Guidelines for clinical trial protocols for interventions involving artificial intelligence: the SPIRIT-AI Extension

The SPIRIT-AI and CONSORT-AI Working Group, Samantha Cruz Rivera, Xiaoxuan Liu, An-Wen Chan, Alastair Denniston, Melanie Calvert

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Abstract

The SPIRIT 2013 (The Standard Protocol Items: Recommendations for Interventional Trials) statement aims to improve the completeness of clinical trial protocol reporting, by providing evidence-based recommendations for the minimum set of items to be addressed. This guidance has been instrumental in promoting transparent evaluation of new interventions. More recently, there is a growing recognition that interventions involving artificial intelligence need to undergo rigorous, prospective evaluation to demonstrate their impact on health outcomes.

The SPIRIT-AI extension is a new reporting guideline for clinical trials protocols evaluating interventions with an AI component. It was developed in parallel with its companion statement for trial reports: CONSORT-AI. Both guidelines were developed using a staged consensus process, involving a literature review and expert consultation to generate 26 candidate items, which were consulted on by an international multi-stakeholder group in a 2-stage Delphi survey (103 stakeholders), agreed on in a consensus meeting (31 stakeholders) and refined through a checklist pilot (34 participants).

The SPIRIT-AI extension includes 15 new items, which were considered sufficiently important for clinical trial protocols of AI interventions. These new items should be routinely reported in addition to the core SPIRIT 2013 items. SPIRIT-AI recommends that investigators provide clear descriptions of the AI intervention, including instructions and skills required for use, the setting in which the AI intervention will be integrated, considerations around the handling of input and output data, the human-AI interaction and analysis of error cases.

SPIRIT-AI will help promote transparency and completeness for clinical trial protocols for AI interventions. Its use will assist editors and peer-reviewers, as well as the general readership, to understand, interpret and critically appraise the design and risk of bias for a planned clinical trial.
Original languageEnglish
Article numberm3210
JournalBMJ
Volume370
DOIs
Publication statusPublished - 9 Sep 2020

Bibliographical note

Funding Information:
Funding: This work was funded by a Wellcome Trust Institutional Strategic Support Fund: Digital Health Pilot Grant, Research England (part of UK Research and Innovation), Health Data Research UK and the Alan Turing Institute. The study was sponsored by the University of Birmingham, UK. The study funders and sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

Keywords

  • Artificial Intelligence
  • Checklist
  • Clinical Protocols
  • Clinical Trials as Topic
  • Consensus
  • Humans
  • Research Design

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