There is a need of ensuring machine learning models that are interpretable. Higher interpretability of the model means easier comprehension and explanation of future predictions for end-users. Further, interpretable machine learning models allow healthcare experts to make reasonable and data-driven decisions to provide personalized decisions that can ultimately lead to higher quality of service in healthcare. Generally, we can classify interpretability approaches in two groups where the first focuses on personalized interpretation (local interpretability) while the second summarizes prediction models on a population level (global interpretability). Alternatively, we can group interpretability methods into model-specific techniques, which are designed to interpret predictions generated by a specific model, such as a neural network, and model-agnostic approaches, which provide easy-to-understand explanations of predictions made by any machine learning model. Here, we give an overview of interpretability approaches and provide examples of practical interpretability of machine learning in different areas of healthcare, including prediction of health-related outcomes, optimizing treatments or improving the efficiency of screening for specific conditions. Further, we outline future directions for interpretable machine learning and highlight the importance of developing algorithmic solutions that can enable machine-learning driven decision making in high-stakes healthcare problems.
Selecting Interpretability Techniques for Healthcare Machine Learning models
University of Antioquia UdeA（安蒂奥基亚大学）；Universidad de Antioquia UdeA（安蒂奥基亚大学）；University of Antioquia（安蒂奥基亚大学）；Hospital Alma Máter de Antioquia（安蒂奥基亚母校医院）；Arcada University of Applied Sciences（阿卡达应用科学大学）
Faculty of Health Sciences, University of Maribor（马里博尔大学健康科学学院）
Machine Learning (ML) models are often complex and difficult to interpret due to their 'black-box' characteristics. Interpretability of a ML model is usually defined as the degree to which a human can understand the cause of decisions reached by a ML model. Interpretability is of extremely high importance in many fields of healthcare due to high levels of risk related to decisions based on ML models. Calibration of the ML model outputs is another issue often overlooked in the application of ML models in practice. This paper represents an early work in examination of prediction model calibratio…
In this review, we examine the problem of designing interpretable and explainable machine learning models. Interpretability and explainability lie at the core of many machine learning and statistical applications in medicine, economics, law, and natural sciences. Although interpretability and explainability have escaped a clear universal definition, many techniques motivated by these properties have been developed over the recent 30 years with the focus currently shifting towards deep learning methods. In this review, we emphasise the divide between interpretability and explainability and illu…
As machine learning systems become ubiquitous, there has been a surge of interest in interpretable machine learning: systems that provide explanation for their outputs. These explanations are often used to qualitatively assess other criteria such as safety or non-discrimination. However, despite the interest in interpretability, there is very little consensus on what interpretable machine learning is and how it should be measured. In this position paper, we first define interpretability and describe when interpretability is needed (and when it is not). Next, we suggest a taxonomy for rigorous …
The increasing availability of healthcare data requires accurate analysis of disease diagnosis, progression, and realtime monitoring to provide improved treatments to the patients. In this context, Machine Learning (ML) models are used to extract valuable features and insights from high-dimensional and heterogeneous healthcare data to detect different diseases and patient activities in a Smart Healthcare System (SHS). However, recent researches show that ML models used in different application domains are vulnerable to adversarial attacks. In this paper, we introduce a new type of adversarial …
Florida State University（佛罗里达州立大学）；Tallahassee Memorial Hospital（塔拉哈西纪念医院）
Deep neural networks have achieved remarkable success in various challenging tasks. However, the black-box nature of such networks is not acceptable to critical applications, such as healthcare. In particular, the existence of adversarial examples and their overgeneralization to irrelevant, out-of-distribution inputs with high confidence makes it difficult, if not impossible, to explain decisions by such networks. In this paper, we analyze the underlying mechanism of generalization of deep neural networks and propose an ($n$, $k$) consensus algorithm which is insensitive to adversarial example…
ETH Zurich（苏黎世联邦理工学院）；Helmholtz Zentrum München（慕尼黑亥姆霍兹中心）；Swiss Institute for Bioinformatics (SIB)（瑞士生物信息学研究所）
Owing to its pristine soft-tissue contrast and high resolution, structural magnetic resonance imaging (MRI) is widely applied in neurology, making it a valuable data source for image-based machine learning (ML) and deep learning applications. The physical nature of MRI acquisition and reconstruction, however, causes variations in image intensity, resolution, and signal-to-noise ratio. Since ML models are sensitive to such variations, performance on out-of-distribution data, which is inherent to the setting of a deployed healthcare ML application, typically drops below acceptable levels. We pro…
The analysis of electrocardiogram (ECG) signals can be time consuming as it is performed manually by cardiologists. Therefore, automation through machine learning (ML) classification is being increasingly proposed which would allow ML models to learn the features of a heartbeat and detect abnormalities. The lack of interpretability hinders the application of Deep Learning in healthcare. Through interpretability of these models, we would understand how a machine learning algorithm makes its decisions and what patterns are being followed for classification. This thesis builds Convolutional Neura…
Centre for Addiction and Mental Health（成瘾与心理健康中心）；University of Edinburgh（爱丁堡大学）；Royal Infirmary of Edinburgh（爱丁堡皇家医院）
Prediction of survival in patients diagnosed with a brain tumour is challenging because of heterogeneous tumour behaviours and responses to treatment. Better estimations of prognosis would support treatment planning and patient support. Advances in machine learning have informed development of clinical predictive models, but their integration into clinical practice is almost non-existent. One reasons for this is the lack of interpretability of models. In this paper, we use a novel brain tumour dataset to compare two interpretable rule list models against popular machine learning approaches for…
University of Massachusetts Amherst（马萨诸塞大学阿默斯特分校）；University of Rochester（罗切斯特大学）；Shanghai Maritime University（上海海事大学）；University of Rochester Medical Center（罗切斯特大学医学中心）
Causal inference and model interpretability research are gaining increasing attention, especially in the domains of healthcare and bioinformatics. Despite recent successes in this field, decorrelating features under nonlinear environments with human interpretable representations has not been adequately investigated. To address this issue, we introduce a novel method with a variable decorrelation regularizer to handle both linear and nonlinear confounding. Moreover, we employ association rules as new representations using association rule mining based on the original features to further proxima…
Lawrence Livermore National Laboratory（劳伦斯利弗莫尔国家实验室）；IBM Research AI（IBM研究AI部门）；Arizona State University（亚利桑那州立大学）
The wide-spread adoption of representation learning technologies in clinical decision making strongly emphasizes the need for characterizing model reliability and enabling rigorous introspection of model behavior. While the former need is often addressed by incorporating uncertainty quantification strategies, the latter challenge is addressed using a broad class of interpretability techniques. In this paper, we argue that these two objectives are not necessarily disparate and propose to utilize prediction calibration to meet both objectives. More specifically, our approach is comprised of a ca…
Deep learning continues to revolutionize an ever-growing number of critical application areas including healthcare, transportation, finance, and basic sciences. Despite their increased predictive power, model transparency and human explainability remain a significant challenge due to the "black box" nature of modern deep learning models. In many cases the desired balance between interpretability and performance is predominately task specific. Human-centric domains such as healthcare necessitate a renewed focus on understanding how and why these frameworks are arriving at critical and potential…
The recent release of large-scale healthcare datasets has greatly propelled the research of data-driven deep learning models for healthcare applications. However, due to the nature of such deep black-boxed models, concerns about interpretability, fairness, and biases in healthcare scenarios where human lives are at stake call for a careful and thorough examinations of both datasets and models. In this work, we focus on MIMIC-IV (Medical Information Mart for Intensive Care, version IV), the largest publicly available healthcare dataset, and conduct comprehensive analyses of dataset representati…
Designing Interpretable ML System to Enhance Trust in Healthcare: A Systematic Review to Proposed Responsible Clinician-AI-Collaboration Framework
Grado Department of Industrial & Systems Engineering, Virginia Tech（弗吉尼亚理工大学格拉多工业与系统工程系）；Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University（迪肯大学智能系统研究与创新研究所）；School of Mathematics, Physics, and Computing, University of Southern Queensland（南昆士兰大学数学、物理与计算学院）；Center for Health Research, University of Southern Queensland（南昆士兰大学健康研究中心）
This is the Proceedings of the 2018 ICML Workshop on Human Interpretability in Machine Learning (WHI 2018), which was held in Stockholm, Sweden, July 14, 2018. Invited speakers were Barbara Engelhardt, Cynthia Rudin, Fernanda Viégas, and Martin Wattenberg.
This is the Proceedings of the 2017 ICML Workshop on Human Interpretability in Machine Learning (WHI 2017), which was held in Sydney, Australia, August 10, 2017. Invited speakers were Tony Jebara, Pang Wei Koh, and David Sontag.
Institute of Integrated and Intelligent Systems, Griffith University（格里菲斯大学集成与智能系统研究所）
The term "interpretability" is oftenly used by machine learning researchers each with their own intuitive understanding of it. There is no universal well agreed upon definition of interpretability in machine learning. As any type of science discipline is mainly driven by the set of formulated questions rather than by different tools in that discipline, e.g. astrophysics is the discipline that learns the composition of stars, not as the discipline that use the spectroscopes. Similarly, we propose that machine learning interpretability should be a discipline that answers specific questions relat…
This is the Proceedings of the 2016 ICML Workshop on Human Interpretability in Machine Learning (WHI 2016), which was held in New York, NY, June 23, 2016. Invited speakers were Susan Athey, Rich Caruana, Jacob Feldman, Percy Liang, and Hanna Wallach.
Massachusetts Institute of Technology（麻省理工学院）；Vector Institute（向量研究所）；University of Toronto（多伦多大学）；New York University（纽约大学）；New York University Grossman School of Medicine（纽约大学格罗斯曼医学院）
Machine learning can be used to make sense of healthcare data. Probabilistic machine learning models help provide a complete picture of observed data in healthcare. In this review, we examine how probabilistic machine learning can advance healthcare. We consider challenges in the predictive model building pipeline where probabilistic models can be beneficial including calibration and missing data. Beyond predictive models, we also investigate the utility of probabilistic machine learning models in phenotyping, in generative models for clinical use cases, and in reinforcement learning.
InterpretML is an open-source Python package which exposes machine learning interpretability algorithms to practitioners and researchers. InterpretML exposes two types of interpretability - glassbox models, which are machine learning models designed for interpretability (ex: linear models, rule lists, generalized additive models), and blackbox explainability techniques for explaining existing systems (ex: Partial Dependence, LIME). The package enables practitioners to easily compare interpretability algorithms by exposing multiple methods under a unified API, and by having a built-in, extensib…
Deep Learning based models are currently dominating most state-of-the-art solutions for disease prediction. Existing works employ RNNs along with multiple levels of attention mechanisms to provide interpretability. These deep learning models, with trainable parameters running into millions, require huge amounts of compute and data to train and deploy. These requirements are sometimes so huge that they render usage of such models as unfeasible. We address these challenges by developing a simpler yet interpretable non-deep learning based model for application to EHR data. We model and showcase o…
Navigating Healthcare Insights: A Birds Eye View of Explainability with Knowledge Graphs
Hajim School of Engineering and Applied Sciences, University of Rochester（罗切斯特大学哈吉米工程与应用科学学院）；College of Engineering and Applied Sciences, University at Albany, State University of New York（纽约州立大学奥尔巴尼分校工程与应用科学学院）；Deloitte LLC（德勤有限责任公司）
Symphony Health, a division of Icon, plc（Icon公众有限公司旗下Symphony Health）；University of Maine（缅因大学）；Grand Canyon University（大峡谷大学）
It is common for researchers to holdout data from a study pool to be used for external validation as well as for future research, and the same desire is true to those using machine learning modeling research. For this discussion, the purpose of the holdout sample it is preserve data for research studies that will be analysis-naive and randomly selected from the full dataset. Analysis-naive are records that are not used for testing or training machine learning (ML) models and records that do not participate in any aspect of the current machine learning study. The methodology suggested for creat…
Parkland Center for Clinical Innovation（帕克兰临床创新中心）；Dallas, TX 75247, USA（美国得克萨斯州达拉斯市75247（注：此条为地址，非机构，按要求不应提取，实际仅需保留Parkland Center for Clinical Innovation））
In recent times, machine learning (ML) and artificial intelligence (AI) based systems have evolved and scaled across different industries such as finance, retail, insurance, energy utilities, etc. Among other things, they have been used to predict patterns of customer behavior, to generate pricing models, and to predict the return on investments. But the successes in deploying machine learning models at scale in those industries have not translated into the healthcare setting. There are multiple reasons why integrating ML models into healthcare has not been widely successful, but from a techni…
Massachusetts Institute of Technology（麻省理工学院）；Beth Israel Deaconess Medical Center（贝斯以色列女执事医疗中心）
The Large Scale Visual Recognition Challenge based on the well-known Imagenet dataset catalyzed an intense flurry of progress in computer vision. Benchmark tasks have propelled other sub-fields of machine learning forward at an equally impressive pace, but in healthcare it has primarily been image processing tasks, such as in dermatology and radiology, that have experienced similar benchmark-driven progress. In the present study, we performed a comprehensive review of benchmarks in medical machine learning for structured data, identifying one based on the Medical Information Mart for Intensive…
The increasing availability of large collections of electronic health record (EHR) data and unprecedented technical advances in deep learning (DL) have sparked a surge of research interest in developing DL based clinical decision support systems for diagnosis, prognosis, and treatment. Despite the recognition of the value of deep learning in healthcare, impediments to further adoption in real healthcare settings remain due to the black-box nature of DL. Therefore, there is an emerging need for interpretable DL, which allows end users to evaluate the model decision making to know whether to acc…
University of Southern California（南加州大学）；Children’s Hospital Los Angeles（洛杉矶儿童医院）
Exponential growth in Electronic Healthcare Records (EHR) has resulted in new opportunities and urgent needs for discovery of meaningful data-driven representations and patterns of diseases in Computational Phenotyping research. Deep Learning models have shown superior performance for robust prediction in computational phenotyping tasks, but suffer from the issue of model interpretability which is crucial for clinicians involved in decision-making. In this paper, we introduce a novel knowledge-distillation approach called Interpretable Mimic Learning, to learn interpretable phenotype features …
Decisions by Machine Learning (ML) models have become ubiquitous. Trusting these decisions requires understanding how algorithms take them. Hence interpretability methods for ML are an active focus of research. A central problem in this context is that both the quality of interpretability methods as well as trust in ML predictions are difficult to measure. Yet evaluations, comparisons and improvements of trust and interpretability require quantifiable measures. Here we propose a quantitative measure for the quality of interpretability methods. Based on that we derive a quantitative measure of …
Understanding why machine learning models behave the way they do empowers both system designers and end-users in many ways: in model selection, feature engineering, in order to trust and act upon the predictions, and in more intuitive user interfaces. Thus, interpretability has become a vital concern in machine learning, and work in the area of interpretable models has found renewed interest. In some applications, such models are as accurate as non-interpretable ones, and thus are preferred for their transparency. Even when they are not accurate, they may still be preferred when interpretabili…
University of the West England (UWE)（西英格兰大学（UWE））；Hamad Bin Khalifa University (HBKU)（哈马德·本·哈利法大学（HBKU））；Information Technology University (ITU)（信息技术大学（ITU））
Recent years have witnessed widespread adoption of machine learning (ML)/deep learning (DL) techniques due to their superior performance for a variety of healthcare applications ranging from the prediction of cardiac arrest from one-dimensional heart signals to computer-aided diagnosis (CADx) using multi-dimensional medical images. Notwithstanding the impressive performance of ML/DL, there are still lingering doubts regarding the robustness of ML/DL in healthcare settings (which is traditionally considered quite challenging due to the myriad security and privacy issues involved), especially in…
In recent years, machine learning researchers have focused on methods to construct flexible and interpretable prediction models. However, an interpretability evaluation, a relationship between generalization performance and an interpretability of the model and a method for improving the interpretability have to be considered. In this paper, a quantitative index of the interpretability is proposed and its rationality is proved, and equilibrium problem between the interpretability and the generalization performance is analyzed. Probability upper bound of the sum of the two performances is analyz…
In this paper, we discuss the impact of the Covid-19 pandemic on alcohol consumption habit changes among healthcare workers in the United States. We utilize multiple supervised and unsupervised machine learning methods and models such as Decision Trees, Logistic Regression, Naive Bayes classifier, k-Nearest Neighbors, Support Vector Machines, Multilayer perceptron, XGBoost, CatBoost, LightGBM, Chi-Squared Test and mutual information method on a mental health survey data obtained from the University of Michigan Inter-University Consortium for Political and Social Research to find out relationsh…
From medical charts to national census, healthcare has traditionally operated under a paper-based paradigm. However, the past decade has marked a long and arduous transformation bringing healthcare into the digital age. Ranging from electronic health records, to digitized imaging and laboratory reports, to public health datasets, today, healthcare now generates an incredible amount of digital information. Such a wealth of data presents an exciting opportunity for integrated machine learning solutions to address problems across multiple facets of healthcare practice and administration. Unfortun…
Symphony Health, a division of Icon, plc（Icon 公司旗下的 Symphony Health）；The University of Maine（缅因大学）；Grand Canyon University（大峡谷大学）
Data scientists and statisticians are often at odds when determining the best approach, machine learning or statistical modeling, to solve an analytics challenge. However, machine learning and statistical modeling are more cousins than adversaries on different sides of an analysis battleground. Choosing between the two approaches or in some cases using both is based on the problem to be solved and outcomes required as well as the data available for use and circumstances of the analysis. Machine learning and statistical modeling are complementary, based on similar mathematical principles, but s…
CNRS-LIMSI（法国国家科学研究中心-计算机科学与机械信息实验室）；Université Paris-Saclay（巴黎-萨克雷大学）；Samovar, CNRS, Télécom SudParis, Institut Polytechnique de Paris（萨莫瓦尔实验室，法国国家科学研究中心，南巴黎电信学院，巴黎综合理工学院）；Université Paris 8（巴黎第八大学）
The adoption of deep learning in healthcare is hindered by their "black box" nature. In this paper, we explore the RETAIN architecture for the task of glusose forecasting for diabetic people. By using a two-level attention mechanism, the recurrent-neural-network-based RETAIN model is interpretable. We evaluate the RETAIN model on the type-2 IDIAB and the type-1 OhioT1DM datasets by comparing its statistical and clinical performances against two deep models and three models based on decision trees. We show that the RETAIN model offers a very good compromise between accuracy and interpretability…
Arizona State University（亚利桑那州立大学）；Army Research Lab（陆军研究实验室）
Machine learning models have had discernible achievements in a myriad of applications. However, most of these models are black-boxes, and it is obscure how the decisions are made by them. This makes the models unreliable and untrustworthy. To provide insights into the decision making processes of these models, a variety of traditional interpretable models have been proposed. Moreover, to generate more human-friendly explanations, recent work on interpretability tries to answer questions related to causality such as "Why does this model makes such decisions?" or "Was it a specific feature that …
KenSci Inc（KenSci公司）；University of Washington - Tacoma（华盛顿大学塔科马分校）；University of Washington - Bothell（华盛顿大学博塞尔分校）
Fairness in AI and machine learning systems has become a fundamental problem in the accountability of AI systems. While the need for accountability of AI models is near ubiquitous, healthcare in particular is a challenging field where accountability of such systems takes upon additional importance, as decisions in healthcare can have life altering consequences. In this paper we present preliminary results on fairness in the context of classification parity in healthcare. We also present some exploratory methods to improve fairness and choosing appropriate classification algorithms in the conte…
Georgia Institute of Technology（佐治亚理工学院）；Sutter Health（萨特健康）
Accuracy and interpretability are two dominant features of successful predictive models. Typically, a choice must be made in favor of complex black box models such as recurrent neural networks (RNN) for accuracy versus less accurate but more interpretable traditional models such as logistic regression. This tradeoff poses challenges in medicine where both accuracy and interpretability are important. We addressed this challenge by developing the REverse Time AttentIoN model (RETAIN) for application to Electronic Health Records (EHR) data. RETAIN achieves high accuracy while remaining clinically…
Skolkovo Institute of Science and Technology（斯科尔科沃科学技术研究院）
Fraud in healthcare is widespread, as doctors could prescribe unnecessary treatments to increase bills. Insurance companies want to detect these anomalous fraudulent bills and reduce their losses. Traditional fraud detection methods use expert rules and manual data processing. Recently, machine learning techniques automate this process, but hand-labeled data is extremely costly and usually out of date. We propose a machine learning model that automates fraud detection in an unsupervised way. Two deep learning approaches include LSTM neural network for prediction next patient visit and a seq2se…
Courant Institute of Mathematical Sciences（科朗数学科学研究所）；Center for Data Science（数据科学中心）；New York University（纽约大学）；New York University Langone Medical Center（纽约大学兰贡医学中心）
As machine learning (ML) models, trained on real-world datasets, become common practice, it is critical to measure and quantify their potential biases. In this paper, we focus on renal failure and compare a commonly used traditional risk score, Tangri, with a more powerful machine learning model, which has access to a larger variable set and trained on 1.6 million patients' EHR data. We will compare and discuss the generalization and applicability of these two models, in an attempt to quantify biases of status quo clinical practice, compared to ML-driven models.
In recent years, smart healthcare IoT devices have become ubiquitous, but they work in isolated networks due to their policy. Having these devices connected in a network enables us to perform medical distributed data analysis. However, the presence of diverse IoT devices in terms of technology, structure, and network policy, makes it a challenging issue while applying traditional centralized learning algorithms on decentralized data collected from the IoT devices. In this study, we present an extensive review of the state-of-the-art machine learning applications particularly in healthcare, cha…
The effectiveness of machine learning algorithms depends on the quality and amount of data and the operationalization and interpretation by the human analyst. In humanitarian response, data is often lacking or overburdening, thus ambiguous, and the time-scarce, volatile, insecure environments of humanitarian activities are likely to inflict cognitive biases. This paper proposes to research the effects of data ambiguity and cognitive biases on the interpretability of machine learning algorithms in humanitarian decision making.
IBM Research Europe（IBM欧洲研究院）；ETH Zürich（苏黎世联邦理工学院）
Interpretability has become a necessary feature for machine learning models deployed in critical scenarios, e.g. legal system, healthcare. In these situations, algorithmic decisions may have (potentially negative) long-lasting effects on the end-user affected by the decision. In many cases, the representational power of deep learning models is not needed, therefore simple and interpretable models (e.g. linear models) should be preferred. However, in high-dimensional and/or complex domains (e.g. computer vision), the universal approximation capabilities of neural networks are required. Inspired…
Haverford College（哈弗福德学院）；University of Arizona（亚利桑那大学）；University of Utah（犹他大学）
The increasing adoption of machine learning tools has led to calls for accountability via model interpretability. But what does it mean for a machine learning model to be interpretable by humans, and how can this be assessed? We focus on two definitions of interpretability that have been introduced in the machine learning literature: simulatability (a user's ability to run a model on a given input) and "what if" local explainability (a user's ability to correctly determine a model's prediction under local changes to the input, given knowledge of the model's original prediction). Through a user…
Interpretability allows the domain-expert to directly evaluate the model's relevance and reliability, a practice that offers assurance and builds trust. In the healthcare setting, interpretable models should implicate relevant biological mechanisms independent of technical factors like data pre-processing. We define personalized interpretability as a measure of sample-specific feature attribution, and view it as a minimum requirement for a precision health model to justify its conclusions. Some health data, especially those generated by high-throughput sequencing experiments, have nuances that…
Machine learning (ML) has shown increasing abilities for predictive analytics over the last decades. It is becoming ubiquitous in different fields, such as healthcare, criminal justice, finance and smart city. For instance, the University of Northampton is building a smart system with multiple layers of IoT and software-defined networks (SDN) on its new Waterside Campus. The system can be used to optimize smart buildings energy efficiency, improve the health and safety of its tenants and visitors, assist crowd management and way-finding, and improve the Internet connectivity.
MLHOps: Machine Learning for Healthcare Operations
Vector Institute for Artificial Intelligence（向量人工智能研究所）；Hospital for Sick Children（病童医院）；University of Toronto（多伦多大学）；York University（约克大学）；Dalhousie University（达尔豪斯大学）
Clemson University（克莱姆森大学）；Geisinger Health System（盖辛格健康系统）
This work is motivated by the needs of predictive analytics on healthcare data as represented by Electronic Medical Records. Such data is invariably problematic: noisy, with missing entries, with imbalance in classes of interests, leading to serious bias in predictive modeling. Since standard data mining methods often produce poor performance measures, we argue for development of specialized techniques of data-preprocessing and classification. In this paper, we propose a new method to simultaneously classify large datasets and reduce the effects of missing values. It is based on a multilevel f…
