264 research outputs found

    Repairing Innovation: A Study of Integrating AI in Clinical Care

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    Over the past two years, a multi-disciplinary team of clinicians and technologists associated with Duke University and Duke Health system have developed and implemented Sepsis Watch, a sociotechnical system combining an artificial intelligence (AI) deep learning model with new hospital protocols to raise the quality of sepsis treatment. Sepsis is a widespread and deadly condition that can develop from any infection and is one of the most common causes of death in hospitals. And while sepsis is treatable, it is notoriously difficult to diagnose consistently. This makes sepsis a prime candidate for AI-based interventions, where new approaches to patient data might raise levels of detection, treatment, and, ultimately, patient outcomes in the form of fewer deaths.As an application of AI, the deep learning model tends to eclipse the other parts of the system; in practice, Sepsis Watch is constituted by a complex combination of human labor and expertise, as well as technical and institutional infrastructures. This report brings into focus the critical role of human labor and organizational context in developing an effective clinical intervention by framing Sepsis Watch as a complex sociotechnical system, not just a machine learning model

    Projective model for the moving image

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    Thesis (S.M. in Art, Culture and Technology)--Massachusetts Institute of Technology, Dept. of Architecture, June 2012."June 2012." Cataloged from PDF version of thesis.Includes bibliographical references (p. 72-74).Humanity's desire to record events happening in time has spawned a lineage of moving-image transcription systems, from early cinematographs to contemporary digital camcorder equipment. These technologies have arisen, however, amongst a setting of concentrated discourse surrounding the nature of what it means to exist as a durational being, also happening in time. This thesis will argue that the depiction of events as captured by these technologies is constricting, limited to conveying a strict sequencing of moments through a narrow spatial window, and so wholly inadequate to reflect a nuanced dialogue. I propose a new visual model, one that can assist in conceptualizing the complexity of concurrent remembering, perceiving, and anticipating. Through a combination of my research into existing discourses and the creation of new models of reading the moving image, I have come to the fold (with deep indebtedness to the thinkers and writers who have proffered this model) as an aesthetic structure capable of visualizing, or diagramming, some of the afore-mentioned strata of complexity resistant to the hegemony of linear temporality. To model the fold, I centrally engage the act of reading the moving image, as a definitive temporal act. I redirect the movement and orientation of the eye as it spans the moving image, to make way for new methods of reading, thinking, and being. Digital manipulation and merging of moving video images comprises the material for these models. Finally, this thesis will examine popular practices of how durational events are recorded, stored, shared in the digital environment, and subsequent implications for the writing of historical narrative, where vast and dispersed authorship can contribute to the emergence of conversant modes of being: potential for redemption in the chaotic.by Elizabeth Anne Watkins.S.M.in Art, Culture and Technolog

    "Help Me Help the AI": Understanding How Explainability Can Support Human-AI Interaction

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    Despite the proliferation of explainable AI (XAI) methods, little is understood about end-users' explainability needs. This gap is critical, because end-users may have needs that XAI methods should but don't yet support. To address this gap and contribute to understanding how explainability can support human-AI interaction, we conducted a study of a real-world AI application via interviews with 20 end-users of Merlin, a bird-identification app. We found that people express a need for practically useful information that can improve their collaboration with the AI system, and intend to use XAI explanations for calibrating trust, improving their task skills, changing their behavior to supply better inputs to the AI system, and giving constructive feedback to developers. We also assessed end-users' perceptions of existing XAI approaches, finding that they prefer part-based explanations. Finally, we discuss implications of our findings and provide recommendations for future designs of XAI, specifically XAI for human-AI collaboration

    Does the Addition of Non-Approved Inclusion and Exclusion Criteria for rtPA Impact Treatment Rates? Findings in Australia, the UK, and the USA

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    Background: Strict criteria for recombinant tissue plasminogen activator (rtPA) eligibility are stipulated on licences for use in ischaemic stroke, however, practitioners may also add non-standard rtPA criteria. We examined eligibility criteria variation in 3 English-speaking countries including use of non-standard criteria, in relation to rtPA treatment rates. Methods: Surveys were mailed to 566 eligible hospitals in Australia (AUS), United Kingdom (UK) and the United States (USA). Criteria were pre-classified as standard (approved indication and contraindications ) or non-standard (approved warning or researcher ‘decoy’). Percentage for criterion selection was calculated/compared; linear regression was used to assess the association between use of non-standard criteria and rtPA treatment rates, and to identify factors associated with addition of non-standard criteria. Results: Response rates were 74% AUS, 65% UK, and 68% USA; mean rtPA treatment rates were 8.7% AUS, 12.7% UK and 8.7% USA. Median percentage of non-standard inclusions was 33% (all 3 countries) and included National Institutes of Health Stroke Scale (NIHSS) scores >4, computed tomography (CT) angiography documented occlusion, and favourable CT perfusion. Median percentage of non-standard exclusions was 25% AUS, 28% UK, and 60% USA, and included depressed consciousness, NIHSS>25, and use of antihypertensive infusions. No AUS or UK sites selected 100% of standard exclusions. Conclusions: Non-standard criteria for rtPA eligibility was evident in all three countries and could, in part, explain comparably low use of rtPA. Differences in the use of standard criteria may signify practitioner intolerance for those derived from original efficacy studies that are no longer relevant

    Oral Care Practices in Stroke: Findings from the UK and Australia

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    Aims: To examine current practice, perceptions of healthcare professionals and factors affecting provision for oral care post-stroke in the UK and Australia. Background: Poor oral care has negative health consequences for people post-stroke. Little is known about oral care practice in hospital for people post-stroke and factors affecting provision in different countries. Design: A cross-sectional survey. Methods: Questionnaires were mailed to stroke specialist nurses in UK and Australian hospitals providing inpatient acute or rehabilitation care post-stroke. The survey was conducted between April and November 2019. Non-respondents were contacted up to five times. Results: Completed questionnaires were received from 150/174 (86%) hospitals in the UK, and 120/162 (74%) in Australia. A total of 52% of UK hospitals and 30% of Australian hospitals reported having a general oral care protocol, with 53% of UK and only 13% of Australian hospitals reporting using oral care assessment tools. Of those using oral care assessment tools, 50% of UK and 38% of Australian hospitals used local hospital-specific tools. Oral care assessments were undertaken on admission in 73% of UK and 57% of Australian hospitals. Staff had received oral care training in the last year in 55% of UK and 30% of Australian hospitals. Inadequate training and education on oral care for pre-registration nurses were reported by 63% of UK and 53% of Australian respondents. Conclusion: Unacceptable variability exists in oral care practices in hospital stroke care settings. Oral care could be improved by increasing training, performing individual assessments on admission, and using standardised assessment tools and protocols to guide high quality care. The study highlights the need for incorporating staff training and the use of oral care standardised assessments and protocols in stroke care in order to improve patient outcomes
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