Artificial Intelligence and Black-Box Medical Decisions: Accuracy versus Explainability

The Hastings Center Report
Alex John London

Abstract

Although decision-making algorithms are not new to medicine, the availability of vast stores of medical data, gains in computing power, and breakthroughs in machine learning are accelerating the pace of their development, expanding the range of questions they can address, and increasing their predictive power. In many cases, however, the most powerful machine learning techniques purchase diagnostic or predictive accuracy at the expense of our ability to access "the knowledge within the machine." Without an explanation in terms of reasons or a rationale for particular decisions in individual cases, some commentators regard ceding medical decision-making to black box systems as contravening the profound moral responsibilities of clinicians. I argue, however, that opaque decisions are more common in medicine than critics realize. Moreover, as Aristotle noted over two millennia ago, when our knowledge of causal systems is incomplete and precarious-as it often is in medicine-the ability to explain how results are produced can be less important than the ability to produce such results and empirically verify their accuracy.

References

May 16, 1987·Lancet·R Swartout
Mar 23, 2011·PLoS Medicine·Jonathan Kimmelman, Alex John London
Jan 30, 2015·The Hastings Center Report·Jonathan Kimmelman, Alex John London
Jun 14, 2016·JAMA Internal Medicine·Alex John London, Jonathan Kimmelman
Nov 30, 2016·JAMA : the Journal of the American Medical Association·Varun GulshanDale R Webster
Oct 22, 2018·The Lancet. Respiratory Medicine· The Lancet Respiratory Medicine

❮ Previous
Next ❯

Citations

Feb 28, 2020·Journal of the American Medical Informatics Association : JAMIA·William K DiproseReece Robinson
Nov 22, 2019·Journal of Medical Ethics·Thomas Grote, Philipp Berens
Jan 11, 2020·Anesthesia and Analgesia·Danton S Char, Alyssa Burgart
Oct 11, 2019·Academic Medicine : Journal of the Association of American Medical Colleges·Holly Fernandez LynchSuzanne M Rivera
Mar 30, 2020·Journal of Medical Ethics·Joshua James Hatherley
May 30, 2020·International Journal of Oncology·Eleftherios TrivizakisKostas Marias
Oct 5, 2019·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·Samer EllahhamMecit Can Emre Simsekler
Jul 6, 2020·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Scott D NelsonThomas A Lasko
Jul 20, 2019·Acta Radiologica Open·Emre Pakdemirli
Apr 8, 2020·Frontiers in Psychology·Leda TortoraStefano Ferracuti
Oct 1, 2020·World Journal of Gastroenterology : WJG·Yu-Hang ZhangBing Hu
Dec 12, 2019·Intensive Care Medicine Experimental·Michael BeilPeter Vernon van Heerden
Feb 26, 2020·Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·Philipp BerensFocke Ziemssen
Sep 10, 2020·Medical Devices : Evidence and Research·Anmol Arora
Sep 26, 2020·Frontiers in Surgery·Michael ChangAlexander R Vaccaro
Mar 24, 2020·Journal of the American Heart Association·Patrick A GladdingTodd T Schlegel
Jul 19, 2019·Medicine, Health Care, and Philosophy·Mark R Tonelli, Jon Williamson
Oct 13, 2020·Stroke; a Journal of Cerebral Circulation·Gianluca BrugnaraPhilipp Vollmuth
Nov 10, 2020·Journal of Evaluation in Clinical Practice·T J Kasperbauer
Dec 2, 2020·BMC Medical Informatics and Decision Making·Julia AmannUNKNOWN Precise4Q consortium
Jan 30, 2021·Experimental Neurology·Fabian EitelKerstin Ritter
Oct 29, 2020·AI & Society·Maximilian Kiener
Nov 24, 2020·Frontiers in Public Health·Sonu BhaskarMaciej Banach
Mar 4, 2021·Advances in Health Sciences Education : Theory and Practice·Gali Katznelson, Sara Gerke
Mar 17, 2021·FEMS Microbiology Reviews·Stephen J GoodswenJohn T Ellis
Aug 24, 2020·Artificial Intelligence in Medicine·Thomas Ploug, Søren Holm
Jan 30, 2021·American Journal of Physiology. Heart and Circulatory Physiology·Ana María Sánchez de la NavaFrancisco Fernández-Avilés
Apr 7, 2021·The Hastings Center Report·Ryan Marshall Felder
Apr 23, 2021·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Lohit VelagapudiStavropoula Tjoumakaris
May 5, 2021·Proceedings of the National Academy of Sciences of the United States of America·Gavin G McDonaldOliver Zahn
May 20, 2021·Journal of Medical Ethics·Chang Ho YoonNaomi Scheinerman
Jun 16, 2021·Circulation. Cardiovascular Imaging·Brandon K Fornwalt, John M Pfeifer
Jun 22, 2021·The American Journal of Bioethics : AJOB·Ramón Alvarado, Nicolae Morar
Jul 31, 2021·Journal of General Internal Medicine·Alexandra K LeeSei J Lee
Mar 14, 2021·Medicine, Health Care, and Philosophy·Georg StarkeBernice S Elger
Jul 8, 2021·Current Opinion in Ophthalmology·Ciara O'ByrnePearse A Keane
Sep 1, 2021·BMC Medical Informatics and Decision Making·Christine AndersonIvo D Dinov

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

The Korean Journal of Internal Medicine
Ki-Jo Kim, Ilias Tagkopoulos
Science Translational Medicine
W Nicholson Price
Translational Research : the Journal of Laboratory and Clinical Medicine
Stephanie RobertsonJohan Hartman
© 2022 Meta ULC. All rights reserved