Mildred Cho, PhD
Professor of Pediatrics, Center of Biomedical Ethics
Professor of Medicine, Primary Care and Population Health
Stanford University
Title: Facilitating Patient and Clinician Value Considerations into AI for Precision Medicine
Abstract:
For the development of ethical machine learning (ML) for precision medicine, it is essential to understand how values play into the decision-making process of developers. We conducted five group design exercises with four developer participants each (N=20) who were asked to discuss and record their design considerations in a series of three hypothetical scenarios involving the design of a tool to predict progression to diabetes. In each group, the scenario was first presented as a research project, then as development of a clinical tool for a health care system, and finally as development of a clinical tool for their own health care system. Throughout, developers documented their process considerations using a virtual collaborative whiteboard platform. Our results suggest that developers more often considered client or user perspectives after changing the context of the scenario from research to a tool for a large healthcare setting. Furthermore, developers were more likely to express concerns arising from the patient perspective and societal and ethical issues such as protection of privacy after imagining themselves as patients in the health care system. Qualitative and quantitative data analysis also revealed that developers made reflective/reflexive statements more often in the third round of the design activity (44 times) than in the first (2) or second (6) rounds. These statements included statements on how the activity connected to their real-life work, what they could take away from the exercises and integrate into actual practice, and commentary on being patients within a health care system using AI. These findings suggest that ML developers can be encouraged to link the consequences of their actions to design choices by encouraging “empathy work” that directs them to take perspectives of specific stakeholder groups. This research could inform the creation of educational resources and exercises for developers to better align daily practices with stakeholder values and ethical ML design.