Accelerating Platforms for Evaluating and eXecuting AI Lifecycles in ADRD (APEX-ADRD)
Funded Grant
Overview
Affiliation
View All
Overview
description
PROJECT SUMMARY (ABSTRACT) | ADMINISTRATIVE CORE The APEX-ADRD Administrative Core provides operational infrastructure enabling APEX-ADRD to compress artificial intelligence (AI) clinical decision support tool evaluation timelines from 18-24 months to 6 months—all while maintaining scientific rigor and ethical standards. Alarmingly, only 2.4% of Federal Drug Administration (FDA)-approved AI devices in the United States underwent randomized trials, and 43% of AI devices for ADRD patients lack clinical validation data, creating an evaluation bottleneck and increasing distrust of the use of AI healthcare, including for aging and Alzheimer’s disease and related dementias (ADRD). Problematically, current processes requiring years for scientific review cannot keep pace with AI’s fast evolution, leaving us without guid- ance on which tools help or harm older adults with ADRD. This Core, in coordination with the Research Innova- tion Core (RIC) and AITC Coordination Center, will ensure a streamlined process for designing, developing, and evaluating AI for aging and ADRD populations, both in the short- and long-term. Broadly, the APEX-ADRD Administrative Core is responsible for: 1) working with the AITC Coordination Center (AITCC) to run national competitions soliciting innovative and meritorious pilot projects for the development and testing for AI clinical decision support in aging and ADRD problems, looking to achieve a 4-week submission-to- award (pending NIA review) timeframe; 2) rapid onboarding of projects with project management, including streamlined data use agreements and single-IRB processes (e.g., templated protocols to reduce approvals from 90 to 14 days) and clear expectations for awarded pilot projects (e.g., regular check-ins, report capture); and 3) engagement of multiple stakeholders, with the RIC, including industry partners, patients and community repre- sentatives, and other individuals who should inform the design and ultimate use of AI in aging and ADRD popu- lations. All these efforts are intended to accelerate the development of AI in a meaningful way that respects fairness, ethics, and other sociotechnical considerations that are emergent. In addition to its standard functions of providing organizational capacity to this Center (e.g., meeting scheduling, progress report generation for NIH, interaction with the AITCC and other AITCs, etc.) we expect this administrative Core to ensure that APEX-ADRD remains dynamic in its perspectives, given how quickly AI itself is changing, by engaging external partners, including industry. Importantly, this Core leverages a range of complementary expertise, being led by experts with demonstrated experience in aging and ADRD research, rapid but comprehensive AI evaluation, as well as senior experience in the conduct of large multi-site efforts and contemporary AI methods. Ultimately, this Core will enable the requisite governance enabling full NIA Stage Model support through Administrative/RIC coordi- nation, building on NIA IMPACT Collaboratory models with AI-specific innovations.
PROJECT SUMMARY/ABSTRACT | OVERALL STRATEGY Despite the 7M Americans living with Alzheimer’s disease and related dementias (ADRD) at an annual cost exceeding $781B, and nearly half of dementia cases being potentially preventable, artificial intelligence (AI) has yet to deliver its promised transformation in aging and ADRD care. Few AI-based clinical decision support tools for ADRD exist and were typically cleared through low-evidence pathways. Markedly, current validation pro- cesses often require years, which is too slow for AI, a technology that is quickly evolving. As a result, clinicians and patients are without trustworthy guidance on which tools help or harm. The gap is growing between innova- tion and evidence, particularly for vulnerable older adults with ADRD. Objectives and impact. The UCLA Accelerating Platforms for Evaluating and Executing AI Lifecycles in ADRD (APEX-ADRD) Collaboratory will transform how AI is developed, tested and deployed for aging and ADRD pop- ulations. Our goal is to stimulate transformative research across the NIA Stage Model (Stages 0-V) and compress timelines from years to months while preserving rigor, safety, and fairness. APEX-ADRD will serve as a national resource to accelerate responsible AI by: 1) building governance and infrastructure for rapid, reproducible eval- uation; 2) catalyzing innovation via design studios that embed co-design and ethics early in the process, along with access to unique data resources; and 3) establishing best practices for ethical and fair AI including contin- uous post-deployment fairness monitoring. UCLA brings unmatched multidisciplinary capacity to lead this effort with demonstrated track records in both the development of novel AI methods deployed into real- world healthcare settings as well as dynamic and comprehensive evaluation strategies. Notably, through our Collaboratory, pilot projects will have access to the University of California (UC) Health Data Warehouse (8.7M patients; 152K ADRD) for in silico validation with electronic health record (EHR) data and imaging; the ATLAS biobank (150K UCLA genotyped patients with EHR data); and other national datasets. This infrastructure is coupled with active guidance from leaders in geriatrics, neurology, biomedical informatics, computer sci- ence/AI, biostatistics, bioethics, health economics, implementation science, and the human-AI interface. Im- portantly, APEX-ADRD brings a strong industry and stakeholder team and will work closely with the AITC Coor- dinating Center and the trans-AITC Stakeholder Engagement Team to ensure all pilots integrate end-user feed- back, algorithmic fairness metrics, and common evaluation tools. Collectively, these facets are integrated throughout the Collaboratory’s services to ensure the success of AI pilot projects in aging and ADRD. By creating scalable models for safe and fair AI evaluation, UCLA’s APEX-ADRD will accelerate national progress toward improving health, independence, and quality of life for older adults and persons living with ADRD.
