Design and Evaluation of User-Centered Explanations for Machine Learning Model Predictions in Healthcare

Challenges in interpreting some high-performing models present complications in applying machine learning (ML) techniques to healthcare problems. Recently, there has been rapid growth in research on model interpretability; however, approaches to explaining complex ML models are rarely informed by end-user needs and user evaluations of model interpretability are lacking, especially in healthcare. This makes it challenging to determine what explanation approaches might enable providers to understand model predictions in a comprehensible and useful way. Therefore, I aimed to utilize clinician perspectives to inform the design of explanations for ML-based prediction tools and improve the adoption of these systems in practice. In this dissertation, I proposed a new theoretical framework for designing user-centered explanations for ML-based systems. I then utilized the framework to propose explanation designs for predictions from a pediatric in-hospital mortality risk model. I conducted focus groups with healthcare providers to obtain feedback on the proposed designs, which was used to inform the design of a user-centered explanation. The user-centered explanation was evaluated in a laboratory study to assess its effect on healthcare provider perceptions of the model and decision-making processes. The results demonstrated that the user-centered explanation design improved provider perceptions of utilizing the predictive model in practice, but exhibited no significant effect on provider accuracy, confidence, or efficiency in making decisions. Limitations of the evaluation study design, including a small sample size, may have affected the ability to detect an impact on decision-making. Nonetheless, the predictive model with the user-centered explanation was positively received by healthcare providers, and demonstrated a viable approach to explaining ML model predictions in healthcare. Future work is required to address the limitations of this study and further explore the potential benefits of user-centered explanation designs for predictive models in healthcare. This work contributes a new theoretical framework for user-centered explanation design for ML-based systems that is generalizable outside the domain of healthcare. Moreover, the work provides meaningful insights into the role of model interpretability and explanation in healthcare while advancing the discussion on how to effectively communicate ML model information to healthcare providers

It is time to talk about people: a human-centered healthcare system

Examining vulnerabilities within our current healthcare system we propose borrowing two tools from the fields of engineering and design: a) Reason's system approach [1] and b) User-centered design [2,3]. Both approaches are human-centered in that they consider common patterns of human behavior when analyzing systems to identify problems and generate solutions. This paper examines these two human-centered approaches in the context of healthcare. We argue that maintaining a human-centered orientation in clinical care, research, training, and governance is critical to the evolution of an effective and sustainable healthcare system

Design of an Integrated Analytics Platform for Healthcare Assessment Centered on the Episode of Care

Assessing care quality and performance is essential to improve healthcare processes and population health management. However, due to bad system design and lack of access to required data, this assessment is often delayed or not done at all. The goal of our research is to investigate an advanced analytics platform that enables healthcare quality and performance assessment. We used a user-centered design approach to identify the system requirements and have the concept of episode of care as the building block of information for a key performance indicator analytics system. We implemented architecture and interface prototypes, and performed a usability test with hospital users with managerial roles. The results show that by using user-centered design we created an analytical platform that provides a holistic and integrated view of the clinical, financial and operational aspects of the institution. Our encouraging results warrant further studies to understand other aspects of usability

Developing and applying a user-centered model for the design and implementation of information visualization tools

The objective of this paper is to show how approaches for user-centered information visualization design and development are being applied in the context of healthcare where users are not familiar with information visualization techniques. We base our design methods on user-centered frameworks in which 'prototyping' plays an important role in the process. We modify existing approaches to involve prototyping at an early stage of the process as the problem domain is assessed. We believe this to be essential, as it increases users' awareness of what information visualization techniques can offer them and that it enables users to participate more effectively in later stages of the design and development process. This also acts as a stimulus for engagement. The problem domain analysis stage of a pilot study using this approach is presented, in which techniques are being collaboratively developed with domain users from a healthcare institution. Our results suggest that this approach has engaged users, who are subsequently able to apply generic information visualization concepts to their domains and as a result are better equipped to take part in the subsequent collaborative design and development process

Linking wellness to design: Creating a tool for evaluating user’s wellness experience at the main lobby of healthcare environments

The design of a healthcare facility’s main entry lobby holds a great potential for user’s health and well-being. The main lobby provides the first impression on the facility to the patients and visitors because it sets expectations for the quality of clinical care (Malkin, 1991). Research findings suggest that healthcare facility design has psychological, physiological and behavioral effects on users’ life satisfaction (Ulrich, 1991; Ananth, 2008). Others presented a wellness-focused model of care as an important consideration in the planning and design of healthcare environments with the evolving concepts of community-centered care, and preventive care rather than treatment (Silvis, 2014; Kraus & Renner, 2016). However, little research has focused on evaluating user’s experience of the main lobby that is evidence-based and associated with a wellness concept in healthcare environments. Therefore, the objectives of this study are: 1) to create user-centered wellness design evaluation criteria to evaluate design of the existing facilities for which future renovation or construction is planned, 2) to examine the importance of design features that are supportive of the physical, emotional, and social experience of users, and 3) to develop and validate design guidelines and a checklist for a main entry lobby that can support design-related decision making by designers and facility managers

User-centred design using Gamestorming

© 2016 IMIA and IOS Press. User-centered design (UX) is becoming a standard in software engineering and has tremendous potential in healthcare. The purpose of this tutorial will be to demonstrate and provide participants with practice in usercentred design methods that involve 'Gamestorming', a form of brainstorming where 'the rules of life are temporarily suspended'. Participants will learn and apply gamestorming methods including persona development via empathy mapping and methods to translate artefacts derived from participatory design sessions into functional and design requirements

Applying User-Centered Design in the Development of a Software Application For the Treatment of a Mental Health Disorder

The research that follows will provide a process for applying a user-centered design methodology to the development of a virtual environment software application for the treatment of a mental health disorder, specifically post traumatic stress disorder (PTSD). The goal is to create a screen-based virtual environment product that focuses on the end user rather than the technological aspects of the system. Moreover, past and present treatments in the mental health and healthcare fields and their effectiveness will be analyzed through an extensive literature review

A Reflection on Virtual Reality Design for Psychological, Cognitive & Behavioral Interventions: Design Needs, Opportunities & Challenges

Despite the substantial research interest in using Virtual Reality (VR) in healthcare in general and in Psychological, Cognitive, and Behavioral (PC&B) interventions in specific, as well as emerging research supporting the efficacy of VR in healthcare, the design process of translating therapies into VR to meet the needs of critical stakeholders such as users and clinicians is rarely addressed. In this paper, we aim to shed light onto the design needs, opportunities and challenges in designing efficient and effective PC&B-VR interventions. Through analyzing the co-design processes of four user-centered PC&B-VR interventions, we examined how therapies were adapted into VR to meet stakeholders’ requirements, explored design elements for meaningful experiences, and investigated how the understanding of healthcare contexts contribute to the VR intervention design. This paper presents the HCI research community with design opportunities and challenges as well as future directions for PC&B-VR intervention design