N. Lance Downing

Daniel Lopez-Martinez, Alex Yakubovich, Martin Seneviratne et al.

While it has been well known in the ML community that deep learning models suffer from instability, the consequences for healthcare deployments are under characterised. We study the stability of different model architectures trained on electronic health records, using a set of outpatient prediction tasks as a case study. We show that repeated training runs of the same deep learning model on the same training data can result in significantly different outcomes at a patient level even though global performance metrics remain stable. We propose two stability metrics for measuring the effect of randomness of model training, as well as mitigation strategies for improving model stability.

Alison Callahan, Duncan McElfresh, Juan M. Banda et al.

The impact of using artificial intelligence (AI) to guide patient care or operational processes is an interplay of the AI model's output, the decision-making protocol based on that output, and the capacity of the stakeholders involved to take the necessary subsequent action. Estimating the effects of this interplay before deployment, and studying it in real time afterwards, are essential to bridge the chasm between AI model development and achievable benefit. To accomplish this, the Data Science team at Stanford Health Care has developed a Testing and Evaluation (T&E) mechanism to identify fair, useful and reliable AI models (FURM) by conducting an ethical review to identify potential value mismatches, simulations to estimate usefulness, financial projections to assess sustainability, as well as analyses to determine IT feasibility, design a deployment strategy, and recommend a prospective monitoring and evaluation plan. We report on FURM assessments done to evaluate six AI guided solutions for potential adoption, spanning clinical and operational settings, each with the potential to impact from several dozen to tens of thousands of patients each year. We describe the assessment process, summarize the six assessments, and share our framework to enable others to conduct similar assessments. Of the six solutions we assessed, two have moved into a planning and implementation phase. Our novel contributions - usefulness estimates by simulation, financial projections to quantify sustainability, and a process to do ethical assessments - as well as their underlying methods and open source tools, are available for other healthcare systems to conduct actionable evaluations of candidate AI solutions.

David Xue, Anin Sayana, Evan Darke et al.

As the senior population rapidly increases, it is challenging yet crucial to provide effective long-term care for seniors who live at home or in senior care facilities. Smart senior homes, which have gained widespread interest in the healthcare community, have been proposed to improve the well-being of seniors living independently. In particular, non-intrusive, cost-effective sensors placed in these senior homes enable gait characterization, which can provide clinically relevant information including mobility level and early neurodegenerative disease risk. In this paper, we present a method to perform gait analysis from a single camera placed within the home. We show that we can accurately calculate various gait parameters, demonstrating the potential for our system to monitor the long-term gait of seniors and thus aid clinicians in understanding a patient's medical profile.