Re-focusing explainability in medicine

Author:

Arbelaez Ossa Laura1ORCID,Starke Georg12ORCID,Lorenzini Giorgia1,Vogt Julia E3,Shaw David M14,Elger Bernice Simone15

Affiliation:

1. Institute for Biomedical Ethics, University of Basel, Switzerland

2. College of Humanities, École Polytechnique Fédérale de Lausanne, Switzerland

3. Department of Computer Science, ETH Zurich, Switzerland

4. Care and Public Health Research Institute, Maastricht University, Netherlands

5. Center for Legal Medicine (CURML), University of Geneva, Switzerland

Abstract

Using artificial intelligence to improve patient care is a cutting-edge methodology, but its implementation in clinical routine has been limited due to significant concerns about understanding its behavior. One major barrier is the explainability dilemma and how much explanation is required to use artificial intelligence safely in healthcare. A key issue is the lack of consensus on the definition of explainability by experts, regulators, and healthcare professionals, resulting in a wide variety of terminology and expectations. This paper aims to fill the gap by defining minimal explainability standards to serve the views and needs of essential stakeholders in healthcare. In that sense, we propose to define minimal explainability criteria that can support doctors’ understanding, meet patients’ needs, and fulfill legal requirements. Therefore, explainability need not to be exhaustive but sufficient for doctors and patients to comprehend the artificial intelligence models’ clinical implications and be integrated safely into clinical practice. Thus, minimally acceptable standards for explainability are context-dependent and should respond to the specific need and potential risks of each clinical scenario for a responsible and ethical implementation of artificial intelligence.

Funder

Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung

Publisher

SAGE Publications

Subject

Health Information Management,Computer Science Applications,Health Informatics,Health Policy

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1. Trust and acceptability of data-driven clinical recommendations in everyday practice: A scoping review;International Journal of Medical Informatics;2024-03

2. A Theoretical Framework for AI Models Explainability with Application in Biomedicine;2023 IEEE Conference on Computational Intelligence in Bioinformatics and Computational Biology (CIBCB);2023-08-29

3. Utility of machine learning for identifying stapes fixation on ultra-high-resolution CT;Japanese Journal of Radiology;2023-08-10

4. Solving the explainable AI conundrum by bridging clinicians’ needs and developers’ goals;npj Digital Medicine;2023-05-22

5. Ignore, Trust, or Negotiate: Understanding Clinician Acceptance of AI-Based Treatment Recommendations in Health Care;Proceedings of the 2023 CHI Conference on Human Factors in Computing Systems;2023-04-19

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