From Clinic to Computer and Back Again: Practical Considerations When Designing and Implementing Machine Learning...

Machine learning (ML), a branch of artificial intelligence, is influencing all fields in medicine, with an abundance of work describing its application to adult practice. ML in pediatrics is distinctly unique with clinical, technical, and ethical nuances limiting the direct translation of ML tools developed for adults to pediatric populations. To our knowledge, no work has yet focused on outlining the unique considerations that need to be taken into account when designing and implementing ML in pediatrics.

The nature of varying developmental stages and the prominence of family-centered care lead to vastly different data-generating processes in pediatrics. Data heterogeneity and a lack of high-quality pediatric databases further complicate ML research. In order to address some of these nuances, we provide a common pipeline for clinicians and computer scientists to use as a foundation for structuring ML projects, and a framework for the translation of a developed model into clinical practice in pediatrics. Throughout these pathways, we also highlight ethical and legal considerations that must be taken into account when working with pediatric populations and data.

Here, we describe a comprehensive outline of special considerations required of ML in pediatrics from project ideation to implementation. We hope this review can serve as a high-level guideline for ML scientists and clinicians alike to identify applications in the pediatric setting, generate effective ML solutions, and subsequently deliver them to patients, families, and providers.