Explainable and Interpretable Machine Learning for Antimicrobial Stewardship: Opportunities and Challenges.

Journal: Clinical therapeutics
PMID:

Abstract

There is growing interest in exploiting the advances in artificial intelligence and machine learning (ML) for improving and monitoring antimicrobial prescriptions in line with antimicrobial stewardship principles. Against this background, the concepts of interpretability and explainability are becoming increasingly essential to understanding how ML algorithms could predict antimicrobial resistance or recommend specific therapeutic agents, to avoid unintended biases related to the "black box" nature of complex models. In this commentary, we review and discuss some relevant topics on the use of ML algorithms for antimicrobial stewardship interventions, highlighting opportunities and challenges, with particular attention paid to interpretability and explainability of employed models. As in other fields of medicine, the exponential growth of artificial intelligence and ML indicates the potential for improving the efficacy of antimicrobial stewardship interventions, at least in part by reducing time-consuming tasks for overwhelmed health care personnel. Improving our knowledge about how complex ML models work could help to achieve crucial advances in promoting the appropriate use of antimicrobials, as well as in preventing antimicrobial resistance selection and dissemination.

Authors

  • Daniele Roberto Giacobbe
    Department of Health Sciences, University of Genoa, Genoa, Italy; UO Clinica Malattie Infettive, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy. Electronic address: danieleroberto.giacobbe@unige.it.
  • Cristina Marelli
    UO Clinica Malattie Infettive, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy.
  • Sabrina Guastavino
    Department of Mathematics, University of Genoa, Genoa, Italy.
  • Sara Mora
    Department of Informatics, Bioengineering, Robotics and System Engineering (DIBRIS), University of Genoa, Italy.
  • Nicola Rosso
    UO Information and Communication Technologies, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy.
  • Alessio Signori
    Section of Biostatistics, Department of Health Sciences, University of Genoa, Genoa, Italy.
  • Cristina Campi
    IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
  • Mauro Giacomini
    DIBRIS, University of Genoa, Genoa, Italy.
  • Matteo Bassetti
    Department of Health Sciences, University of Genoa, Genoa, Italy; UO Clinica Malattie Infettive, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy.