Developing Robust AI Applications for Clinical Use: The Special Case of Pathology

Robustness is a key requirement for any method in medicine, especially when the method in question is being used as part of a diagnostic process. This is particularly true for artificial intelligence-based decision support systems, which, although being used as a supportive tool, will ultimately influence diagnostic assessments. In pathology, attaining clinical robustness in AI methods poses a particularly challenging task, primarily due to the extensive diversity of digital images, which humans can adapt to far more easily. This paper presents factors that contribute to this challenge, but also identifies and evaluates common solutions to counteract domain shift, which is known to deteriorate the performance of artificial intelligence models.