Erik Duhaime

Gunnar P. Epping, Andrew Caplin, Erik Duhaime et al.

Many operational AI systems depend on large-scale human annotation to detect rare but consequential events (e.g., fraud, defects, and medical abnormalities). When positives are rare, the prevalence effect induces systematic cognitive biases that inflate misses and can propagate through the AI lifecycle via biased training labels. We analyze prior experimental evidence and run a field experiment on DiagnosUs, a medical crowdsourcing platform, in which we hold the true prevalence in the unlabeled stream fixed (20% blasts) while varying (i) the prevalence of positives in the gold-standard feedback stream (20% vs. 50%) and (ii) the response interface (binary labels vs. elicited probabilities). We then post-process probabilistic labels using a linear-in-log-odds recalibration approach at the worker and crowd levels, and train convolutional neural networks on the resulting labels. Balanced feedback and probabilistic elicitation reduce rare-event misses, and pipeline-level recalibration substantially improves both classification performance and probabilistic calibration; these gains carry through to downstream CNN reliability out of sample.

Mingye Gao, Aman Varshney, Shan Chen et al.

Cancer clinical trials often face challenges in recruitment and engagement due to a lack of participant-facing informational and educational resources. This study investigated the potential of Large Language Models (LLMs), specifically GPT4, in generating patient-friendly educational content from clinical trial informed consent forms. Using data from ClinicalTrials.gov, we employed zero-shot learning for creating trial summaries and one-shot learning for developing multiple-choice questions, evaluating their effectiveness through patient surveys and crowdsourced annotation. Results showed that GPT4-generated summaries were both readable and comprehensive, and may improve patients' understanding and interest in clinical trials. The multiple-choice questions demonstrated high accuracy and agreement with crowdsourced annotators. For both resource types, hallucinations were identified that require ongoing human oversight. The findings demonstrate the potential of LLMs "out-of-the-box" to support the generation of clinical trial education materials with minimal trial-specific engineering, but implementation with a human-in-the-loop is still needed to avoid misinformation risks.

Xuhai Xu, Haoyu Hu, Haoran Zhang et al.

Artificial intelligence (AI) is increasingly permeating healthcare, from physician assistants to consumer applications. Since AI algorithm's opacity challenges human interaction, explainable AI (XAI) addresses this by providing AI decision-making insight, but evidence suggests XAI can paradoxically induce over-reliance or bias. We present results from two large-scale experiments (623 lay people; 153 primary care physicians, PCPs) combining a fairness-based diagnosis AI model and different XAI explanations to examine how XAI assistance, particularly multimodal large language models (LLMs), influences diagnostic performance. AI assistance balanced across skin tones improved accuracy and reduced diagnostic disparities. However, LLM explanations yielded divergent effects: lay users showed higher automation bias - accuracy boosted when AI was correct, reduced when AI erred - while experienced PCPs remained resilient, benefiting irrespective of AI accuracy. Presenting AI suggestions first also led to worse outcomes when the AI was incorrect for both groups. These findings highlight XAI's varying impact based on expertise and timing, underscoring LLMs as a "double-edged sword" in medical AI and informing future human-AI collaborative system design.