An Exploration of Visual Analytic Techniques for XAI: Applications in Clinical Decision Support

Artificial Intelligence (AI) systems exhibit considerable potential in providing decision support across various domains. In this context, the methodology of eXplainable AI (XAI) becomes crucial, as it aims to enhance the transparency and comprehensibility of AI models\u27 decision-making processes. However, after a review of XAI methods and their application in clinical decision support, there exist notable gaps within the XAI methodology, particularly concerning the effective communication of explanations to users. This thesis aims to bridge these existing gaps by presenting in Chapter 3 a framework designed to communicate AI-generated explanations effectively to end-users. This is particularly pertinent in fields like healthcare, where the successful implementation of AI decision support hinges on the ability to convey actionable insights to medical professionals. Building upon this framework, subsequent chapters illustrate how visualization and visual analytics can be used with XAI in the context of clinical decision support. Chapter 4 introduces a visual analytic tool designed for ranking and triaging patients in the intensive care unit (ICU). Leveraging various XAI methods, the tool enables healthcare professionals to understand how the ranking model functions and how individual patients are prioritized. Through interactivity, users can explore influencing factors, evaluate alternate scenarios, and make informed decisions for optimal patient care. The pivotal role of transparency and comprehensibility within machine learning models is explored in Chapter 5. Leveraging the power of explainable AI techniques and visualization, it investigates the factors contributing to model performance and errors. Furthermore, it investigates scenarios in which the model outperforms, ultimately fostering user trust by shedding light on the model\u27s strengths and capabilities. Recognizing the ethical concerns associated with predictive models in health, Chapter 6 addresses potential bias and discrimination in ranking systems. By using the proposed visual analytic tool, users can assess the fairness and equity of the system, promoting equal treatment. This research emphasizes the need for unbiased decision-making in healthcare. Having developed the framework and illustrated ways of combining XAI with visual analytics in the service of clinical decision support, the thesis concludes by identifying important future directions of research in this area

Predicting the Effectiveness of Medical Interventions

This dissertation explores several conceptual and methodological features of medical science that influence our ability to accurately predict medical effectiveness. Making reliable predictions about the effectiveness of medical treatments is crucial to mitigating death and disease and improving individual and population health, yet generating such predictions is fraught with difficulties. Each chapter deals with a unique challenge to predictions of medical effectiveness. In Chapter 1, I describe and analyze the principles underlying three prominent approaches to physical disease classification—the etiological, symptom-based, and pathophysiological models—and suggest a broadly pragmatic approach whereby appropriate classifications depend on the goal in question. In line with this, I argue that particular features of the pathophysiological model, such as its focus on disease mechanisms, make it most relevant for predicting medical effectiveness. Chapter 2 explores the debate between those who argue that statistical evidence is sufficient for inferring medical effectiveness and those who argue that we require both statistical and mechanistic evidence. I focus on the question of how mechanistic and statistical evidence can be integrated. I highlight some of the challenges facing formal techniques, such as Bayesian networks, and use Toulmin’s model of argumentation to offer a complementary model of evidence amalgamation, which allows for the systematic integration of statistical and mechanistic evidence. In Chapter 3, I focus on p-hacking, an application of analytic techniques that may lead to exaggerated experimental results. I use philosophical tools from decision theory to illustrate how severe the effects of p-hacking can be. While it is typically considered epistemically questionable and practically harmful, I appeal to the argument from inductive risk to defend the view that there are some contexts in which p-hacking may be warranted. Chapter 4 draws attention to a particular set of biases plaguing medical research: Meta-biases. I argue that biases of this type, such as publication bias and sponsorship bias, lead to exaggerated clinical trial results. I then offer a framework, the bias dynamics model, that corrects for the influence of meta-biases on estimations of medical effectiveness. In Chapter 5, I argue against the prominent view that AI models are not explainable by showing how four familiar accounts of scientific explanation can be applied to neural networks. The confusion about explaining AI models is due to the conflation of ‘explainability’, ‘understandability’, and ‘interpretability’. To remedy this, I offer a novel account of AI-interpretability, according to which an interpretation is something one does to an explanation with the explicit aim of producing another, more understandable, explanation.The Oppenheimer Memorial Trust Department of History and Philosophy of Science, Cambridge Universit

Data science, analytics and artificial intelligence in e-health : trends, applications and challenges

Acknowledgments. This work has been partially supported by the Divina Pastora Seguros company.More than ever, healthcare systems can use data, predictive models, and intelligent algorithms to optimize their operations and the service they provide. This paper reviews the existing literature regarding the use of data science/analytics methods and artificial intelligence algorithms in healthcare. The paper also discusses how healthcare organizations can benefit from these tools to efficiently deal with a myriad of new possibilities and strategies. Examples of real applications are discussed to illustrate the potential of these methods. Finally, the paper highlights the main challenges regarding the use of these methods in healthcare, as well as some open research lines

Front-Line Physicians' Satisfaction with Information Systems in Hospitals

Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.Peer reviewe

Automatic production and integration of knowledge to the support of the decision and planning activities in medical-clinical diagnosis, treatment and prognosis.

El concepto de procedimiento médico se refiere al conjunto de actividades seguidas por los profesionales de la salud para solucionar o mitigar el problema de salud que afecta a un paciente. La toma de decisiones dentro del procedimiento médico ha sido, por largo tiempo, uno de las áreas más interesantes de investigación en la informática médica y el contexto de investigación de esta tesis. La motivación para desarrollar este trabajo de investigación se basa en tres aspectos fundamentales: no hay modelos de conocimiento para todas las actividades médico-clínicas que puedan ser inducidas a partir de datos médicos, no hay soluciones de aprendizaje inductivo para todas las actividades de la asistencia médica y no hay un modelo integral que formalice el concepto de procedimiento médico. Por tanto, nuestro objetivo principal es desarrollar un modelo computable basado en conocimiento que integre todas las actividades de decisión y planificación para el diagnóstico, tratamiento y pronóstico médico-clínicos. Para alcanzar el objetivo principal, en primer lugar, explicamos el problema de investigación. En segundo lugar, describimos los antecedentes del problema de investigación desde los contextos médico e informático. En tercer lugar, explicamos el desarrollo de la propuesta de investigación, basada en cuatro contribuciones principales: un nuevo modelo, basado en datos y conocimiento, para la actividad de planificación en el diagnóstico y tratamiento médico-clínicos; una novedosa metodología de aprendizaje inductivo para la actividad de planificación en el diagnóstico y tratamiento médico-clínico; una novedosa metodología de aprendizaje inductivo para la actividad de decisión en el pronóstico médico-clínico, y finalmente, un nuevo modelo computable, basado en datos y conocimiento, que integra las actividades de decisión y planificación para el diagnóstico, tratamiento y pronóstico médico-clínicos.The concept of medical procedure refers to the set of activities carried out by the health care professionals to solve or mitigate the health problems that affect a patient. Decisions making within a medical procedure has been, for a long time, one of the most interesting research areas in medical informatics and the research context of this thesis. The motivation to develop this research work is based on three main aspects: Nowadays there are not knowledge models for all the medical-clinical activities that can be induced from medical data, there are not inductive learning solutions for all the medical-clinical activities, and there is not an integral model that formalizes the concept of medical procedure. Therefore, our main objective is to develop a computable model based in knowledge that integrates all the decision and planning activities for the medical-clinical diagnosis, treatment and prognosis. To achieve this main objective: first, we explain the research problem. Second, we describe the background of the work from both the medical and the informatics contexts. Third, we explain the development of the research proposal based on four main contributions: a novel knowledge representation model, based in data, to the planning activity in medical-clinical diagnosis and treatment; a novel inductive learning methodology to the planning activity in diagnosis and medical-clinical treatment; a novel inductive learning methodology to the decision activity in medical-clinical prognosis, and finally, a novel computable model, based on data and knowledge, which integrates the decision and planning activities of medical-clinical diagnosis, treatment and prognosis

pHealth 2021. Proc. of the 18th Internat. Conf. on Wearable Micro and Nano Technologies for Personalised Health, 8-10 November 2021, Genoa, Italy

Smart mobile systems – microsystems, smart textiles, smart implants, sensor-controlled medical devices – together with related body, local and wide-area networks up to cloud services, have become important enablers for telemedicine and the next generation of healthcare services. The multilateral benefits of pHealth technologies offer enormous potential for all stakeholder communities, not only in terms of improvements in medical quality and industrial competitiveness, but also for the management of healthcare costs and, last but not least, the improvement of patient experience. This book presents the proceedings of pHealth 2021, the 18th in a series of conferences on wearable micro and nano technologies for personalized health with personal health management systems, hosted by the University of Genoa, Italy, and held as an online event from 8 – 10 November 2021. The conference focused on digital health ecosystems in the transformation of healthcare towards personalized, participative, preventive, predictive precision medicine (5P medicine). The book contains 46 peer-reviewed papers (1 keynote, 5 invited papers, 33 full papers, and 7 poster papers). Subjects covered include the deployment of mobile technologies, micro-nano-bio smart systems, bio-data management and analytics, autonomous and intelligent systems, the Health Internet of Things (HIoT), as well as potential risks for security and privacy, and the motivation and empowerment of patients in care processes. Providing an overview of current advances in personalized health and health management, the book will be of interest to all those working in the field of healthcare today