"226 of 521 FDA-approved medical devices, or approximately 43%, lacked published clinical validation data."

The lack of "published" clinical validation studies implies neither that the AI developer performed no clinical validation nor that the FDA hasn't seen it. So, it is not clear if the problem is with the lack of clinical validation or the lack of reporting. For some reason the title exaggerates yet further (half of FDA-approved AI not "trained" on real patient data).