Explainable Artificial Intelligence (XAI): Concepts, Taxonomies, Opportunities and Challenges toward Responsible AI

Here we present deep-learning techniques for healthcare, centering our discussion on deep learning in computer vision, natural language processing, reinforcement learning, and generalized methods. We describe how these computational techniques can impact a few key areas of medicine and explore how to build end-to-end systems. Our discussion of computer vision focuses largely on medical imaging, and we describe the application of natural language processing to domains such as electronic health record data. Similarly, reinforcement learning is discussed in the context of robotic-assisted surgery, and generalized deep-learning methods for genomics are reviewed.

A guide to deep learning in healthcare.

In the last years, Artificial Intelligence (AI) has achieved a notable momentum that may deliver the best of expectations over many application sectors across the field. For this to occur, the entire community stands in front of the barrier of explainability, an inherent problem of AI techniques brought by sub-symbolism (e.g. ensembles or Deep Neural Networks) that were not present in the last hype of AI. Paradigms underlying this problem fall within the so-called eXplainable AI (XAI) field, which is acknowledged as a crucial feature for the practical deployment of AI models. This overview examines the existing literature in the field of XAI, including a prospect toward what is yet to be reached. We summarize previous efforts to define explainability in Machine Learning, establishing a novel definition that covers prior conceptual propositions with a major focus on the audience for which explainability is sought. We then propose and discuss about a taxonomy of recent contributions related to the explainability of different Machine Learning models, including those aimed at Deep Learning methods for which a second taxonomy is built. This literature analysis serves as the background for a series of challenges faced by XAI, such as the crossroads between data fusion and explainability. Our prospects lead toward the concept of Responsible Artificial Intelligence, namely, a methodology for the large-scale implementation of AI methods in real organizations with fairness, model explainability and accountability at its core. Our ultimate goal is to provide newcomers to XAI with a reference material in order to stimulate future research advances, but also to encourage experts and professionals from other disciplines to embrace the benefits of AI in their activity sectors, without any prior bias for its lack of interpretability.

Explainable Artificial Intelligence (XAI): Concepts, Taxonomies, Opportunities and Challenges toward Responsible AI.

Gaining knowledge and actionable insights from complex, high-dimensional and heterogeneous biomedical data remains a key challenge in transforming health care. Various types of data have been emerging in modern biomedical research, including electronic health records, imaging, -omics, sensor data and text, which are complex, heterogeneous, poorly annotated and generally unstructured. Traditional data mining and statistical learning approaches typically need to first perform feature engineering to obtain effective and more robust features from those data, and then build prediction or clustering models on top of them. There are lots of challenges on both steps in a scenario of complicated data and lacking of sufficient domain knowledge. The latest advances in deep learning technologies provide new effective paradigms to obtain end-to-end learning models from complex data. In this article, we review the recent literature on applying deep learning technologies to advance the health care domain. Based on the analyzed work, we suggest that deep learning approaches could be the vehicle for translating big biomedical data into improved human health. However, we also note limitations and needs for improved methods development and applications, especially in terms of ease-of-understanding for domain experts and citizen scientists. We discuss such challenges and suggest developing holistic and meaningful interpretable architectures to bridge deep learning models and human interpretability.

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Deep learning for healthcare: review, opportunities and challenges.

Deep learning describes a class of machine learning algorithms that are capable of combining raw inputs into layers of intermediate features. These algorithms have recently shown impressive results across a variety of domains. Biology and medicine are data-rich disciplines, but the data are complex and often ill-understood. Hence, deep learning techniques may be particularly well suited to solve problems of these fields. We examine applications of deep learning to a variety of biomedical problems-patient classification, fundamental biological processes and treatment of patients-and discuss whether deep learning will be able to transform these tasks or if the biomedical sphere poses unique challenges. Following from an extensive literature review, we find that deep learning has yet to revolutionize biomedicine or definitively resolve any of the most pressing challenges in the field, but promising advances have been made on the prior state of the art. Even though improvements over previous baselines have been modest in general, the recent progress indicates that deep learning methods will provide valuable means for speeding up or aiding human investigation. Though progress has been made linking a specific neural network's prediction to input features, understanding how users should interpret these models to make testable hypotheses about the system under study remains an open challenge. Furthermore, the limited amount of labelled data for training presents problems in some domains, as do legal and privacy constraints on work with sensitive health records. Nonetheless, we foresee deep learning enabling changes at both bench and bedside with the potential to transform several areas of biology and medicine.

https://royalsocietypublishing.org/doi/pdf/10.1098/rsif.2017.0387

Opportunities and obstacles for deep learning in biology and medicine.

Leveraging large historical data in electronic health record (EHR), we developed Doctor AI, a generic predictive model that covers observed medical conditions and medication uses. Doctor AI is a temporal model using recurrent neural networks (RNN) and was developed and applied to longitudinal time stamped EHR data from 260K patients over 8 years. Encounter records (e.g. diagnosis codes, medication codes or procedure codes) were input to RNN to predict (all) the diagnosis and medication categories for a subsequent visit. Doctor AI assesses the history of patients to make multilabel predictions (one label for each diagnosis or medication category). Based on separate blind test set evaluation, Doctor AI can perform differential diagnosis with up to 79% recall@30, significantly higher than several baselines. Moreover, we demonstrate great generalizability of Doctor AI by adapting the resulting models from one institution to another without losing substantial accuracy.

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Doctor AI: Predicting Clinical Events via Recurrent Neural Networks

Using recurrent neural network models for early detection of heart failure onset.

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 interpretable and is based on a two-level neural attention model that detects influential past visits and significant clinical variables within those visits (e.g. key diagnoses). RETAIN mimics physician practice by attending the EHR data in a reverse time order so that recent clinical visits are likely to receive higher attention. RETAIN was tested on a large health system EHR dataset with 14 million visits completed by 263K patients over an 8 year period and demonstrated predictive accuracy and computational scalability comparable to state-of-the-art methods such as RNN, and ease of interpretability comparable to traditional models.

RETAIN: An Interpretable Predictive Model for Healthcare using Reverse Time Attention Mechanism

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Andy Schuetz

Papers

Doctor AI: Predicting Clinical Events via Recurrent Neural Networks

Using recurrent neural network models for early detection of heart failure onset.

RETAIN: An Interpretable Predictive Model for Healthcare using Reverse Time Attention Mechanism

RETAIN: An interpretable predictive model for healthcare using reverse time attention mechanism

Doctor AI: Predicting Clinical Events via Recurrent Neural Networks