Rethinking Human-AI Collaboration in Complex Medical Decision Making: A Case Study in Sepsis Diagnosis.

Shao Zhang, Jianing Yu, Xuhai Xu, Changchang Yin, Yuxuan Lu, Bingsheng Yao, Melanie Tory, Lace M Padilla, Jeffrey Caterino, Ping Zhang, Dakuo Wang
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Abstract

Today's AI systems for medical decision support often succeed on benchmark datasets in research papers but fail in real-world deployment. This work focuses on the decision making of sepsis, an acute life-threatening systematic infection that requires an early diagnosis with high uncertainty from the clinician. Our aim is to explore the design requirements for AI systems that can support clinical experts in making better decisions for the early diagnosis of sepsis. The study begins with a formative study investigating why clinical experts abandon an existing AI-powered Sepsis predictive module in their electrical health record (EHR) system. We argue that a human-centered AI system needs to support human experts in the intermediate stages of a medical decision-making process (e.g., generating hypotheses or gathering data), instead of focusing only on the final decision. Therefore, we build SepsisLab based on a state-of-the-art AI algorithm and extend it to predict the future projection of sepsis development, visualize the prediction uncertainty, and propose actionable suggestions (i.e., which additional laboratory tests can be collected) to reduce such uncertainty. Through heuristic evaluation with six clinicians using our prototype system, we demonstrate that SepsisLab enables a promising human-AI collaboration paradigm for the future of AI-assisted sepsis diagnosis and other high-stakes medical decision making.

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反思复杂医疗决策中的人机协作:败血症诊断案例研究》。
当今用于医疗决策支持的人工智能系统往往在研究论文中的基准数据集上取得成功,但在实际应用中却失败了。这项工作的重点是败血症的决策制定,败血症是一种危及生命的急性系统性感染,需要临床医生在高度不确定的情况下进行早期诊断。我们的目标是探索人工智能系统的设计要求,以支持临床专家为败血症的早期诊断做出更好的决策。这项研究从一项形成性研究开始,调查临床专家为何放弃电子健康记录(EHR)系统中现有的人工智能脓毒症预测模块。我们认为,以人为本的人工智能系统需要在医疗决策过程的中间阶段(如生成假设或收集数据)为人类专家提供支持,而不是只关注最终决策。因此,我们基于最先进的人工智能算法建立了败血症实验室(SepsisLab),并对其进行了扩展,以预测败血症的未来发展预测,将预测的不确定性可视化,并提出可操作的建议(即可以收集哪些额外的实验室测试)以减少这种不确定性。通过对使用我们原型系统的六位临床医生进行启发式评估,我们证明了脓毒症实验室为未来人工智能辅助脓毒症诊断和其他高风险医疗决策提供了一种前景广阔的人类-人工智能合作模式。
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