Artificial Intelligence Governance in Health Systems: Systematic Review of Frameworks and Integrative Model Proposal

CLAIM (Claim-Specific Citation Network audit, sometimes called CSN) is a forensic method for testing whether a scientific or medical claim's authority is supported by evidence or by citation dynamics. It detects citation bias, amplification, citation diversion, citation transmutation, dead-end citation, and back-door invention.

The ASSAY skill runs a structured, CLAIM-compatible extraction and integrity assessment on an article. Output is a verdict (sound, mixed, flagged, problematic, or cascade), a count of claims extracted, the central key claim, and an integrity note describing the structural read.

This scan restricts ASSAY to peer-reviewed publications and preprint servers. Journalism, opinion pieces, and government documents are evaluated under different frameworks (CAIHL for power and agency; editor's note for context).

ASSAY found the central claims well-supported by the underlying evidence; methodology stands; the integrity-of-citation check raised no structural concerns.

Across the AI-governance frameworks now deployed in health systems, the convergence is on principles (transparency, accountability, fairness) and the divergence is on enforcement mechanism — no framework reviewed includes a patient-side actionable instrument as a constitutive element.

Total claims extracted from the article: 8. The key claim is the single most load-bearing assertion the rest of the argument depends on.

Methodology follows standard systematic-review conventions (PRISMA-aligned, multi-database) and reports an integrative synthesis rather than a meta-analytic effect. The proposed integrative model is a useful taxonomy but a taxonomy is not a deployment. The structural claim — that existing frameworks are clinician- and developer-oriented and that the patient is treated as an object of governance rather than a participant — is well-supported by the included literature.

Editor's note: The systematic review counts the frameworks; nobody has yet built the systematic review that counts the binding instruments. The first sentence of every framework review has to start with the disclaimer that frameworks are not enforcement.

Summary: JMIR: Systematic review of AI governance frameworks deployed inside health systems, with an integrative model that maps where existing frameworks converge and where they leave gaps.

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