Guidelines for Clinical Trial Protocols of Interventions with Artificial Intelligence: The SPIRIT-AI Extension

In the realm of medical research, transparency is the cornerstone of progress

April 2024

**Unlocking Transparency: The SPIRIT-AI Extension**

In the realm of medical research, transparency is the cornerstone of progress. It ensures that interventions, whether novel or established, undergo rigorous evaluation to ascertain their efficacy and safety. However, as technology evolves, so do the methodologies required for thorough assessment. Enter the SPIRIT-AI (Standard Protocol Items: Recommendations for Interventional Trials–Artificial Intelligence) extension, a pioneering guideline set to revolutionize the reporting of clinical trial protocols involving artificial intelligence (AI).

Introduced as an extension to the SPIRIT 2013 statement, SPIRIT-AI is tailored to address the unique considerations inherent in trials featuring AI interventions. Its inception stems from a crucial recognition: as AI becomes increasingly prevalent in healthcare, there is a pressing need for standardized protocols that ensure the rigorous evaluation of these interventions.

The SPIRIT-AI extension, developed in tandem with its counterpart CONSORT-AI (Consolidated Standards of Reporting Trials–Artificial Intelligence), signifies a pivotal milestone in promoting transparency and completeness in AI-related clinical trials. A collaborative effort involving a diverse array of stakeholders, its formulation underwent meticulous scrutiny through a staged consensus process.

At its core lies a comprehensive set of 15 new items, meticulously crafted to capture the intricacies of AI interventions within clinical trial protocols. These items delve into essential aspects such as the description of the AI intervention, elucidating the requisite skills and instructions for its utilization, the integration setting, data handling procedures, human–AI interaction nuances, and analysis of error cases.

The importance of SPIRIT-AI transcends mere documentation; it serves as a beacon guiding researchers, editors, peer reviewers, and readers alike through the labyrinth of AI-inclusive trial protocols. By providing a structured framework for reporting, it not only enhances comprehension but also facilitates critical appraisal of study designs and risk of bias.

The adoption of SPIRIT-AI heralds a new era of transparency and accountability in AI-driven clinical research. As the healthcare landscape continues to evolve, adherence to such standardized guidelines becomes increasingly indispensable. It is through initiatives like SPIRIT-AI that we pave the way for transformative advancements, ensuring that innovation in healthcare is met with the rigorous scrutiny it warrants.