Cited by 597Artificial Intelligence in Healthcare and EducationAdversarial Robustness in Machine LearningExplainable Artificial Intelligence (XAI)

The DOI matches its Crossref record; 29 of the 29 references it cites were found in a registry or an index; none of the 20 sources its claims cite is checked for support yet.

The need for uncertainty quantification in machine-assisted medical decision making

Open access
Begoli, Edmon, Bhattacharya, Tanmoy, Kusnezov, Dimitri·2019·Nature Machine Intelligence

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This perspective argues that machine-assisted medical decision making, especially deep learning, requires a principled and formal discipline of uncertainty quantification (UQ) comparable to that used in nuclear stockpile stewardship and risk management. It maps where uncertainty enters the DL pipeline, identifies four overlapping challenge areas, and sketches research directions for building UQ for DL.

Key findings

  • The paper contends that predictions without UQ "are neither predictions nor actionable," and that automated clinical systems not analyzable via known causal connections will require formal UQ to be adopted, as happened in nuclear security.
  • It identifies four overlapping challenge groups for UQ of data-driven approaches: (1) absence of theory (no "hard laws" in medicine), (2) absence of causal models (DL exploits correlations without causal links), (3) sensitivity to imperfect data (missing elements and errors with patterned confounds), and (4) computational expense of recomputation for uncertainty bounds.
  • It proposes that uncertainty must be quantified across at least four pipeline steps: collection/selection of training data and its coverage of the medical phenomenon, accuracy and completeness of labelling, selection and understanding of the DL model and its performance bounds, and model performance against operational (clinical inference) data.
  • It highlights three research directions: quantifying and limiting overfitting (noting classical information criteria fail given DL's parameter counts and capacity to memorize random noise), understanding DL internals, and training DL to provide its own uncertainty estimates—suggesting GANs for detecting out-of-sample cases as "particularly fruitful."
  • Cited (not original) performance claims: DL transfer-learning applications reported performance comparable to human experts or better, and DL function estimators reported performance better than state-of-the-art classical predictive models.

Methods

  • Design: a conceptual/perspective article (no empirical study, dataset, or experiment conducted by the authors).
  • Content: narrative discussion of the role of DL in clinical decision making, the proposed place of UQ, anticipated challenges, and foreseen research directions, illustrated by a figure of uncertainty sources in the DL pipeline.
  • Analysis: argumentative synthesis drawing analogies to UQ practice in nuclear security and risk management; no statistical analysis is performed.

Limitations

  • Stated by the paper: the domains where DL is applied lack underlying mechanistic theory to ground uncertainties; DL lacks causal models, limiting conclusions; real-world data is imperfect with patterned errors that can confound prediction; and recomputation for uncertainty bounds may currently be prohibitively expensive.
  • Evident in the text: the article is a position/perspective piece with no empirical validation, no concrete UQ framework or method proposed, and no quantitative results of its own; the authors explicitly note that "it is possible that the entire new field of UQ for DL might need to be developed" and that a review of ongoing research is beyond its scope.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1038/s42256-018-0004-1

Cites

29 of 29 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

29 Own interpretation · 17 No basis given · 10 Not checked yet

Verify all 20 references — free account

Show all 8 claims

  • Probably not a substantial claim. 44
  • It may state two separate claims as one. 16
48 of 48
  • The paper relies on this without support.

    The reluctance to delegate to machine intelligence a function of life-critical and patient-safety-related decision making is a primary reason for the slow adoption of AI in medicine.

    “There are many reasons for this, primarily the reluctance to delegate to machine intelligence a function of life-critical and patient-safety-related decision making.”
  • The authors state this as an assumption.

    Fair sampling in the training data holds.

    “assuming fair sampling in the training data”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Show all 22 references

Cited by

Sorted by citations

Items 301–400 of 583

Metadata

Authors
Begoli, E., Bhattacharya, T., & Kusnezov, D.
Affiliations
  • Oak Ridge National Laboratory (US)
  • United States Department of Energy (US)
Corresponding author
Begoli, Edmon
Venue
Nature Machine Intelligence
Published
2019-01-07
Volume
1
Issue
1
Pages
20-23
ISSN
2522-5839 (ISSN-L)
OpenAlex
W2904422658
Cited by
597
References
22
Citations by year
2026: 158 · 2025: 102 · 2024: 73 · 2023: 94 · 2022: 72 · 2021: 47 · 2020: 33 · 2019: 16
FWCI
6.47
Type
journal article
Language
en
Open access
Locations
  • Nature Machine Intelligence (publishedVersion)
  • OSTI OAI (U.S. Department of Energy Office of Scientific and Technical Information) (submittedVersion)
Funders
  • Battelle (DE-AC05- 00OR22725, DE-AC05)
  • UT-Battelle (DE-AC05, DEAC05-00OR22725, AC05-00OR22725)
Topics
  • Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
  • Physical Sciences › Computer Science › Artificial Intelligence › Adversarial Robustness in Machine Learning
  • Physical Sciences › Computer Science › Artificial Intelligence › Explainable Artificial Intelligence (XAI)
Keywords
uncertainty quantification, artificial intelligence in healthcare, deep learning, patient safety, trust in AI, forecast uncertainty

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