Natalie Harris

Subhrajit Roy, Diana Mincu, Lev Proleev et al.

Literature on machine learning for multiple sclerosis has primarily focused on the use of neuroimaging data such as magnetic resonance imaging and clinical laboratory tests for disease identification. However, studies have shown that these modalities are not consistent with disease activity such as symptoms or disease progression. Furthermore, the cost of collecting data from these modalities is high, leading to scarce evaluations. In this work, we used multi-dimensional, affordable, physical and smartphone-based performance outcome measures (POM) in conjunction with demographic data to predict multiple sclerosis disease progression. We performed a rigorous benchmarking exercise on two datasets and present results across 13 clinically actionable prediction endpoints and 6 machine learning models. To the best of our knowledge, our results are the first to show that it is possible to predict disease progression using POMs and demographic data in the context of both clinical trials and smartphone-base studies by using two datasets. Moreover, we investigate our models to understand the impact of different POMs and demographics on model performance through feature ablation studies. We also show that model performance is similar across different demographic subgroups (based on age and sex). To enable this work, we developed an end-to-end reusable pre-processing and machine learning framework which allows quicker experimentation over disparate MS datasets.

Eric Loreaux, Ke Yu, Jonas Kemp et al.

Machine learning systems show significant promise for forecasting patient adverse events via risk scores. However, these risk scores implicitly encode assumptions about future interventions that the patient is likely to receive, based on the intervention policy present in the training data. Without this important context, predictions from such systems are less interpretable for clinicians. We propose a joint model of intervention policy and adverse event risk as a means to explicitly communicate the model's assumptions about future interventions. We develop such an intervention policy model on MIMIC-III, a real world de-identified ICU dataset, and discuss some use cases that highlight the utility of this approach. We show how combining typical risk scores, such as the likelihood of mortality, with future intervention probability scores leads to more interpretable clinical predictions.

Ibtihel Amara, Ahmed Imtiaz Humayun, Ivana Kajic et al.

Concept erasure techniques have recently gained significant attention for their potential to remove unwanted concepts from text-to-image models. While these methods often demonstrate promising results in controlled settings, their robustness in real-world applications and suitability for deployment remain uncertain. In this work, we (1) identify a critical gap in evaluating sanitized models, particularly in assessing their performance across diverse concept dimensions, and (2) systematically analyze the failure modes of text-to-image models post-erasure. We focus on the unintended consequences of concept removal on non-target concepts across different levels of interconnected relationships including visually similar, binomial, and semantically related concepts. To address this, we introduce EraseBench, a comprehensive benchmark for evaluating post-erasure performance. EraseBench includes over 100 curated concepts, targeted evaluation prompts, and a robust set of metrics to assess both effectiveness and side effects of erasure. Our findings reveal a phenomenon of concept entanglement, where erasure leads to unintended suppression of non-target concepts, causing spillover degradation that manifests as distortions and a decline in generation quality.

Stephen R. Pfohl, Natalie Harris, Chirag Nagpal et al.

Disaggregated evaluation across subgroups is critical for assessing the fairness of machine learning models, but its uncritical use can mislead practitioners. We show that equal performance across subgroups is an unreliable measure of fairness when data are representative of the relevant populations but reflective of real-world disparities. Furthermore, when data are not representative due to selection bias, both disaggregated evaluation and alternative approaches based on conditional independence testing may be invalid without explicit assumptions regarding the bias mechanism. We use causal graphical models to characterize fairness properties and metric stability across subgroups under different data generating processes. Our framework suggests complementing disaggregated evaluations with explicit causal assumptions and analysis to control for confounding and distribution shift, including conditional independence testing and weighted performance estimation. These findings have broad implications for how practitioners design and interpret model assessments given the ubiquity of disaggregated evaluation.

Amir Taubenfeld, Zorik Gekhman, Lior Nezry et al.

As LLMs integrate into our daily lives, understanding their behavior becomes essential. In this work, we focus on behavioral dispositions$-$the underlying tendencies that shape responses in social contexts$-$and introduce a framework to study how closely the dispositions expressed by LLMs align with those of humans. Our approach is grounded in established psychological questionnaires but adapts them for LLMs by transforming human self-report statements into Situational Judgment Tests (SJTs). These SJTs assess behavior by eliciting natural recommendations in realistic user-assistant scenarios. We generate 2,500 SJTs, each validated by three human annotators, and collect preferred actions from 10 annotators per SJT, from a large pool of 550 participants. In a comprehensive study involving 25 LLMs, we find that models often do not reflect the distribution of human preferences: (1) in scenarios with low human consensus, LLMs consistently exhibit overconfidence in a single response; (2) when human consensus is high, smaller models deviate significantly, and even some frontier models do not reflect the consensus in 15-20% of cases; (3) traits can exhibit cross-LLM patterns, e.g., LLMs may encourage emotion expression in contexts where human consensus favors composure. Lastly, mapping psychometric statements directly to behavioral scenarios presents a unique opportunity to evaluate the predictive validity of self-reports, revealing considerable gaps between LLMs' stated values and their revealed behavior.

Elahe Vedadi, David Barrett, Natalie Harris et al.

Recent work has demonstrated the promise of conversational AI systems for diagnostic dialogue. However, real-world assurance of patient safety means that providing individual diagnoses and treatment plans is considered a regulated activity by licensed professionals. Furthermore, physicians commonly oversee other team members in such activities, including nurse practitioners (NPs) or physician assistants/associates (PAs). Inspired by this, we propose a framework for effective, asynchronous oversight of the Articulate Medical Intelligence Explorer (AMIE) AI system. We propose guardrailed-AMIE (g-AMIE), a multi-agent system that performs history taking within guardrails, abstaining from individualized medical advice. Afterwards, g-AMIE conveys assessments to an overseeing primary care physician (PCP) in a clinician cockpit interface. The PCP provides oversight and retains accountability of the clinical decision. This effectively decouples oversight from intake and can thus happen asynchronously. In a randomized, blinded virtual Objective Structured Clinical Examination (OSCE) of text consultations with asynchronous oversight, we compared g-AMIE to NPs/PAs or a group of PCPs under the same guardrails. Across 60 scenarios, g-AMIE outperformed both groups in performing high-quality intake, summarizing cases, and proposing diagnoses and management plans for the overseeing PCP to review. This resulted in higher quality composite decisions. PCP oversight of g-AMIE was also more time-efficient than standalone PCP consultations in prior work. While our study does not replicate existing clinical practices and likely underestimates clinicians' capabilities, our results demonstrate the promise of asynchronous oversight as a feasible paradigm for diagnostic AI systems to operate under expert human oversight for enhancing real-world care.

Jessica Schrouff, Natalie Harris, Oluwasanmi Koyejo et al.

Diagnosing and mitigating changes in model fairness under distribution shift is an important component of the safe deployment of machine learning in healthcare settings. Importantly, the success of any mitigation strategy strongly depends on the structure of the shift. Despite this, there has been little discussion of how to empirically assess the structure of a distribution shift that one is encountering in practice. In this work, we adopt a causal framing to motivate conditional independence tests as a key tool for characterizing distribution shifts. Using our approach in two medical applications, we show that this knowledge can help diagnose failures of fairness transfer, including cases where real-world shifts are more complex than is often assumed in the literature. Based on these results, we discuss potential remedies at each step of the machine learning pipeline.