Louis Agha-Mir-Salim

Valerie Bürger, Marlie Besouw, Jana Fehr et al.

Meta-research and Trustworthy AI (TAI) share common goals, namely improving evidence, robustness, and transparency, yet there is very little interplay between the two fields. To investigate the potential benefits of closer collaboration between the domains of TAI in healthcare and meta-research, we convened an interdisciplinary workshop funded by the Volkswagen Foundation in February 2025. The workshop aimed to collaboratively examine key tensions in translating AI ethics principles into practice and to identify potential solutions informed by meta-research approaches. A Design Thinking-informed co-creation approach was followed by an inductive descriptive analysis of the outputs. Our results demonstrate how meta-research can offer concrete contributions to address pressing challenges of TAI in healthcare. These challenges include achieving robustness, reproducibility, and replicability; late-stage development and the integration of AI into clinical practice; the selection of appropriate evaluation metrics; specific AI-related challenges in preclinical and biomedical research; gaps of transparency in medical AI, as well as the need for improved conceptual clarity and AI literacy among stakeholders. Finally, we offer a catalog of ideas and roadmap for future research to inform scholars in both fields on existing interconnections and serve as a foundation for guiding future interdisciplinary efforts.

Behrooz Mamandipoor, Wesley Yeung, Louis Agha-Mir-Salim et al.

Purpose. Elevations in initially obtained serum lactate levels are strong predictors of mortality in critically ill patients. Identifying patients whose serum lactate levels are more likely to increase can alert physicians to intensify care and guide them in the frequency of tending the blood test. We investigate whether machine learning models can predict subsequent serum lactate changes. Methods. We investigated serum lactate change prediction using the MIMIC-III and eICU-CRD datasets in internal as well as external validation of the eICU cohort on the MIMIC-III cohort. Three subgroups were defined based on the initial lactate levels: i) normal group (<2 mmol/L), ii) mild group (2-4 mmol/L), and iii) severe group (>4 mmol/L). Outcomes were defined based on increase or decrease of serum lactate levels between the groups. We also performed sensitivity analysis by defining the outcome as lactate change of >10% and furthermore investigated the influence of the time interval between subsequent lactate measurements on predictive performance. Results. The LSTM models were able to predict deterioration of serum lactate values of MIMIC-III patients with an AUC of 0.77 (95% CI 0.762-0.771) for the normal group, 0.77 (95% CI 0.768-0.772) for the mild group, and 0.85 (95% CI 0.840-0.851) for the severe group, with a slightly lower performance in the external validation. Conclusion. The LSTM demonstrated good discrimination of patients who had deterioration in serum lactate levels. Clinical studies are needed to evaluate whether utilization of a clinical decision support tool based on these results could positively impact decision-making and patient outcomes.