Shah Lab

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====== Responsible AI in Healthcare ======

Our team is focused on bringing AI into clinical use, safely, ethically and cost effectively. Our work is organized in two broad work-streams.

====== Responsible AI in Healthcare ======

Our team is focused on bringing AI into clinical use, safely, ethically and cost effectively. Our work is organized in two broad work-streams.

===== Creation and adoption of foundation models in medicine =====

Given the high interest in using large language models (LLMs) in medicine, the [[https://jamanetwork.com/journals/jama/fullarticle/2808296|creation and use of LLMs in medicine]] needs to be actively shaped by provisioning relevant training data, specifying the desired benefits, and evaluating the benefits via testing in real-world deployments.

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We study whether commercial language models [[https://arxiv.org/abs/2304.13714|support real-world needs]] or can follow [[https://medalign.stanford.edu/|medical instructions (MedAlign)]] that clinicians would expect them to follow. We build clinical foundation models such as [[https://www.sciencedirect.com/science/article/pii/S1532046420302653| CLMBR]], [[https://arxiv.org/abs/2301.03150| MOTOR]] and verify their benefits such as [[https://www.nature.com/articles/s41598-023-30820-8| robustness over time]], [[https://pubmed.ncbi.nlm.nih.gov/37639620/| populations]] and [[https://arxiv.org/abs/2311.11483| sites]]. we release de-identified datasets such as [[https://ehrshot.stanford.edu/| EHRSHOT]] for few-shot evaluation of foundation models and multi-modal datasets such as [[https://inspect.stanford.edu/| INSPECT]].


===== Making machine learning models clinically useful =====

Whether a classifier or prediction [[ https://jamanetwork.com/journals/jama/article-abstract/2748179 | model is usefulness]] in guiding care depends on the interplay between the model's output, the intervention it triggers, and the intervention’s benefits and harms. Our work stemmed from the effort [[http://stanmed.stanford.edu/2018summer/artificial-intelligence-puts-humanity-health-care.html|in improving palliative care]] using machine learning. [[https://www.tinyurl.com/hai-blogs | Blog posts at HAI]] summarize our work in easily accessible manner. 

{{  :model-interplay.png?400&nolink&  }}

We study how to quantify the [[https://www.sciencedirect.com/science/article/pii/S1532046423000400|impact of work capacity constraints]] on achievable benefit, estimate [[https://www.sciencedirect.com/science/article/pii/S1532046421001544|individualized utility]], and learn [[https://pubmed.ncbi.nlm.nih.gov/34350942/|optimal decision thresholds]]. We question conventional wisdom on whether models [[https://tinyurl.com/donot-explain | need to be explainable]], and [[https://www.nature.com/articles/s41591-023-02540-z |generalizable]]. We examine if consequences of using [[https://hai.stanford.edu/news/when-algorithmic-fairness-fixes-fail-case-keeping-humans-loop | algorithm guided care are fair]] and how to [[https://hai.stanford.edu/news/how-do-we-ensure-healthcare-ai-useful | ensure that healthcare models are useful]]. We study this interplay to guide the work of the [[https://dsatshc.stanford.edu/ | Data Science Team at Stanford Healthcare]].
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