AEGIS

An Operational Infrastructure for Post-Market Governance of Adaptive Medical AI Under US and EU Regulatory Frameworks

APPROVE CONDITIONAL REVIEW ALARM REJECT

AEGIS at a glance

A visual summary of the framework: data management, monitoring, and structured decision-making under FDA and EU regulatory frameworks.

AEGIS framework infographic showing the DARM, MMM, and CDM modules and their regulatory mapping

Overview & Research

A quick introduction to the AEGIS framework and its research foundation.

🎧 Podcast: Quick Overview (20 min)

A concise conversational introduction to the AEGIS framework covering the three-module architecture and key decision categories.

🎧 Podcast: Deep Dive (46 min)

A detailed discussion of the AEGIS infrastructure, including threshold derivation, regulatory mapping, validation results, and implementation guidance.

🎬 Video Overview

A 10-minute walkthrough of the AEGIS three-module architecture and regulatory decision logic.

↗ Watch on YouTube

🎬 Presentation

A detailed presentation of the AEGIS infrastructure, validation results, and regulatory alignment.

↗ Watch on YouTube

The adaptive AI governance gap

Medical AI systems that learn from new data need structured post-market oversight — not just initial approval.

4
Deployment decision categories + independent PMS ALARM
3
Modules: DARM, MMM, CDM
2
Regulatory frameworks: FDA PCCP & EU MDR/AI Act

Three-module architecture

DARM manages data, MMM monitors performance and drift, CDM makes structured decisions.

DARM Dataset Assimilation & Retraining MMM Model Monitoring Metrics CDM Clinical Decision Module DECISION feedback loop

DARM

Dataset Assimilation and Retraining Module. Manages training (DT,k), golden (DG), and drifting (DD,k) datasets with unconditional accumulation.

MMM

Model Monitoring Metrics. Computes MLcps composite score, drift detection via Bonferroni-corrected KS test, and fairness metrics.

CDM

Clinical Decision Module. Priority-ordered decision hierarchy (P1–P4) with independent PMS alarm channel (A1–A3).

Decision taxonomy

Four deployment decision categories with composite output — APPROVE + ALARM is not contradictory.

APPROVE CONDITIONAL APPROVAL CLINICAL REVIEW ALARM REJECT
Priority Condition Decision Regulatory action
P1 (highest) Any metric < Pfail REJECT Suspend model; initiate CAPA
P2 Performance buffer / regression from Pref CLINICAL REVIEW Hold deployment; clinician review required
P3 Minor drift or TAI concern CONDITIONAL APPROVAL Deploy with enhanced monitoring
P4 (lowest) All checks pass APPROVE Release model; routine PMS

Get started

Three paths to implementing AEGIS in your organisation.

1

Read the guide

9 chapters covering concepts, configuration, thresholds, CDM logic, drift detection, audit trail, and regulatory mapping.

Start reading →
2

Fill the templates

Interactive forms with pre-fill examples (sepsis, brain tumour). Download completed documents as .docx — all data stays in your browser.

Open forms →
3

Run the examples

Jupyter notebook with 11 iterations of adaptive AI governance on the PhysioNet Sepsis Challenge dataset. All four deployment decision categories exercised.

View examples →

Experimental results

Performance trajectories across iterative governance cycles.

Example implementations

Two complete case studies demonstrating AEGIS across different clinical domains.

Sepsis prediction

PhysioNet Challenge 2019. Random Forest classifier. 11 iterations with progressive data corruption. All four deployment decision categories exercised.

View notebook →

Brain tumour segmentation

BraTS 2023/24. nnU-Net ResENC-M. 12 iterations with binary APPROVE/REJECT governance (intermediate categories disabled).

View example →

Citation

If you use AEGIS in your research, please cite our preprint:

@article{afdideh2026aegis,
  title   = {AEGIS: An Operational Infrastructure for Post-Market
             Governance of Adaptive Medical AI Under US and EU
             Regulatory Frameworks},
  author  = {Afdideh, Fardin and Astaraki, Mehdi and Seoane, Fernando
             and Abtahi, Farhad},
  year    = {2026},
  journal = {Research Square (Preprint)},
  doi     = {10.21203/rs.3.rs-9199100/v1},
  url     = {https://doi.org/10.21203/rs.3.rs-9199100/v1}
}