The clinicians' perspectives on machine learning - Nature.com
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The intended purpose of machine learning (ML) in cardiovascular medicine is to help guide clinical diagnoses as well as promote scientific discovery. Whether ML is implemented by most clinical cardiologists and cardiovascular researchers will likely depend on the successful resolution of concerns fueling hesitancy to embrace ML. This commentary discusses caveats related to ML in clinical practice, and offers suggestions for stakeholders on how to bridge knowledge gaps and clinicians’ misgivings to bring this powerful approach to the clinic to improve care of the patients we serve.
First is a transparency issue. Most clinicians view ML as a black box. Undoubtedly, this leads them to question whether ML can be used to make a decision that may impact life or death. This skepticism is further intensified as most ML developers indeed admit that ML models, such as a deep learning model, can be hard to interpret despite various algorithms developed to tackle this problem. In addition, sometimes ML unveils an entirely new link between biological features and patient outcomes. A great example is a recent publication using deep learning to demonstrate that branching complexity and density of retinal microvasculature is associated with higher risk of cardiovascular disease (CVD)2. As this novel finding has not been validated by any pre-clinical model, the question remains, can we trust the ML-based discoveries not yet corroborated in practice?
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