk of AI model performance degradation over time. This research investigates current practices and what difficulties radiologists face in monitoring AI. Semi-structured virtual interviews were conducted with 6 USA and 10 Europe-based radiologists. The interviews were automatically transcribed and underwent thematic analysis. The findings suggest that AI monitoring in radiology is still relatively nascent as most of the AI projects had not yet progressed into a fully live clinical deployment. The most common method of monitoring involved a manual process of retrospectively comparing the AI results against the radiology report. Automated and statistical methods of monitoring were much less common. The biggest challenges are a lack of resources to support AI monitoring and uncertainty about how to create a robust and scalable process of monitoring the breadth and variety of radiology AI applications available. There is currently a lack of practical guidelines on how to monitor AI which has led to a variety of approaches being proposed from both healthcare providers and vendors. An ensemble of mixed methods is recommended to monitor AI across multiple domains and metrics. This will be enabled by appropriate allocation of resources and the formation of robust and diverse multidisciplinary AI governance groups.