Raffaele Rasoini

Unintended Consequences of Machine Learning in Medicine.

Over the past decade, machine learning techniques have made substantial advances in many domains. In health care, global interest in the potential of machine learning has increased; for example, a deep learning algorithm has shown high accuracy in detecting diabetic retinopathy.1 There have been suggestions that machine learning will drive changes in health care within a few years, specifically in medical disciplines that require more accurate prognostic models (eg, oncology) and those based on pattern recognition (eg, radiology and pathology). However, comparative studies on the effectiveness of machine learning–based decision support systems (ML-DSS) in medicine are lacking, especially regarding the effects on health outcomes. Moreover, the introduction of new technologies in health care has not always been straightforward or without unintended and adverse effects.2 In this Viewpoint we consider the potential unintended consequences that may result from the application of ML-DSS in clinical practice.

A Giant with Feet of Clay: On the Validity of the Data that Feed Machine Learning in Medicine

This paper considers the use of machine learning in medicine by focusing on the main problem that it has been aimed at solving or at least minimizing: uncertainty. However, we point out how uncertainty is so ingrained in medicine that it biases also the representation of clinical phenomena, that is the very input of this class of computational models, thus undermining the clinical significance of their output. Recognizing this can motivate researchers to pursue different ways to assess the value of these decision aids, as well as alternative techniques that do not “sweep uncertainty under the rug” within an objectivist fiction (which doctors can come up by trusting).

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Over the past decade, machine learning techniques have made substantial advances in many domains. In health care, global interest in the potential of machine learning has increased; for example, a deep learning algorithm has shown high accuracy in detecting diabetic retinopathy.1 There have been suggestions that machine learning will drive changes in health care within a few years, specifically in medical disciplines that require more accurate prognostic models (eg, oncology) and those based on pattern recognition (eg, radiology and pathology). However, comparative studies on the effectiveness of machine learning–based decision support systems (ML-DSS) in medicine are lacking, especially regarding the effects on health outcomes. Moreover, the introduction of new technologies in health care has not always been straightforward or without unintended and adverse effects.2 In this Viewpoint we consider the potential unintended consequences that may result from the application of ML-DSS in clinical practice.

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Over the past decade, machine learning techniques have made substantial advances in many domains. In health care, global interest in the potential of machine learning has increased; for example, a deep learning algorithm has shown high accuracy in detecting diabetic retinopathy.1 There have been suggestions that machine learning will drive changes in health care within a few years, specifically in medical disciplines that require more accurate prognostic models (eg, oncology) and those based on pattern recognition (eg, radiology and pathology). However, comparative studies on the effectiveness of machine learning–based decision support systems (ML-DSS) in medicine are lacking, especially regarding the effects on health outcomes. Moreover, the introduction of new technologies in health care has not always been straightforward or without unintended and adverse effects.2 In this Viewpoint we consider the potential unintended consequences that may result from the application of ML-DSS in clinical practice.

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Over the past decade, machine learning techniques have made substantial advances in many domains. In health care, global interest in the potential of machine learning has increased; for example, a deep learning algorithm has shown high accuracy in detecting diabetic retinopathy.1 There have been suggestions that machine learning will drive changes in health care within a few years, specifically in medical disciplines that require more accurate prognostic models (eg, oncology) and those based on pattern recognition (eg, radiology and pathology). However, comparative studies on the effectiveness of machine learning–based decision support systems (ML-DSS) in medicine are lacking, especially regarding the effects on health outcomes. Moreover, the introduction of new technologies in health care has not always been straightforward or without unintended and adverse effects.2 In this Viewpoint we consider the potential unintended consequences that may result from the application of ML-DSS in clinical practice.

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Over the past decade, machine learning techniques have made substantial advances in many domains. In health care, global interest in the potential of machine learning has increased; for example, a deep learning algorithm has shown high accuracy in detecting diabetic retinopathy.1 There have been suggestions that machine learning will drive changes in health care within a few years, specifically in medical disciplines that require more accurate prognostic models (eg, oncology) and those based on pattern recognition (eg, radiology and pathology). However, comparative studies on the effectiveness of machine learning–based decision support systems (ML-DSS) in medicine are lacking, especially regarding the effects on health outcomes. Moreover, the introduction of new technologies in health care has not always been straightforward or without unintended and adverse effects.2 In this Viewpoint we consider the potential unintended consequences that may result from the application of ML-DSS in clinical practice.

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Over the past decade, machine learning techniques have made substantial advances in many domains. In health care, global interest in the potential of machine learning has increased; for example, a deep learning algorithm has shown high accuracy in detecting diabetic retinopathy.1 There have been suggestions that machine learning will drive changes in health care within a few years, specifically in medical disciplines that require more accurate prognostic models (eg, oncology) and those based on pattern recognition (eg, radiology and pathology). However, comparative studies on the effectiveness of machine learning–based decision support systems (ML-DSS) in medicine are lacking, especially regarding the effects on health outcomes. Moreover, the introduction of new technologies in health care has not always been straightforward or without unintended and adverse effects.2 In this Viewpoint we consider the potential unintended consequences that may result from the application of ML-DSS in clinical practice.

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Over the past decade, machine learning techniques have made substantial advances in many domains. In health care, global interest in the potential of machine learning has increased; for example, a deep learning algorithm has shown high accuracy in detecting diabetic retinopathy.1 There have been suggestions that machine learning will drive changes in health care within a few years, specifically in medical disciplines that require more accurate prognostic models (eg, oncology) and those based on pattern recognition (eg, radiology and pathology). However, comparative studies on the effectiveness of machine learning–based decision support systems (ML-DSS) in medicine are lacking, especially regarding the effects on health outcomes. Moreover, the introduction of new technologies in health care has not always been straightforward or without unintended and adverse effects.2 In this Viewpoint we consider the potential unintended consequences that may result from the application of ML-DSS in clinical practice.

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Over the past decade, machine learning techniques have made substantial advances in many domains. In health care, global interest in the potential of machine learning has increased; for example, a deep learning algorithm has shown high accuracy in detecting diabetic retinopathy.1 There have been suggestions that machine learning will drive changes in health care within a few years, specifically in medical disciplines that require more accurate prognostic models (eg, oncology) and those based on pattern recognition (eg, radiology and pathology). However, comparative studies on the effectiveness of machine learning–based decision support systems (ML-DSS) in medicine are lacking, especially regarding the effects on health outcomes. Moreover, the introduction of new technologies in health care has not always been straightforward or without unintended and adverse effects.2 In this Viewpoint we consider the potential unintended consequences that may result from the application of ML-DSS in clinical practice.

Value of Telemonitoring and Telemedicine in Heart Failure Management

The use of telemonitoring and telemedicine is a relatively new but quickly developing area in medicine. As new digital tools and applications are being created and used to manage medical conditions such as heart failure, many implications require close consideration and further study, including the effectiveness and safety of these telemonitoring tools in diagnosing, treating and managing heart failure compared to traditional face-to-face doctor-patient interaction. When compared to multidisciplinary intervention programs which are frequently hindered by economic, geographic and bureaucratic barriers, non-invasive remote monitoring could be a solution to support and promote the care of patients over time. Therefore it is crucial to identify the most relevant biological parameters to monitor, which heart failure sub-populations may gain real benefits from telehealth interventions and in which specific healthcare subsets these interventions should be implemented in order to maximise value.