Thomas H. McCoy | Searcharxiv

arXiv2021

Designing AI for Trust and Collaboration in Time-Constrained Medical Decisions: A Sociotechnical Lens

Major depressive disorder is a debilitating disease affecting 264 million people worldwide. While many antidepressant medications are available, few clinical guidelines support choosing among them. Decision support tools (DSTs) embodying machine learning models may help improve the treatment selection process, but often fail in clinical practice due to poor system integration. We use an iterative, co-design process to investigate clinicians' perceptions of using DSTs in antidepressant treatment decisions. We identify ways in which DSTs need to engage with the healthcare sociotechnical system, including clinical processes, patient preferences, resource constraints, and domain knowledge. Our results suggest that clinical DSTs should be designed as multi-user systems that support patient-provider collaboration and offer on-demand explanations that address discrepancies between predictions and current standards of care. Through this work, we demonstrate how current trends in explainable AI may be inappropriate for clinical environments and consider paths towards designing these tools for real-world medical systems.

cs.HC↗

arXiv2017

Prediction-Constrained Topic Models for Antidepressant Recommendation

Supervisory signals can help topic models discover low-dimensional data representations that are more interpretable for clinical tasks. We propose a framework for training supervised latent Dirichlet allocation that balances two goals: faithful generative explanations of high-dimensional data and accurate prediction of associated class labels. Existing approaches fail to balance these goals by not properly handling a fundamental asymmetry: the intended task is always predicting labels from data, not data from labels. Our new prediction-constrained objective trains models that predict labels from heldout data well while also producing good generative likelihoods and interpretable topic-word parameters. In a case study on predicting depression medications from electronic health records, we demonstrate improved recommendations compared to previous supervised topic models and high- dimensional logistic regression from words alone.

cs.LG↗