Keeping Medical AI Healthy and Trustworthy: A Review of Detection and Correction Methods for System Degradation

TL;DR

This paper reviews methods for detecting and correcting performance degradation in medical AI systems, emphasizing the importance of continuous monitoring, root cause analysis, and adaptation to ensure safety and reliability in healthcare.

Contribution

It provides a comprehensive overview of techniques for monitoring, diagnosing, and correcting AI system degradation in medical applications, including traditional models and large language models.

Findings

Identification of key causes of AI performance degradation.

Summary of drift detection and root cause analysis techniques.

Discussion of correction strategies like retraining and adaptation.

Abstract

Artificial intelligence (AI) is increasingly integrated into modern healthcare, offering powerful support for clinical decision-making. However, in real-world settings, AI systems may experience performance degradation over time, due to factors such as shifting data distributions, changes in patient characteristics, evolving clinical protocols, and variations in data quality. These factors can compromise model reliability, posing safety concerns and increasing the likelihood of inaccurate predictions or adverse outcomes. This review presents a forward-looking perspective on monitoring and maintaining the "health" of AI systems in healthcare. We highlight the urgent need for continuous performance monitoring, early degradation detection, and effective self-correction mechanisms. The paper begins by reviewing common causes of performance degradation at both data and model levels. We then summarize key techniques for detecting data and model drift, followed by an in-depth look at root cause analysis. Correction strategies are further reviewed, ranging from model retraining to test-time adaptation. Our survey spans both traditional machine learning models and state-of-the-art large language models (LLMs), offering insights into their strengths and limitations. Finally, we discuss ongoing technical challenges and propose future research directions. This work aims to guide the development of reliable, robust medical AI systems capable of sustaining safe, long-term deployment in dynamic clinical settings.