arXiv subjects

Enrico Coiera

Publications and source records attributed to Enrico Coiera.

10 recordsLinked to original sources

arXiv2026

Evaluation format, not model capability, drives triage failure in the assessment of consumer health AI

Ramaswamy et al. reported in Nature Medicine that ChatGPT Health under-triages 51.6% of emergencies, concluding that consumer-facing AI triage poses safety risks. However, their evaluation used an exam-style protocol -- forced A/B/C/D output, knowledge suppression, and suppression of clarifying questions -- that differs fundamentally from how consumers use health chatbots. We tested five frontier LLMs (GPT-5.2, Claude Sonnet 4.6, Claude Opus 4.6, Gemini 3 Flash, Gemini 3.1 Pro) on a 17-scenario partial replication bank under constrained (exam-style, 1,275 trials) and naturalistic (patient-style messages, 850 trials) conditions, with targeted ablations and prompt-faithful checks using the authors' released prompts. Naturalistic interaction improved triage accuracy by 6.4 percentage points ($p = 0.015$). Diabetic ketoacidosis was correctly triaged in 100% of trials across all models and conditions. Asthma triage improved from 48% to 80%. The forced A/B/C/D format was the dominant failure mechanism: three models scored 0--24% with forced choice but 100% with free text (all $p < 10^{-8}$), consistently recommending emergency care in their own words while the forced-choice format registered under-triage. Prompt-faithful checks on the authors' exact released prompts confirmed the scaffold produces model-dependent, case-dependent results. Our results suggest that the headline under-triage rate is highly contingent on evaluation format and may not generalize as a stable estimate of deployed triage behavior. Valid evaluation of consumer health AI requires testing under conditions that reflect actual use.

cs.HC↗

arXiv2024

A Model for Intelligible Interaction Between Agents That Predict and Explain

Machine Learning (ML) has emerged as a powerful form of data modelling with widespread applicability beyond its roots in the design of autonomous agents. However, relatively little attention has been paid to the interaction between people and ML systems. In this paper we view interaction between humans and ML systems within the broader context of communication between agents capable of prediction and explanation. We formalise the interaction model by taking agents to be automata with some special characteristics and define a protocol for communication between such agents. We define One- and Two-Way Intelligibility as properties that emerge at run-time by execution of the protocol. The formalisation allows us to identify conditions under which run-time sequences are bounded, and identify conditions under which the protocol can correctly implement an axiomatic specification of intelligible interaction between a human and an ML system. We also demonstrate using the formal model to: (a) identify instances of One- and Two-Way Intelligibility in literature reports on humans interacting with ML systems providing logic-based explanations, as is done in Inductive Logic Programming (ILP); and (b) map interactions between humans and machines in an elaborate natural-language based dialogue-model to One- or Two-Way Intelligible interactions in the formal model.

cs.AI↗

arXiv2023

The Standard Problem

Objective: This paper proposes a framework to support the scientific research of standards so that they can be better measured, evaluated, and designed. Methods: Beginning with the notion of common models, the framework describes the general standard problem - the seeming impossibility of creating a singular, persistent and definitive standard which is not subject to change over time in an open system. Results: The standard problem arises from uncertainty driven by variations in operating context, standard quality, differences in implementation, and drift over time. As a result, fitting work using conformance services is needed to repair these gaps between a standard and what is required for real-world use. To guide standards design and repair, a framework for measuring performance in context is suggested, based on signal detection theory and technomarkers. Based on the type of common model in operation, different conformance strategies are identified: (a) Universal conformance (all agents access the same standard); (b) Mediated conformance (an interoperability layer supports heterogeneous agents) and (c) Localized conformance (autonomous adaptive agents manage their own needs). Conformance methods include incremental design, modular design, adaptors, and creating interactive and adaptive agents. Discussion: Machine learning should have a major role in adaptive fitting. Research to guide the choice and design of conformance services may focus on the stability and homogeneity of shared tasks, and whether common models are shared ahead of time or adjusted at task time. Conclusion: This analysis conceptually decouples interoperability and standardization. While standards facilitate interoperability, interoperability is achievable without standardization.

cs.OH↗

arXiv2022

One-way Explainability Isn't The Message

Recent engineering developments in specialised computational hardware, data-acquisition and storage technology have seen the emergence of Machine Learning (ML) as a powerful form of data analysis with widespread applicability beyond its historical roots in the design of autonomous agents. However -- possibly because of its origins in the development of agents capable of self-discovery -- relatively little attention has been paid to the interaction between people and ML. In this paper we are concerned with the use of ML in automated or semi-automated tools that assist one or more human decision makers. We argue that requirements on both human and machine in this context are significantly different to the use of ML either as part of autonomous agents for self-discovery or as part statistical data analysis. Our principal position is that the design of such human-machine systems should be driven by repeated, two-way intelligibility of information rather than one-way explainability of the ML-system's recommendations. Iterated rounds of intelligible information exchange, we think, will characterise the kinds of collaboration that will be needed to understand complex phenomena for which neither man or machine have complete answers. We propose operational principles -- we call them Intelligibility Axioms -- to guide the design of a collaborative decision-support system. The principles are concerned with: (a) what it means for information provided by the human to be intelligible to the ML system; and (b) what it means for an explanation provided by an ML system to be intelligible to a human. Using examples from the literature on the use of ML for drug-design and in medicine, we demonstrate cases where the conditions of the axioms are met. We describe some additional requirements needed for the design of a truly collaborative decision-support system.

cs.LG↗

arXiv2021

Automatically applying a credibility appraisal tool to track vaccination-related communications shared on social media

Background: Tools used to appraise the credibility of health information are time-consuming to apply and require context-specific expertise, limiting their use for quickly identifying and mitigating the spread of misinformation as it emerges. Our aim was to estimate the proportion of vaccination-related posts on Twitter are likely to be misinformation, and how unevenly exposure to misinformation was distributed among Twitter users. Methods: Sampling from 144,878 vaccination-related web pages shared on Twitter between January 2017 and March 2018, we used a seven-point checklist adapted from two validated tools to appraise the credibility of a small subset of 474. These were used to train several classifiers (random forest, support vector machines, and a recurrent neural network with transfer learning), using the text from a web page to predict whether the information satisfies each of the seven criteria. Results: Applying the best performing classifier to the 144,878 web pages, we found that 14.4% of relevant posts to text-based communications were linked to webpages of low credibility and made up 9.2% of all potential vaccination-related exposures. However, the 100 most popular links to misinformation were potentially seen by between 2 million and 80 million Twitter users, and for a substantial sub-population of Twitter users engaging with vaccination-related information, links to misinformation appear to dominate the vaccination-related information to which they were exposed. Conclusions: We proposed a new method for automatically appraising the credibility of webpages based on a combination of validated checklist tools. The results suggest that an automatic credibility appraisal tool can be used to find populations at higher risk of exposure to misinformation or applied proactively to add friction to the sharing of low credibility vaccination information.

cs.SI↗

arXiv2020

Automatic Speech Summarisation: A Scoping Review

Speech summarisation techniques take human speech as input and then output an abridged version as text or speech. Speech summarisation has applications in many domains from information technology to health care, for example improving speech archives or reducing clinical documentation burden. This scoping review maps the speech summarisation literature, with no restrictions on time frame, language summarised, research method, or paper type. We reviewed a total of 110 papers out of a set of 153 found through a literature search and extracted speech features used, methods, scope, and training corpora. Most studies employ one of four speech summarisation architectures: (1) Sentence extraction and compaction; (2) Feature extraction and classification or rank-based sentence selection; (3) Sentence compression and compression summarisation; and (4) Language modelling. We also discuss the strengths and weaknesses of these different methods and speech features. Overall, supervised methods (e.g. Hidden Markov support vector machines, Ranking support vector machines, Conditional random fields) performed better than unsupervised methods. As supervised methods require manually annotated training data which can be costly, there was more interest in unsupervised methods. Recent research into unsupervised methods focusses on extending language modelling, for example by combining Uni-gram modelling with deep neural networks. Protocol registration: The protocol for this scoping review is registered at https://osf.io.

cs.CL↗

arXiv2020

Empirical Analysis of Zipf's Law, Power Law, and Lognormal Distributions in Medical Discharge Reports

Bayesian modelling and statistical text analysis rely on informed probability priors to encourage good solutions. This paper empirically analyses whether text in medical discharge reports follow Zipf's law, a commonly assumed statistical property of language where word frequency follows a discrete power law distribution. We examined 20,000 medical discharge reports from the MIMIC-III dataset. Methods included splitting the discharge reports into tokens, counting token frequency, fitting power law distributions to the data, and testing whether alternative distributions--lognormal, exponential, stretched exponential, and truncated power law--provided superior fits to the data. Results show that discharge reports are best fit by the truncated power law and lognormal distributions. Our findings suggest that Bayesian modelling and statistical text analysis of discharge report text would benefit from using truncated power law and lognormal probability priors.

cs.CL↗

arXiv2019

Modeling Spatiotemporal Factors Associated With Sentiment on Twitter: Synthesis and Suggestions for Improving the Identification of Localized Deviations

Background: Studies examining how sentiment on social media varies depending on timing and location appear to produce inconsistent results, making it hard to design systems that use sentiment to detect localized events for public health applications. Objective: The aim of this study was to measure how common timing and location confounders explain variation in sentiment on Twitter. Methods: Using a dataset of 16.54 million English-language tweets from 100 cities posted between July 13 and November 30, 2017, we estimated the positive and negative sentiment for each of the cities using a dictionary-based sentiment analysis and constructed models to explain the differences in sentiment using time of day, day of week, weather, city, and interaction type (conversations or broadcasting) as factors and found that all factors were independently associated with sentiment. Results: In the full multivariable model of positive (Pearson r in test data 0.236; 95\% CI 0.231-0.241) and negative (Pearson r in test data 0.306; 95\% CI 0.301-0.310) sentiment, the city and time of day explained more of the variance than weather and day of week. Models that account for these confounders produce a different distribution and ranking of important events compared with models that do not account for these confounders. Conclusions: In public health applications that aim to detect localized events by aggregating sentiment across populations of Twitter users, it is worthwhile accounting for baseline differences before looking for unexpected changes.

cs.SI↗

arXiv2018

A shared latent space matrix factorisation method for recommending new trial evidence for systematic review updates

Clinical trial registries can be used to monitor the production of trial evidence and signal when systematic reviews become out of date. However, this use has been limited to date due to the extensive manual review required to search for and screen relevant trial registrations. Our aim was to evaluate a new method that could partially automate the identification of trial registrations that may be relevant for systematic review updates. We identified 179 systematic reviews of drug interventions for type 2 diabetes, which included 537 clinical trials that had registrations in ClinicalTrials.gov. We tested a matrix factorisation approach that uses a shared latent space to learn how to rank relevant trial registrations for each systematic review, comparing the performance to document similarity to rank relevant trial registrations. The two approaches were tested on a holdout set of the newest trials from the set of type 2 diabetes systematic reviews and an unseen set of 141 clinical trial registrations from 17 updated systematic reviews published in the Cochrane Database of Systematic Reviews. The matrix factorisation approach outperformed the document similarity approach with a median rank of 59 and recall@100 of 60.9%, compared to a median rank of 138 and recall@100 of 42.8% in the document similarity baseline. In the second set of systematic reviews and their updates, the highest performing approach used document similarity and gave a median rank of 67 (recall@100 of 62.9%). The proposed method was useful for ranking trial registrations to reduce the manual workload associated with finding relevant trials for systematic review updates. The results suggest that the approach could be used as part of a semi-automated pipeline for monitoring potentially new evidence for inclusion in a review update.

cs.IR↗

arXiv2018

Unreported links between trial registrations and published articles were identified using document similarity measures in a cross-sectional analysis of ClinicalTrials.gov

Objectives: Trial registries can be used to measure reporting biases and support systematic reviews but 45% of registrations do not provide a link to the article reporting on the trial. We evaluated the use of document similarity methods to identify unreported links between ClinicalTrials.gov and PubMed. Study Design and Setting: We extracted terms and concepts from a dataset of 72,469 ClinicalTrials.gov registrations and 276,307 PubMed articles, and tested methods for ranking articles across 16,005 reported links and 90 manually-identified unreported links. Performance was measured by the median rank of matching articles, and the proportion of unreported links that could be found by screening ranked candidate articles in order. Results: The best performing concept-based representation produced a median rank of 3 (IQR 1-21) for reported links and 3 (IQR 1-19) for the manually-identified unreported links, and term-based representations produced a median rank of 2 (1-20) for reported links and 2 (IQR 1-12) in unreported links. The matching article was ranked first for 40% of registrations, and screening 50 candidate articles per registration identified 86% of the unreported links. Conclusions: Leveraging the growth in the corpus of reported links between ClinicalTrials.gov and PubMed, we found that document similarity methods can assist in the identification of unreported links between trial registrations and corresponding articles.

cs.IR↗