Artificial Intelligence in Brazilian medical practice: Clinical integration, governance challenges, and strategic perspectives
DOI:
https://doi.org/10.33448/rsd-v15i3.50733Keywords:
Artificial Intelligence, Brazil, Medical practice, Health governance, Digital health.Abstract
Artificial Intelligence (AI) has progressively expanded from experimental applications to clinically relevant performance across multiple medical domains. This integrative review analyzes current applications of AI in Brazilian medical practice, with emphasis on clinical integration, governance challenges, and strategic perspectives. A structured search of PubMed, SciELO, and Google Scholar was conducted covering publications from 2018 to 2025. A total of 127 studies were included in the qualitative synthesis, and 20 high-impact studies were selected for in-depth thematic analysis. Results indicate consolidated diagnostic performance in imaging-based specialties and predictive modeling, while highlighting persistent gaps in external validation, real-world implementation, and equitable deployment. Recent developments in generative AI introduce additional regulatory and safety complexities, particularly regarding dynamic validation and post-deployment monitoring. In Brazil, AI integration occurs within a universal healthcare system marked by infrastructural heterogeneity and evolving regulatory frameworks, including the General Data Protection Law and the National Digital Health Strategy. The findings suggest that sustainable AI integration depends not solely on algorithmic sophistication but on governance maturity, institutional readiness, and equitable health system strengthening.
References
Angus, D. C. (2025). Artificial intelligence, health, and health care today and tomorrow. JAMA. Advance online publication.
Aromataris, E., & Munn, Z. (Eds.). (2020). JBI manual for evidence synthesis. JBI.
Brasil. (2018). Lei nº 13.709, de 14 de agosto de 2018. Lei Geral de Proteção de Dados Pessoais (LGPD). Diário Oficial da União.
Brasil, Ministério da Saúde. (2020). Estratégia de saúde digital para o Brasil 2020–2028. Ministério da Saúde.
Campanella, G., Hanna, M. G., Geneslaw, L., et al. (2019). Clinical-grade computational pathology using weakly supervised deep learning. Nature Medicine, 25(8), 1301–1309. https://doi.org/10.1038/s41591-019-0508-1
Crossetti, M. G. O. (2012). Revisão integrativa de pesquisa na enfermagem: O rigor científico que lhe é exigido. Revista Gaúcha de Enfermagem, 33(2), 8–13.
European Commission. (2019). Ethics guidelines for trustworthy AI. European Union.
Hong, Q. N., Pluye, P., Fàbregues, S., et al. (2018). Mixed methods appraisal tool (MMAT), version 2018. User guide. McGill University.
Kelly, C. J., Karthikesalingam, A., Suleyman, M., et al. (2019). Key challenges for delivering clinical impact with artificial intelligence. BMC Medicine, 17, 195. https://doi.org/10.1186/s12916-019-1426-2
Kung, T. H., Cheatham, M., Medenilla, A., et al. (2023). Performance of ChatGPT on USMLE: Potential for AI-assisted medical education. PLOS Digital Health, 2(2), e0000198. https://doi.org/10.1371/journal.pdig.0000198
Lancet Digital Health. (2025). One shot at trust: Building credible evidence for medical AI. The Lancet Digital Health. Advance online publication.
Liu, X., Faes, L., Kale, A. U., et al. (2019). A comparison of deep learning performance against health-care professionals in detecting diseases from medical imaging: A systematic review and meta-analysis. The Lancet Digital Health, 1(6), e271–e297. https://doi.org/10.1016/S2589-7500(19)30123-2
Massuda, A., Hone, T., Leles, F. A. G., et al. (2018). The Brazilian health system at crossroads: Progress, crisis and resilience. BMJ Global Health, 3, e000829. https://doi.org/10.1136/bmjgh-2018-000829
McKinney, S. M., Sieniek, M., Godbole, V., et al. (2020). International evaluation of an AI system for breast cancer screening. Nature, 577, 89–94. https://doi.org/10.1038/s41586-019-1799-6
Nemati, S., Holder, A., Razmi, F., et al. (2018). An interpretable machine learning model for accurate prediction of sepsis in the ICU. Critical Care Medicine, 46(4), 547–553. https://doi.org/10.1097/CCM.0000000000002936
Obermeyer, Z., Powers, B., Vogeli, C., & Mullainathan, S. (2019). Dissecting racial bias in an algorithm used to manage population health. Science, 366(6464), 447–453. https://doi.org/10.1126/science.aax2342
Page, M. J., McKenzie, J. E., Bossuyt, P. M., et al. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia da pesquisa científica. UFSM.
Rajkomar, A., Dean, J., & Kohane, I. (2019). Machine learning in medicine. New England Journal of Medicine, 380(14), 1347–1358. https://doi.org/10.1056/NEJMra1814259
Rajpurkar, P., Chen, E., Banerjee, O., & Topol, E. J. (2022). AI in health and medicine. Nature Medicine, 28(1), 31–38. https://doi.org/10.1038/s41591-021-01614-0
Rosenthal, J. T., et al. (2025). Rethinking clinical trials for medical AI with dynamic deployment. npj Digital Medicine. Advance online publication.
Sendak, M. P., D’Arcy, J., Kashyap, S., et al. (2020). A path for translation of machine learning products into healthcare delivery. EMJ Innovations, 4(1), 55–60.
Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research, 104, 333–339. https://doi.org/10.1016/j.jbusres.2019.07.039
Takita, H., et al. (2025). Diagnostic performance of generative AI models: A systematic review and meta-analysis. npj Digital Medicine. Advance online publication.
Topol, E. J. (2019). High-performance medicine: The convergence of human and artificial intelligence. Nature Medicine, 25(1), 44–56. https://doi.org/10.1038/s41591-018-0300-7
Wartman, S. A., & Combs, C. D. (2019). Reimagining medical education in the age of AI. Academic Medicine, 94(10), 1413–1416. https://doi.org/10.1097/ACM.0000000000002821
Whittemore, R., & Knafl, K. (2005). The integrative review: Updated methodology. Journal of Advanced Nursing, 52(5), 546–553. https://doi.org/10.1111/j.1365-2648.2005.03621.x
Wiens, J., Saria, S., Sendak, M., et al. (2019). Do no harm: A roadmap for responsible machine learning for health care. Nature Medicine, 25(9), 1337–1340. https://doi.org/10.1038/s41591-019-0548-6
World Health Organization. (2021). Ethics and governance of artificial intelligence for health. WHO.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 José Carlos Velozo Júnior

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
