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    2023-24 Takeda Fellows: Advancing research at the intersection of AI and health

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    The School of Engineering has selected 13 new Takeda Fellows for the 2023-24 academic year. With support from Takeda, the graduate students will conduct pathbreaking research ranging from remote health monitoring for virtual clinical trials to ingestible devices for at-home, long-term diagnostics.

    Now in its fourth year, the MIT-Takeda Program, a collaboration between MIT’s School of Engineering and Takeda, fuels the development and application of artificial intelligence capabilities to benefit human health and drug development. Part of the Abdul Latif Jameel Clinic for Machine Learning in Health, the program coalesces disparate disciplines, merges theory and practical implementation, combines algorithm and hardware innovations, and creates multidimensional collaborations between academia and industry.

    The 2023-24 Takeda Fellows are:

    Adam Gierlach

    Adam Gierlach is a PhD candidate in the Department of Electrical Engineering and Computer Science. Gierlach’s work combines innovative biotechnology with machine learning to create ingestible devices for advanced diagnostics and delivery of therapeutics. In his previous work, Gierlach developed a non-invasive, ingestible device for long-term gastric recordings in free-moving patients. With the support of a Takeda Fellowship, he will build on this pathbreaking work by developing smart, energy-efficient, ingestible devices powered by application-specific integrated circuits for at-home, long-term diagnostics. These revolutionary devices — capable of identifying, characterizing, and even correcting gastrointestinal diseases — represent the leading edge of biotechnology. Gierlach’s innovative contributions will help to advance fundamental research on the enteric nervous system and help develop a better understanding of gut-brain axis dysfunctions in Parkinson’s disease, autism spectrum disorder, and other prevalent disorders and conditions.

    Vivek Gopalakrishnan

    Vivek Gopalakrishnan is a PhD candidate in the Harvard-MIT Program in Health Sciences and Technology. Gopalakrishnan’s goal is to develop biomedical machine-learning methods to improve the study and treatment of human disease. Specifically, he employs computational modeling to advance new approaches for minimally invasive, image-guided neurosurgery, offering a safe alternative to open brain and spinal procedures. With the support of a Takeda Fellowship, Gopalakrishnan will develop real-time computer vision algorithms that deliver high-quality, 3D intraoperative image guidance by extracting and fusing information from multimodal neuroimaging data. These algorithms could allow surgeons to reconstruct 3D neurovasculature from X-ray angiography, thereby enhancing the precision of device deployment and enabling more accurate localization of healthy versus pathologic anatomy.

    Hao He

    Hao He is a PhD candidate in the Department of Electrical Engineering and Computer Science. His research interests lie at the intersection of generative AI, machine learning, and their applications in medicine and human health, with a particular emphasis on passive, continuous, remote health monitoring to support virtual clinical trials and health-care management. More specifically, He aims to develop trustworthy AI models that promote equitable access and deliver fair performance independent of race, gender, and age. In his past work, He has developed monitoring systems applied in clinical studies of Parkinson’s disease, Alzheimer’s disease, and epilepsy. Supported by a Takeda Fellowship, He will develop a novel technology for the passive monitoring of sleep stages (using radio signaling) that seeks to address existing gaps in performance across different demographic groups. His project will tackle the problem of imbalance in available datasets and account for intrinsic differences across subpopulations, using generative AI and multi-modality/multi-domain learning, with the goal of learning robust features that are invariant to different subpopulations. He’s work holds great promise for delivering advanced, equitable health-care services to all people and could significantly impact health care and AI.

    Chengyi Long

    Chengyi Long is a PhD candidate in the Department of Civil and Environmental Engineering. Long’s interdisciplinary research integrates the methodology of physics, mathematics, and computer science to investigate questions in ecology. Specifically, Long is developing a series of potentially groundbreaking techniques to explain and predict the temporal dynamics of ecological systems, including human microbiota, which are essential subjects in health and medical research. His current work, supported by a Takeda Fellowship, is focused on developing a conceptual, mathematical, and practical framework to understand the interplay between external perturbations and internal community dynamics in microbial systems, which may serve as a key step toward finding bio solutions to health management. A broader perspective of his research is to develop AI-assisted platforms to anticipate the changing behavior of microbial systems, which may help to differentiate between healthy and unhealthy hosts and design probiotics for the prevention and mitigation of pathogen infections. By creating novel methods to address these issues, Long’s research has the potential to offer powerful contributions to medicine and global health.

    Omar Mohd

    Omar Mohd is a PhD candidate in the Department of Electrical Engineering and Computer Science. Mohd’s research is focused on developing new technologies for the spatial profiling of microRNAs, with potentially important applications in cancer research. Through innovative combinations of micro-technologies and AI-enabled image analysis to measure the spatial variations of microRNAs within tissue samples, Mohd hopes to gain new insights into drug resistance in cancer. This work, supported by a Takeda Fellowship, falls within the emerging field of spatial transcriptomics, which seeks to understand cancer and other diseases by examining the relative locations of cells and their contents within tissues. The ultimate goal of Mohd’s current project is to find multidimensional patterns in tissues that may have prognostic value for cancer patients. One valuable component of his work is an open-source AI program developed with collaborators at Beth Israel Deaconess Medical Center and Harvard Medical School to auto-detect cancer epithelial cells from other cell types in a tissue sample and to correlate their abundance with the spatial variations of microRNAs. Through his research, Mohd is making innovative contributions at the interface of microsystem technology, AI-based image analysis, and cancer treatment, which could significantly impact medicine and human health.

    Sanghyun Park

    Sanghyun Park is a PhD candidate in the Department of Mechanical Engineering. Park specializes in the integration of AI and biomedical engineering to address complex challenges in human health. Drawing on his expertise in polymer physics, drug delivery, and rheology, his research focuses on the pioneering field of in-situ forming implants (ISFIs) for drug delivery. Supported by a Takeda Fellowship, Park is currently developing an injectable formulation designed for long-term drug delivery. The primary goal of his research is to unravel the compaction mechanism of drug particles in ISFI formulations through comprehensive modeling and in-vitro characterization studies utilizing advanced AI tools. He aims to gain a thorough understanding of this unique compaction mechanism and apply it to drug microcrystals to achieve properties optimal for long-term drug delivery. Beyond these fundamental studies, Park’s research also focuses on translating this knowledge into practical applications in a clinical setting through animal studies specifically aimed at extending drug release duration and improving mechanical properties. The innovative use of AI in developing advanced drug delivery systems, coupled with Park’s valuable insights into the compaction mechanism, could contribute to improving long-term drug delivery. This work has the potential to pave the way for effective management of chronic diseases, benefiting patients, clinicians, and the pharmaceutical industry.

    Huaiyao Peng

    Huaiyao Peng is a PhD candidate in the Department of Biological Engineering. Peng’s research interests are focused on engineered tissue, microfabrication platforms, cancer metastasis, and the tumor microenvironment. Specifically, she is advancing novel AI techniques for the development of pre-cancer organoid models of high-grade serous ovarian cancer (HGSOC), an especially lethal and difficult-to-treat cancer, with the goal of gaining new insights into progression and effective treatments. Peng’s project, supported by a Takeda Fellowship, will be one of the first to use cells from serous tubal intraepithelial carcinoma lesions found in the fallopian tubes of many HGSOC patients. By examining the cellular and molecular changes that occur in response to treatment with small molecule inhibitors, she hopes to identify potential biomarkers and promising therapeutic targets for HGSOC, including personalized treatment options for HGSOC patients, ultimately improving their clinical outcomes. Peng’s work has the potential to bring about important advances in cancer treatment and spur innovative new applications of AI in health care. 

    Priyanka Raghavan

    Priyanka Raghavan is a PhD candidate in the Department of Chemical Engineering. Raghavan’s research interests lie at the frontier of predictive chemistry, integrating computational and experimental approaches to build powerful new predictive tools for societally important applications, including drug discovery. Specifically, Raghavan is developing novel models to predict small-molecule substrate reactivity and compatibility in regimes where little data is available (the most realistic regimes). A Takeda Fellowship will enable Raghavan to push the boundaries of her research, making innovative use of low-data and multi-task machine learning approaches, synthetic chemistry, and robotic laboratory automation, with the goal of creating an autonomous, closed-loop system for the discovery of high-yielding organic small molecules in the context of underexplored reactions. Raghavan’s work aims to identify new, versatile reactions to broaden a chemist’s synthetic toolbox with novel scaffolds and substrates that could form the basis of essential drugs. Her work has the potential for far-reaching impacts in early-stage, small-molecule discovery and could help make the lengthy drug-discovery process significantly faster and cheaper.

    Zhiye Song

    Zhiye “Zoey” Song is a PhD candidate in the Department of Electrical Engineering and Computer Science. Song’s research integrates cutting-edge approaches in machine learning (ML) and hardware optimization to create next-generation, wearable medical devices. Specifically, Song is developing novel approaches for the energy-efficient implementation of ML computation in low-power medical devices, including a wearable ultrasound “patch” that captures and processes images for real-time decision-making capabilities. Her recent work, conducted in collaboration with clinicians, has centered on bladder volume monitoring; other potential applications include blood pressure monitoring, muscle diagnosis, and neuromodulation. With the support of a Takeda Fellowship, Song will build on that promising work and pursue key improvements to existing wearable device technologies, including developing low-compute and low-memory ML algorithms and low-power chips to enable ML on smart wearable devices. The technologies emerging from Song’s research could offer exciting new capabilities in health care, enabling powerful and cost-effective point-of-care diagnostics and expanding individual access to autonomous and continuous medical monitoring.

    Peiqi Wang

    Peiqi Wang is a PhD candidate in the Department of Electrical Engineering and Computer Science. Wang’s research aims to develop machine learning methods for learning and interpretation from medical images and associated clinical data to support clinical decision-making. He is developing a multimodal representation learning approach that aligns knowledge captured in large amounts of medical image and text data to transfer this knowledge to new tasks and applications. Supported by a Takeda Fellowship, Wang will advance this promising line of work to build robust tools that interpret images, learn from sparse human feedback, and reason like doctors, with potentially major benefits to important stakeholders in health care.

    Oscar Wu

    Haoyang “Oscar” Wu is a PhD candidate in the Department of Chemical Engineering. Wu’s research integrates quantum chemistry and deep learning methods to accelerate the process of small-molecule screening in the development of new drugs. By identifying and automating reliable methods for finding transition state geometries and calculating barrier heights for new reactions, Wu’s work could make it possible to conduct the high-throughput ab initio calculations of reaction rates needed to screen the reactivity of large numbers of active pharmaceutical ingredients (APIs). A Takeda Fellowship will support his current project to: (1) develop open-source software for high-throughput quantum chemistry calculations, focusing on the reactivity of drug-like molecules, and (2) develop deep learning models that can quantitatively predict the oxidative stability of APIs. The tools and insights resulting from Wu’s research could help to transform and accelerate the drug-discovery process, offering significant benefits to the pharmaceutical and medical fields and to patients.

    Soojung Yang

    Soojung Yang is a PhD candidate in the Department of Materials Science and Engineering. Yang’s research applies cutting-edge methods in geometric deep learning and generative modeling, along with atomistic simulations, to better understand and model protein dynamics. Specifically, Yang is developing novel tools in generative AI to explore protein conformational landscapes that offer greater speed and detail than physics-based simulations at a substantially lower cost. With the support of a Takeda Fellowship, she will build upon her successful work on the reverse transformation of coarse-grained proteins to the all-atom resolution, aiming to build machine-learning models that bridge multiple size scales of protein conformation diversity (all-atom, residue-level, and domain-level). Yang’s research holds the potential to provide a powerful and widely applicable new tool for researchers who seek to understand the complex protein functions at work in human diseases and to design drugs to treat and cure those diseases.

    Yuzhe Yang

    Yuzhe Yang is a PhD candidate in the Department of Electrical Engineering and Computer Science. Yang’s research interests lie at the intersection of machine learning and health care. In his past and current work, Yang has developed and applied innovative machine-learning models that address key challenges in disease diagnosis and tracking. His many notable achievements include the creation of one of the first machine learning-based solutions using nocturnal breathing signals to detect Parkinson’s disease (PD), estimate disease severity, and track PD progression. With the support of a Takeda Fellowship, Yang will expand this promising work to develop an AI-based diagnosis model for Alzheimer’s disease (AD) using sleep-breathing data that is significantly more reliable, flexible, and economical than current diagnostic tools. This passive, in-home, contactless monitoring system — resembling a simple home Wi-Fi router — will also enable remote disease assessment and continuous progression tracking. Yang’s groundbreaking work has the potential to advance the diagnosis and treatment of prevalent diseases like PD and AD, and it offers exciting possibilities for addressing many health challenges with reliable, affordable machine-learning tools.  More

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      A new dataset of Arctic images will spur artificial intelligence research

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      As the U.S. Coast Guard (USCG) icebreaker Healy takes part in a voyage across the North Pole this summer, it is capturing images of the Arctic to further the study of this rapidly changing region. Lincoln Laboratory researchers installed a camera system aboard the Healy while at port in Seattle before it embarked on a three-month science mission on July 11. The resulting dataset, which will be one of the first of its kind, will be used to develop artificial intelligence tools that can analyze Arctic imagery.

      “This dataset not only can help mariners navigate more safely and operate more efficiently, but also help protect our nation by providing critical maritime domain awareness and an improved understanding of how AI analysis can be brought to bear in this challenging and unique environment,” says Jo Kurucar, a researcher in Lincoln Laboratory’s AI Software Architectures and Algorithms Group, which led this project.

      As the planet warms and sea ice melts, Arctic passages are opening up to more traffic, both to military vessels and ships conducting illegal fishing. These movements may pose national security challenges to the United States. The opening Arctic also leaves questions about how its climate, wildlife, and geography are changing.

      Today, very few imagery datasets of the Arctic exist to study these changes. Overhead images from satellites or aircraft can only provide limited information about the environment. An outward-looking camera attached to a ship can capture more details of the setting and different angles of objects, such as other ships, in the scene. These types of images can then be used to train AI computer-vision tools, which can help the USCG plan naval missions and automate analysis. According to Kurucar, USCG assets in the Arctic are spread thin and can benefit greatly from AI tools, which can act as a force multiplier.

      The Healy is the USCG’s largest and most technologically advanced icebreaker. Given its current mission, it was a fitting candidate to be equipped with a new sensor to gather this dataset. The laboratory research team collaborated with the USCG Research and Development Center to determine the sensor requirements. Together, they developed the Cold Region Imaging and Surveillance Platform (CRISP).

      “Lincoln Laboratory has an excellent relationship with the Coast Guard, especially with the Research and Development Center. Over a decade, we’ve established ties that enabled the deployment of the CRISP system,” says Amna Greaves, the CRISP project lead and an assistant leader in the AI Software Architectures and Algorithms Group. “We have strong ties not only because of the USCG veterans working at the laboratory and in our group, but also because our technology missions are complementary. Today it was deploying infrared sensing in the Arctic; tomorrow it could be operating quadruped robot dogs on a fast-response cutter.”

      The CRISP system comprises a long-wave infrared camera, manufactured by Teledyne FLIR (for forward-looking infrared), that is designed for harsh maritime environments. The camera can stabilize itself during rough seas and image in complete darkness, fog, and glare. It is paired with a GPS-enabled time-synchronized clock and a network video recorder to record both video and still imagery along with GPS-positional data.  

      The camera is mounted at the front of the ship’s fly bridge, and the electronics are housed in a ruggedized rack on the bridge. The system can be operated manually from the bridge or be placed into an autonomous surveillance mode, in which it slowly pans back and forth, recording 15 minutes of video every three hours and a still image once every 15 seconds.

      “The installation of the equipment was a unique and fun experience. As with any good project, our expectations going into the install did not meet reality,” says Michael Emily, the project’s IT systems administrator who traveled to Seattle for the install. Working with the ship’s crew, the laboratory team had to quickly adjust their route for running cables from the camera to the observation station after they discovered that the expected access points weren’t in fact accessible. “We had 100-foot cables made for this project just in case of this type of scenario, which was a good thing because we only had a few inches to spare,” Emily says.

      The CRISP project team plans to publicly release the dataset, anticipated to be about 4 terabytes in size, once the USCG science mission concludes in the fall.

      The goal in releasing the dataset is to enable the wider research community to develop better tools for those operating in the Arctic, especially as this region becomes more navigable. “Collecting and publishing the data allows for faster and greater progress than what we could accomplish on our own,” Kurucar adds. “It also enables the laboratory to engage in more advanced AI applications while others make more incremental advances using the dataset.”

      On top of providing the dataset, the laboratory team plans to provide a baseline object-detection model, from which others can make progress on their own models. More advanced AI applications planned for development are classifiers for specific objects in the scene and the ability to identify and track objects across images.

      Beyond assisting with USCG missions, this project could create an influential dataset for researchers looking to apply AI to data from the Arctic to help combat climate change, says Paul Metzger, who leads the AI Software Architectures and Algorithms Group.

      Metzger adds that the group was honored to be a part of this project and is excited to see the advances that come from applying AI to novel challenges facing the United States: “I’m extremely proud of how our group applies AI to the highest-priority challenges in our nation, from predicting outbreaks of Covid-19 and assisting the U.S. European Command in their support of Ukraine to now employing AI in the Arctic for maritime awareness.”

      Once the dataset is available, it will be free to download on the Lincoln Laboratory dataset website. More

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      Putting clear bounds on uncertainty

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      In science and technology, there has been a long and steady drive toward improving the accuracy of measurements of all kinds, along with parallel efforts to enhance the resolution of images. An accompanying goal is to reduce the uncertainty in the estimates that can be made, and the inferences drawn, from the data (visual or otherwise) that have been collected. Yet uncertainty can never be wholly eliminated. And since we have to live with it, at least to some extent, there is much to be gained by quantifying the uncertainty as precisely as possible.

      Expressed in other terms, we’d like to know just how uncertain our uncertainty is.

      That issue was taken up in a new study, led by Swami Sankaranarayanan, a postdoc at MIT’s Computer Science and Artificial Intelligence Laboratory (CSAIL), and his co-authors — Anastasios Angelopoulos and Stephen Bates of the University of California at Berkeley; Yaniv Romano of Technion, the Israel Institute of Technology; and Phillip Isola, an associate professor of electrical engineering and computer science at MIT. These researchers succeeded not only in obtaining accurate measures of uncertainty, they also found a way to display uncertainty in a manner the average person could grasp.

      Their paper, which was presented in December at the Neural Information Processing Systems Conference in New Orleans, relates to computer vision — a field of artificial intelligence that involves training computers to glean information from digital images. The focus of this research is on images that are partially smudged or corrupted (due to missing pixels), as well as on methods — computer algorithms, in particular — that are designed to uncover the part of the signal that is marred or otherwise concealed. An algorithm of this sort, Sankaranarayanan explains, “takes the blurred image as the input and gives you a clean image as the output” — a process that typically occurs in a couple of steps.

      First, there is an encoder, a kind of neural network specifically trained by the researchers for the task of de-blurring fuzzy images. The encoder takes a distorted image and, from that, creates an abstract (or “latent”) representation of a clean image in a form — consisting of a list of numbers — that is intelligible to a computer but would not make sense to most humans. The next step is a decoder, of which there are a couple of types, that are again usually neural networks. Sankaranarayanan and his colleagues worked with a kind of decoder called a “generative” model. In particular, they used an off-the-shelf version called StyleGAN, which takes the numbers from the encoded representation (of a cat, for instance) as its input and then constructs a complete, cleaned-up image (of that particular cat). So the entire process, including the encoding and decoding stages, yields a crisp picture from an originally muddied rendering.

      But how much faith can someone place in the accuracy of the resultant image? And, as addressed in the December 2022 paper, what is the best way to represent the uncertainty in that image? The standard approach is to create a “saliency map,” which ascribes a probability value — somewhere between 0 and 1 — to indicate the confidence the model has in the correctness of every pixel, taken one at a time. This strategy has a drawback, according to Sankaranarayanan, “because the prediction is performed independently for each pixel. But meaningful objects occur within groups of pixels, not within an individual pixel,” he adds, which is why he and his colleagues are proposing an entirely different way of assessing uncertainty.

      Their approach is centered around the “semantic attributes” of an image — groups of pixels that, when taken together, have meaning, making up a human face, for example, or a dog, or some other recognizable thing. The objective, Sankaranarayanan maintains, “is to estimate uncertainty in a way that relates to the groupings of pixels that humans can readily interpret.”

      Whereas the standard method might yield a single image, constituting the “best guess” as to what the true picture should be, the uncertainty in that representation is normally hard to discern. The new paper argues that for use in the real world, uncertainty should be presented in a way that holds meaning for people who are not experts in machine learning. Rather than producing a single image, the authors have devised a procedure for generating a range of images — each of which might be correct. Moreover, they can set precise bounds on the range, or interval, and provide a probabilistic guarantee that the true depiction lies somewhere within that range. A narrower range can be provided if the user is comfortable with, say, 90 percent certitude, and a narrower range still if more risk is acceptable.

      The authors believe their paper puts forth the first algorithm, designed for a generative model, which can establish uncertainty intervals that relate to meaningful (semantically-interpretable) features of an image and come with “a formal statistical guarantee.” While that is an important milestone, Sankaranarayanan considers it merely a step toward “the ultimate goal. So far, we have been able to do this for simple things, like restoring images of human faces or animals, but we want to extend this approach into more critical domains, such as medical imaging, where our ‘statistical guarantee’ could be especially important.”

      Suppose that the film, or radiograph, of a chest X-ray is blurred, he adds, “and you want to reconstruct the image. If you are given a range of images, you want to know that the true image is contained within that range, so you are not missing anything critical” — information that might reveal whether or not a patient has lung cancer or pneumonia. In fact, Sankaranarayanan and his colleagues have already begun working with a radiologist to see if their algorithm for predicting pneumonia could be useful in a clinical setting.

      Their work may also have relevance in the law enforcement field, he says. “The picture from a surveillance camera may be blurry, and you want to enhance that. Models for doing that already exist, but it is not easy to gauge the uncertainty. And you don’t want to make a mistake in a life-or-death situation.” The tools that he and his colleagues are developing could help identify a guilty person and help exonerate an innocent one as well.

      Much of what we do and many of the things happening in the world around us are shrouded in uncertainty, Sankaranarayanan notes. Therefore, gaining a firmer grasp of that uncertainty could help us in countless ways. For one thing, it can tell us more about exactly what it is we do not know.

      Angelopoulos was supported by the National Science Foundation. Bates was supported by the Foundations of Data Science Institute and the Simons Institute. Romano was supported by the Israel Science Foundation and by a Career Advancement Fellowship from Technion. Sankaranarayanan’s and Isola’s research for this project was sponsored by the U.S. Air Force Research Laboratory and the U.S. Air Force Artificial Intelligence Accelerator and was accomplished under Cooperative Agreement Number FA8750-19-2- 1000. MIT SuperCloud and the Lincoln Laboratory Supercomputing Center also provided computing resources that contributed to the results reported in this work. More

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      Artificial intelligence predicts patients’ race from their medical images

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      The miseducation of algorithms is a critical problem; when artificial intelligence mirrors unconscious thoughts, racism, and biases of the humans who generated these algorithms, it can lead to serious harm. Computer programs, for example, have wrongly flagged Black defendants as twice as likely to reoffend as someone who’s white. When an AI used cost as a proxy for health needs, it falsely named Black patients as healthier than equally sick white ones, as less money was spent on them. Even AI used to write a play relied on using harmful stereotypes for casting. 

      Removing sensitive features from the data seems like a viable tweak. But what happens when it’s not enough? 

      Examples of bias in natural language processing are boundless — but MIT scientists have investigated another important, largely underexplored modality: medical images. Using both private and public datasets, the team found that AI can accurately predict self-reported race of patients from medical images alone. Using imaging data of chest X-rays, limb X-rays, chest CT scans, and mammograms, the team trained a deep learning model to identify race as white, Black, or Asian — even though the images themselves contained no explicit mention of the patient’s race. This is a feat even the most seasoned physicians cannot do, and it’s not clear how the model was able to do this. 

      In an attempt to tease out and make sense of the enigmatic “how” of it all, the researchers ran a slew of experiments. To investigate possible mechanisms of race detection, they looked at variables like differences in anatomy, bone density, resolution of images — and many more, and the models still prevailed with high ability to detect race from chest X-rays. “These results were initially confusing, because the members of our research team could not come anywhere close to identifying a good proxy for this task,” says paper co-author Marzyeh Ghassemi, an assistant professor in the MIT Department of Electrical Engineering and Computer Science and the Institute for Medical Engineering and Science (IMES), who is an affiliate of the Computer Science and Artificial Intelligence Laboratory (CSAIL) and of the MIT Jameel Clinic. “Even when you filter medical images past where the images are recognizable as medical images at all, deep models maintain a very high performance. That is concerning because superhuman capacities are generally much more difficult to control, regulate, and prevent from harming people.”

      In a clinical setting, algorithms can help tell us whether a patient is a candidate for chemotherapy, dictate the triage of patients, or decide if a movement to the ICU is necessary. “We think that the algorithms are only looking at vital signs or laboratory tests, but it’s possible they’re also looking at your race, ethnicity, sex, whether you’re incarcerated or not — even if all of that information is hidden,” says paper co-author Leo Anthony Celi, principal research scientist in IMES at MIT and associate professor of medicine at Harvard Medical School. “Just because you have representation of different groups in your algorithms, that doesn’t guarantee it won’t perpetuate or magnify existing disparities and inequities. Feeding the algorithms with more data with representation is not a panacea. This paper should make us pause and truly reconsider whether we are ready to bring AI to the bedside.” 

      The study, “AI recognition of patient race in medical imaging: a modeling study,” was published in Lancet Digital Health on May 11. Celi and Ghassemi wrote the paper alongside 20 other authors in four countries.

      To set up the tests, the scientists first showed that the models were able to predict race across multiple imaging modalities, various datasets, and diverse clinical tasks, as well as across a range of academic centers and patient populations in the United States. They used three large chest X-ray datasets, and tested the model on an unseen subset of the dataset used to train the model and a completely different one. Next, they trained the racial identity detection models for non-chest X-ray images from multiple body locations, including digital radiography, mammography, lateral cervical spine radiographs, and chest CTs to see whether the model’s performance was limited to chest X-rays. 

      The team covered many bases in an attempt to explain the model’s behavior: differences in physical characteristics between different racial groups (body habitus, breast density), disease distribution (previous studies have shown that Black patients have a higher incidence for health issues like cardiac disease), location-specific or tissue specific differences, effects of societal bias and environmental stress, the ability of deep learning systems to detect race when multiple demographic and patient factors were combined, and if specific image regions contributed to recognizing race. 

      What emerged was truly staggering: The ability of the models to predict race from diagnostic labels alone was much lower than the chest X-ray image-based models. 

      For example, the bone density test used images where the thicker part of the bone appeared white, and the thinner part appeared more gray or translucent. Scientists assumed that since Black people generally have higher bone mineral density, the color differences helped the AI models to detect race. To cut that off, they clipped the images with a filter, so the model couldn’t color differences. It turned out that cutting off the color supply didn’t faze the model — it still could accurately predict races. (The “Area Under the Curve” value, meaning the measure of the accuracy of a quantitative diagnostic test, was 0.94–0.96). As such, the learned features of the model appeared to rely on all regions of the image, meaning that controlling this type of algorithmic behavior presents a messy, challenging problem. 

      The scientists acknowledge limited availability of racial identity labels, which caused them to focus on Asian, Black, and white populations, and that their ground truth was a self-reported detail. Other forthcoming work will include potentially looking at isolating different signals before image reconstruction, because, as with bone density experiments, they couldn’t account for residual bone tissue that was on the images. 

      Notably, other work by Ghassemi and Celi led by MIT student Hammaad Adam has found that models can also identify patient self-reported race from clinical notes even when those notes are stripped of explicit indicators of race. Just as in this work, human experts are not able to accurately predict patient race from the same redacted clinical notes.

      “We need to bring social scientists into the picture. Domain experts, which are usually the clinicians, public health practitioners, computer scientists, and engineers are not enough. Health care is a social-cultural problem just as much as it’s a medical problem. We need another group of experts to weigh in and to provide input and feedback on how we design, develop, deploy, and evaluate these algorithms,” says Celi. “We need to also ask the data scientists, before any exploration of the data, are there disparities? Which patient groups are marginalized? What are the drivers of those disparities? Is it access to care? Is it from the subjectivity of the care providers? If we don’t understand that, we won’t have a chance of being able to identify the unintended consequences of the algorithms, and there’s no way we’ll be able to safeguard the algorithms from perpetuating biases.”

      “The fact that algorithms ‘see’ race, as the authors convincingly document, can be dangerous. But an important and related fact is that, when used carefully, algorithms can also work to counter bias,” says Ziad Obermeyer, associate professor at the University of California at Berkeley, whose research focuses on AI applied to health. “In our own work, led by computer scientist Emma Pierson at Cornell, we show that algorithms that learn from patients’ pain experiences can find new sources of knee pain in X-rays that disproportionately affect Black patients — and are disproportionately missed by radiologists. So just like any tool, algorithms can be a force for evil or a force for good — which one depends on us, and the choices we make when we build algorithms.”

      The work is supported, in part, by the National Institutes of Health. More