Demystifying the Black Box: The Importance of Interpretability of Predictive Models in Neurocritical Care.

Journal: Neurocritical care
Published Date:

Abstract

Neurocritical care patients are a complex patient population, and to aid clinical decision-making, many models and scoring systems have previously been developed. More recently, techniques from the field of machine learning have been applied to neurocritical care patient data to develop models with high levels of predictive accuracy. However, although these recent models appear clinically promising, their interpretability has often not been considered and they tend to be black box models, making it extremely difficult to understand how the model came to its conclusion. Interpretable machine learning methods have the potential to provide the means to overcome some of these issues but are largely unexplored within the neurocritical care domain. This article examines existing models used in neurocritical care from the perspective of interpretability. Further, the use of interpretable machine learning will be explored, in particular the potential benefits and drawbacks that the techniques may have when applied to neurocritical care data. Finding a solution to the lack of model explanation, transparency, and accountability is important because these issues have the potential to contribute to model trust and clinical acceptance, and, increasingly, regulation is stipulating a right to explanation for decisions made by models and algorithms. To ensure that the prospective gains from sophisticated predictive models to neurocritical care provision can be realized, it is imperative that interpretability of these models is fully considered.

Authors

  • Laura Moss
    Department of Clinical Physics & Bioengineering, NHS Greater Glasgow and Clyde, Room 2.41, Level 2, New Lister Building, Glasgow Royal Infirmary, 10-16 Alexandra Parade, Glasgow, G31 2ER, UK. Laura.Moss@glasgow.ac.uk.
  • David Corsar
    School of Computing, Robert Gordon University, Aberdeen, UK.
  • Martin Shaw
    Department of Clinical Physics & Bioengineering, NHS Greater Glasgow and Clyde, Room 2.41, Level 2, New Lister Building, Glasgow Royal Infirmary, 10-16 Alexandra Parade, Glasgow, G31 2ER, UK.
  • Ian Piper
    Institute of Neurological Sciences, Queen Elizabeth University Hospital, Clinical Physics, Glasgow, Scotland, UK. ian.piper@brainit.org.
  • Christopher Hawthorne
    Wellcome-Wolfson Institute for Experimental Medicine, Queen's University of Belfast, Belfast, Northern Ireland, United Kingdom.