Authors
Xiang Zhou, Hongyan Liu, Zhengdong Hua
Published in
Journal of medical Internet research. Volume 28. Pages e106243. Sep 23, 2026. Epub Sep 23, 2026.
Abstract
AI is increasingly embedded in digital public health systems, but model performance, system deployment, message delivery, alert volume, and user engagement do not establish whether an AI-supported workflow has changed public health practice. This viewpoint proposes a public health action end point-a prespecified, auditable, AI output-specific, actor-bound, time-bound, denominator-based way to specify and measure an existing proximal process or implementation end point. It begins with a defined AI output and records the corresponding action opportunity, accountable actor, action status, and evidence concerning the AI's role in the action. A complete specification includes rules for repeated outputs, completed action, justified nonaction, missed action, unresolved cases, denominator loss, and paired safety, workload, privacy, equity, and model drift monitoring. A public health action end point is not a new causal outcome, reporting guideline, or validated surrogate for a population health benefit. An observed action rate alone does not establish that AI initiated or caused the action; causal claims require a documented attribution strategy and an appropriate comparator or causal design. The framework applies to research and production deployments but complements rather than replaces ethics review, trial registration, and jurisdiction-specific regulatory and governance obligations. It is intended to help authors, implementers, reviewers, and editors align claims with what an evaluation has actually measured.
PMID:
42777191
Bibliographic data and abstract were imported from PubMed on 24 Sep 2026.
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