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As over-hyped as artificial intelligence is—everyone’s talking about it, few fully understand it, it might leave us all unemployed but also solve all the world’s problems—its list of accomplishments is growing. AI can now write realistic-sounding text, give a debating champ a run for his money, diagnose illnesses, and generate fake human faces—among much more.
After training these systems on massive datasets, their creators essentially just let them do their thing to arrive at certain conclusions or outcomes. The problem is that more often than not, even the creators don’t know exactly why they’ve arrived at those conclusions or outcomes. There’s no easy way to trace a machine learning system’s rationale, so to speak. The further we let AI go down this opaque path, the more likely we are to end up somewhere we don’t want to be—and may not be able to come back from.
In a panel at the South by Southwest interactive festival last week titled “Ethics and AI: How to plan for the unpredictable,” experts in the field shared their thoughts on building more transparent, explainable, and accountable AI systems.
Not New, but Different
Ryan Welsh, founder and director of explainable AI startup Kyndi, pointed out that having knowledge-based systems perform advanced tasks isn’t new; he cited logistical, scheduling, and tax software as examples. What’s new is the learning component, our inability to trace how that learning occurs, and the ethical implications that could result.
“Now we have these systems that are learning from data, and we’re trying to understand why they’re arriving at certain outcomes,” Welsh said. “We’ve never actually had this broad society discussion about ethics in those scenarios.”
Rather than continuing to build AIs with opaque inner workings, engineers must start focusing on explainability, which Welsh broke down into three subcategories. Transparency and interpretability come first, and refer to being able to find the units of high influence in a machine learning network, as well as the weights of those units and how they map to specific data and outputs.
Then there’s provenance: knowing where something comes from. In an ideal scenario, for example, Open AI’s new text generator would be able to generate citations in its text that reference academic (and human-created) papers or studies.
Explainability itself is the highest and final bar and refers to a system’s ability to explain itself in natural language to the average user by being able to say, “I generated this output because x, y, z.”
“Humans are unique in our ability and our desire to ask why,” said Josh Marcuse, executive director of the Defense Innovation Board, which advises Department of Defense senior leaders on innovation. “The reason we want explanations from people is so we can understand their belief system and see if we agree with it and want to continue to work with them.”
Similarly, we need to have the ability to interrogate AIs.
Two Types of Thinking
Welsh explained that one big barrier standing in the way of explainability is the tension between the deep learning community and the symbolic AI community, which see themselves as two different paradigms and historically haven’t collaborated much.
Symbolic or classical AI focuses on concepts and rules, while deep learning is centered around perceptions. In human thought this is the difference between, for example, deciding to pass a soccer ball to a teammate who is open (you make the decision because conceptually you know that only open players can receive passes), and registering that the ball is at your feet when someone else passes it to you (you’re taking in information without making a decision about it).
“Symbolic AI has abstractions and representation based on logic that’s more humanly comprehensible,” Welsh said. To truly mimic human thinking, AI needs to be able to both perceive information and conceptualize it. An example of perception (deep learning) in an AI is recognizing numbers within an image, while conceptualization (symbolic learning) would give those numbers a hierarchical order and extract rules from the hierachy (4 is greater than 3, and 5 is greater than 4, therefore 5 is also greater than 3).
Explainability comes in when the system can say, “I saw a, b, and c, and based on that decided x, y, or z.” DeepMind and others have recently published papers emphasizing the need to fuse the two paradigms together.
Implications Across Industries
One of the most prominent fields where AI ethics will come into play, and where the transparency and accountability of AI systems will be crucial, is defense. Marcuse said, “We’re accountable beings, and we’re responsible for the choices we make. Bringing in tech or AI to a battlefield doesn’t strip away that meaning and accountability.”
In fact, he added, rather than worrying about how AI might degrade human values, people should be asking how the tech could be used to help us make better moral choices.
It’s also important not to conflate AI with autonomy—a worst-case scenario that springs to mind is an intelligent destructive machine on a rampage. But in fact, Marcuse said, in the defense space, “We have autonomous systems today that don’t rely on AI, and most of the AI systems we’re contemplating won’t be autonomous.”
The US Department of Defense released its 2018 artificial intelligence strategy last month. It includes developing a robust and transparent set of principles for defense AI, investing in research and development for AI that’s reliable and secure, continuing to fund research in explainability, advocating for a global set of military AI guidelines, and finding ways to use AI to reduce the risk of civilian casualties and other collateral damage.
Though these were designed with defense-specific aims in mind, Marcuse said, their implications extend across industries. “The defense community thinks of their problems as being unique, that no one deals with the stakes and complexity we deal with. That’s just wrong,” he said. Making high-stakes decisions with technology is widespread; safety-critical systems are key to aviation, medicine, and self-driving cars, to name a few.
Marcuse believes the Department of Defense can invest in AI safety in a way that has far-reaching benefits. “We all depend on technology to keep us alive and safe, and no one wants machines to harm us,” he said.
A Creation Superior to Its Creator
That said, we’ve come to expect technology to meet our needs in just the way we want, all the time—servers must never be down, GPS had better not take us on a longer route, Google must always produce the answer we’re looking for.
With AI, though, our expectations of perfection may be less reasonable.
“Right now we’re holding machines to superhuman standards,” Marcuse said. “We expect them to be perfect and infallible.” Take self-driving cars. They’re conceived of, built by, and programmed by people, and people as a whole generally aren’t great drivers—just look at traffic accident death rates to confirm that. But the few times self-driving cars have had fatal accidents, there’s been an ensuing uproar and backlash against the industry, as well as talk of implementing more restrictive regulations.
This can be extrapolated to ethics more generally. We as humans have the ability to explain our decisions, but many of us aren’t very good at doing so. As Marcuse put it, “People are emotional, they confabulate, they lie, they’re full of unconscious motivations. They don’t pass the explainability test.”
Why, then, should explainability be the standard for AI?
Even if humans aren’t good at explaining our choices, at least we can try, and we can answer questions that probe at our decision-making process. A deep learning system can’t do this yet, so working towards being able to identify which input data the systems are triggering on to make decisions—even if the decisions and the process aren’t perfect—is the direction we need to head.
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Training a doctor takes years of grueling work in universities and hospitals. Building a doctor may be as easy as teaching an AI how to read.
Artificial intelligence has taken another step towards becoming an integral part of 21st-century medicine. New research out of Guangzhou, China, published February 11th in Nature Medicine Letters, has demonstrated a natural-language processing AI that is capable of out-performing rookie pediatricians in diagnosing common childhood ailments.
The massive study examined the electronic health records (EHR) from nearly 600,000 patients over an 18-month period at the Guangzhou Women and Children’s Medical Center and then compared AI-generated diagnoses against new assessments from physicians with a range of experience.
The verdict? On average, the AI was noticeably more accurate than junior physicians and nearly as reliable as the more senior ones. These results are the latest demonstration that artificial intelligence is on the cusp of becoming a healthcare staple on a global scale.
Less Like a Computer, More Like a Person
To outshine human doctors, the AI first had to become more human. Like IBM’s Watson, the pediatric AI leverages natural language processing, in essence “reading” written notes from EHRs not unlike how a human doctor would review those same records. But the similarities to human doctors don’t end there. The AI is a machine learning classifier (MLC), capable of placing the information learned from the EHRs into categories to improve performance.
Like traditionally-trained pediatricians, the AI broke cases down into major organ groups and infection areas (upper/lower respiratory, gastrointestinal, etc.) before breaking them down even further into subcategories. It could then develop associations between various symptoms and organ groups and use those associations to improve its diagnoses. This hierarchical approach mimics the deductive reasoning human doctors employ.
Another key strength of the AI developed for this study was the enormous size of the dataset collected to teach it: 1,362,559 outpatient visits from 567,498 patients yielded some 101.6 million data points for the MLC to devour on its quest for pediatric dominance. This allowed the AI the depth of learning needed to distinguish and accurately select from the 55 different diagnosis codes across the various organ groups and subcategories.
When comparing against the human doctors, the study used 11,926 records from an unrelated group of children, giving both the MLC and the 20 humans it was compared against an even playing field. The results were clear: while cohorts of senior pediatricians performed better than the AI, junior pediatricians (those with 3-15 years of experience) were outclassed.
Helping, Not Replacing
While the research used a competitive analysis to measure the success of the AI, the results should be seen as anything but hostile to human doctors. The near future of artificial intelligence in medicine will see these machine learning programs augment, not replace, human physicians. The authors of the study specifically call out augmentation as the key short-term application of their work. Triaging incoming patients via intake forms, performing massive metastudies using EHRs, providing rapid ‘second opinions’—the applications for an AI doctor that is better-but-not-the-best are as varied as the healthcare industry itself.
That’s only considering how artificial intelligence could make a positive impact immediately upon implementation. It’s easy to see how long-term use of a diagnostic assistant could reshape the way modern medical institutions approach their work.
Look at how the MLC results fit snugly between the junior and senior physician groups. Essentially, it took nearly 15 years before a physician could consistently out-diagnose the machine. That’s a decade and a half wherein an AI diagnostic assistant would be an invaluable partner—both as a training tool and a safety measure. Likewise, on the other side of the experience curve you have physicians whose performance could be continuously leveraged to improve the AI’s effectiveness. This is a clear opportunity for a symbiotic relationship, with humans and machines each assisting the other as they mature.
Closer to Us, But Still Dependent on Us
No matter the ultimate application, the AI doctors of the future are drawing nearer to us step by step. This latest research is a demonstration that artificial intelligence can mimic the results of human deductive reasoning even in some of the most complex and important decision-making processes. True, the MLC required input from humans to function; both the initial data points and the cases used to evaluate the AI depended on EHRs written by physicians. While every effort was made to design a test schema that removed any indication of the eventual diagnosis, some “data leakage” is bound to occur.
In other words, when AIs use human-created data, they inherit human insight to some degree. Yet the progress made in machine imaging, chatbots, sensors, and other fields all suggest that this dependence on human input is more about where we are right now than where we could be in the near future.
Data, and More Data
That near future may also have some clear winners and losers. For now, those winners seem to be the institutions that can capture and apply the largest sets of data. With a rapidly digitized society gathering incredible amounts of data, China has a clear advantage. Combined with their relatively relaxed approach to privacy, they are likely to continue as one of the driving forces behind machine learning and its applications. So too will Google/Alphabet with their massive medical studies. Data is the uranium in this AI arms race, and everyone seems to be scrambling to collect more.
In a global community that seems increasingly aware of the potential problems arising from this need for and reliance on data, it’s nice to know there’ll be an upside as well. The technology behind AI medical assistants is looking more and more mature—even if we are still struggling to find exactly where, when, and how that technology should first become universal.
Yet wherever we see the next push to make AI a standard tool in a real-world medical setting, I have little doubt it will greatly improve the lives of human patients. Today Doctor AI is performing as well as a human colleague with more than 10 years of experience. By next year or so, it may take twice as long for humans to be competitive. And in a decade, the combined medical knowledge of all human history may be a tool as common as a stethoscope in your doctor’s hands.
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