Integrating statistical design and inference: A roadmap for robust and trustworthy medical AI

In the rapidly evolving field of artificial intelligence (AI), statistics plays a crucial role in addressing challenges faced by medical AI. This review begins by highlighting the primary tasks of medical AI and the integration of statistical methodologies into their modeling processes. Despite the widespread application of AI in medicine and healthcare, key challenges persist: poor model interpretability, lack of causal reasoning, overfitting, unfairness, imbalanced dataset, AI "hallucinations" and "disinformation". Statistics provides unique strategies to tackle these challenges, including rigorous statistical design, regularization techniques, and statistical frameworks grounded in causal inference. Finally, the review offers several recommendations for the sustainable development of medical AI: enhancing data quality, promoting model simplicity and transparency, fostering independent validation standards, and facilitating interdisciplinary collaboration between statisticians and medical AI practitioners.