Responsible and Regulatory Conform Machine Learning for Medicine: A Survey of Challenges and Solutions

Machine learning is expected to fuel significant improvements in medical care. To ensure that fundamental principles such as beneficence, respect for human autonomy, prevention of harm, justice, privacy, and transparency are respected, medical machine learning systems must be developed responsibly. Many high-level declarations of ethical principles have been put forth for this purpose, but there is a severe lack of technical guidelines explicating the practical consequences for medical machine learning. Similarly, there is currently considerable uncertainty regarding the exact regulatory requirements placed upon medical machine learning systems. This survey provides an overview of the technical and procedural challenges involved in creating medical machine learning systems responsibly and in conformity with existing regulations, as well as possible solutions to address these challenges. First, a brief review of existing regulations affecting medical machine learning is provided, showing that properties such as safety, robustness, reliability, privacy, security, transparency, explainability, and nondiscrimination are all demanded already by existing law and regulations - albeit, in many cases, to an uncertain degree. Next, the key technical obstacles to achieving these desirable properties are discussed, as well as important techniques to overcome these obstacles in the medical context. We notice that distribution shift, spurious correlations, model underspecification, uncertainty quantification, and data scarcity represent severe challenges in the medical context. Promising solution approaches include the use of large and representative datasets and federated learning as a means to that end, the careful exploitation of domain knowledge, the use of inherently transparent models, comprehensive out-of-distribution model testing and verification, as well as algorithmic impact assessments

Secure and robust machine learning for healthcare: A survey

Recent years have witnessed widespread adoption of machine learning (ML)/deep learning (DL) techniques due to their superior performance for a variety of healthcare applications ranging from the prediction of cardiac arrest from one-dimensional heart signals to computer-aided diagnosis (CADx) using multi-dimensional medical images. Notwithstanding the impressive performance of ML/DL, there are still lingering doubts regarding the robustness of ML/DL in healthcare settings (which is traditionally considered quite challenging due to the myriad security and privacy issues involved), especially in light of recent results that have shown that ML/DL are vulnerable to adversarial attacks. In this paper, we present an overview of various application areas in healthcare that leverage such techniques from security and privacy point of view and present associated challenges. In addition, we present potential methods to ensure secure and privacy-preserving ML for healthcare applications. Finally, we provide insight into the current research challenges and promising directions for future research