Machine Learning for Health: Algorithm Auditing & Quality Control.

Developers proposing new machine learning for health (ML4H) tools often pledge to match or even surpass the performance of existing tools, yet the reality is usually more complicated. Reliable deployment of ML4H to the real world is challenging as examples from diabetic retinopathy or Covid-19 screening show. We envision an integrated framework of algorithm auditing and quality control that provides a path towards the effective and reliable application of ML systems in healthcare. In this editorial, we give a summary of ongoing work towards that vision and announce a call for participation to the special issue  Machine Learning for Health: Algorithm Auditing & Quality Control in this journal to advance the practice of ML4H auditing.

Piloting a Survey-Based Assessment of Transparency and Trustworthiness with Three Medical AI Tools.

Artificial intelligence (AI) offers the potential to support healthcare delivery, but poorly trained or validated algorithms bear risks of harm. Ethical guidelines stated transparency about model development and validation as a requirement for trustworthy AI. Abundant guidance exists to provide transparency through reporting, but poorly reported medical AI tools are common. To close this transparency gap, we developed and piloted a framework to quantify the transparency of medical AI tools with three use cases. Our framework comprises a survey to report on the intended use, training and validation data and processes, ethical considerations, and deployment recommendations. The transparency of each response was scored with either 0, 0.5, or 1 to reflect if the requested information was not, partially, or fully provided. Additionally, we assessed on an analogous three-point scale if the provided responses fulfilled the transparency requirement for a set of trustworthiness criteria from ethical guidelines. The degree of transparency and trustworthiness was calculated on a scale from 0% to 100%. Our assessment of three medical AI use cases pin-pointed reporting gaps and resulted in transparency scores of 67% for two use cases and one with 59%. We report anecdotal evidence that business constraints and limited information from external datasets were major obstacles to providing transparency for the three use cases. The observed transparency gaps also lowered the degree of trustworthiness, indicating compliance gaps with ethical guidelines. All three pilot use cases faced challenges to provide transparency about medical AI tools, but more studies are needed to investigate those in the wider medical AI sector. Applying this framework for an external assessment of transparency may be infeasible if business constraints prevent the disclosure of information. New strategies may be necessary to enable audits of medical AI tools while preserving business secrets.

Detecting failure modes in image reconstructions with interval neural network uncertainty.

PURPOSE: The quantitative detection of failure modes is important for making deep neural networks reliable and usable at scale. We consider three examples for common failure modes in image reconstruction and demonstrate the potential of uncertainty quantification as a fine-grained alarm system. METHODS: We propose a deterministic, modular and lightweight approach called Interval Neural Network (INN) that produces fast and easy to interpret uncertainty scores for deep neural networks. Importantly, INNs can be constructed post hoc for already trained prediction networks. We compare it against state-of-the-art baseline methods (MCDROP, PROBOUT). RESULTS: We demonstrate on controlled, synthetic inverse problems the capacity of INNs to capture uncertainty due to noise as well as directional error information. On a real-world inverse problem with human CT scans, we can show that INNs produce uncertainty scores which improve the detection of all considered failure modes compared to the baseline methods. CONCLUSION: Interval Neural Networks offer a promising tool to expose weaknesses of deep image reconstruction models and ultimately make them more reliable. The fact that they can be applied post hoc to equip already trained deep neural network models with uncertainty scores makes them particularly interesting for deployment.

Improving Uncertainty Estimation With Semi-Supervised Deep Learning for COVID-19 Detection Using Chest X-Ray Images.

In this work we implement a COVID-19 infection detection system based on chest X-ray images with uncertainty estimation. Uncertainty estimation is vital for safe usage of computer aided diagnosis tools in medical applications. Model estimations with high uncertainty should be carefully analyzed by a trained radiologist. We aim to improve uncertainty estimations using unlabelled data through the MixMatch semi-supervised framework. We test popular uncertainty estimation approaches, comprising Softmax scores, Monte-Carlo dropout and deterministic uncertainty quantification. To compare the reliability of the uncertainty estimates, we propose the usage of the Jensen-Shannon distance between the uncertainty distributions of correct and incorrect estimations. This metric is statistically relevant, unlike most previously used metrics, which often ignore the distribution of the uncertainty estimations. Our test results show a significant improvement in uncertainty estimates when using unlabelled data. The best results are obtained with the use of the Monte Carlo dropout method.