Maturity Framework for Operationalizing Machine Learning Applications in Health Care: Scoping Review
Bibliographic record
Abstract
Background: The exponential growth of publications regarding the application of machine learning (ML) tools in medicine highlights the significant potential for ML to revolutionize the field. Despite the multitude of literature surrounding this topic, there are limited publications addressing the implementation and feasibility of ML models in clinical practice. Currently, Machine Learning Operations (MLOps), a set of practices designed to deploy and maintain ML models in production, is used in various information technology and industrial settings. However, the MLOps pipeline is not well researched in medical settings, where multiple barriers exist to implementing ML pipelines into practice. Objective: This study aims to detail how MLOps is implemented in health care and propose a maturity framework for the health care implementations. Methods: A scoping review search was conducted according to the Joanna Briggs Institute Manual for Evidence Synthesis. Results were synthesized using the 3-stage basic qualitative content analysis. We searched 4 databases (eg, MEDLINE, Embase, Web of Science, and Scopus) to include any studies that involved proof of concept or real-world implementation of MLOps in health care. Studies not reported in English were excluded. Results: A total of 19 studies were included in this scoping review. The MLOps workflow identified within the studies included (1) data extraction (19/19 studies), (2) data preparation and engineering (18/19 studies), (3) model training (19/19 studies), (4) measured ML metrics and model evaluation (17/19 studies), (5) model validation and test in production (14/19 studies), (6) model serving and deployment (15/19 studies), (7) continuous monitoring (14/19 studies), and (8) continual learning (13/19 studies). We proposed a 3-stage MLOps maturity framework for health care based on existing studies in the field, that is, low (5/19 studies), partial (1/19 studies), and full maturity (13/19 studies). There were 8/19 studies that discussed ethical, legislative, and stakeholder considerations for MLOps implementations in health care settings. Conclusions: We investigated the implementation of MLOps in health care with a corresponding maturity framework. It is evident that only a limited number of studies reported the implementation of ML in health care contexts. Hence, it is imperative that we shift our focus toward creating an environment that supports the development of ML health care applications, such as improving existing data infrastructure, and engaging partners to support the development of MLOps applications. Specifically, we can include patients, policymakers, and health care professionals in the creation and implementation of ML applications. One of the main limitations includes the varying quality of each extracted study in terms of how the MLOps implementation was presented. Hence, it was difficult to verify the presence and discuss in depth all steps of the MLOps workflow for each study. Furthermore, due to the inherent nature of a scoping review protocol, there may be a compromise on an in-depth discussion of each step within the MLOps workflow.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.075 | 0.223 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.005 | 0.008 |
| Bibliometrics | 0.035 | 0.028 |
| Science and technology studies | 0.003 | 0.004 |
| Scholarly communication | 0.011 | 0.011 |
| Open science | 0.005 | 0.006 |
| Research integrity | 0.005 | 0.004 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".