Navigating the Pitfalls of AI in Clinical Drug Development

By Christina Dinger, Sr. Director of Product, ThoughtSphere. Joe Lebers, Product Manager, ThoughtSphere

October 2024

Imagine a future where life-saving drugs reach patients faster than ever before, with AI driving the discovery, development, and delivery processes. This future is within reach, but as we rush to embrace AI’s promise, we must also confront a stark reality: the very technology poised to revolutionize clinical drug development carries hidden risks that could undermine its potential.
This article explores three significant AI challenges— the Black Box Dilemma, Data Bias & Hallucinations, and Over-Reliance on Automation—that the industry must grapple with to harness AI’s true potential.

The Black Box Dilemma

The Black Box Dilemma refers to the opaque nature of many AI models, particularly deep learning algorithms. These models can make highly accurate predictions, yet the rationale behind their decisions is often hidden from human understanding. In clinical drug development, where transparency, traceability, and reproducibility are vital, this lack of interpretability can be a significant barrier to adoption.

The main risk associated with the Black Box Dilemma is the potential for unanticipated errors. If the AI model makes a mistake, it may be challenging to identify the cause and correct it. This can lead to regulatory setbacks, compromised patient safety, and a loss of trust in AI technologies. When revolutionary pre-clinical technologies like high-throughput screening and in vitro cell-based assays became widely used, they were thoroughly validated – so we must do our best to apply the same rigor and logic transparency to AI predictive models.

Data Bias & Hallucinations

AI models are only as good as the data they are trained on. When biased or incomplete data is used, the AI may perpetuate or amplify the blind spots and biases in the training data, leading to skewed results. Additionally, AI models are prone to hallucinations, where they generate information or predictions that are not based on the input data, often because of ambiguous or sparse data points.

This can have serious consequences. Consider a 50 patient Phase II clinical trial where the majority of participants belong to a particular demographic group. An AI model trained on the Phase II data may become biased, predicting drug efficacy more accurately for that group while failing to do so for underrepresented populations found in the Phase III study where the AI model is applied. Moreover, in cases where data is sparse, the AI might hallucinate a response, predicting outcomes that are not supported by the data, leading to misleading conclusions.

Data bias can result in ineffective or even harmful treatments for certain patient groups, while hallucinations can lead to incorrect predictions and misguided clinical decisions. These issues not only jeopardize patient safety but can also lead to costly delays in drug development and potential regulatory penalties.

Over-Reliance on Automation

The allure of AI often lies in its promise to automate complex processes, reducing human workload and creating process efficiencies. However, over-reliance on automation can lead to the erosion of critical human oversight and decision-making, which are essential in the nuanced field of drug development and the governance of AI. Even Elon Musk acknowledged that “Humans are underrated” during a 2018 interview discussing Tesla’s Model 3 production challenges, where he admitted that over-automating the production process was a mistake and that human workers were more effective at certain tasks.

Over-reliance on AI-driven automation in clinical drug development can lead to missed opportunities for early intervention, failure to identify safety issues, and an overall reduction in the quality of clinical data. The consequences can be severe, ranging from trial failures to severe patient harm. If a Medical Monitor prioritized time savings over patient safety and trial success, it would be deemed unacceptable. So we should not over-rely on predictive models in the name of efficiency. A balance between automated and manual processes is essential to enhance workflows, not remove the need for human accountability.

Navigating the AI Landscape: Moderation is Key

While these pitfalls highlight significant challenges in the adoption of AI in clinical drug development, they are not insurmountable. The key lies in integrating AI with human expertise through a Human-In-the-Loop (HITL) approach. HITL involves human oversight at critical stages, ensuring that AI-driven processes remain aligned with clinical realities and GCP standards. HITL are the key “Quality Gates” that must be established at various time points to ensure the model is acting appropriately.
By weaving AI into well-established, human-led processes, we can create powerful synergies. For instance, while AI can handle large-scale data analysis, human experts can provide the necessary context and insight, interpreting AI outputs in a clinically meaningful way. This collaboration can lead to more informed decision-making, greater accuracy, and enhanced safety in drug development.

In Summary

To truly revolutionize clinical development, we must be strategic in our adoption of AI. This means recognizing AI’s limitations, actively working to mitigate its risks, and ensuring that human intelligence remains at the core of the process. Only by doing so can we fully leverage AI’s capabilities while safeguarding the integrity and safety of clinical drug development.

About ThoughtSphere

At ThoughtSphere, we specialize in delivering AI-powered solutions that blend cutting-edge technology with human insight to revolutionize clinical data orchestration & management. Our platform integrates machine learning models with Human-in-the-Loop (HITL) approaches to ensure quality, transparency, and accuracy at every step of clinical development. We believe that AI should enhance—not replace—human decision-making, and our solutions are designed to streamline processes while maintaining the highest standards of safety and compliance. Learn more about how ThoughtSphere is shaping the future of clinical trials by visiting our website to schedule a demo today.

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