Abstract
Machine learning platforms have emerged as a new promissory technology that some argue will revolutionize work practices across a broad range of professions, including medical care. During the past few years, IBM has been testing its Watson for Oncology platform at several oncology departments around the world. Published reports, news stories, as well as our own empirical research show that in some cases, the levels of concordance over recommended treatment protocols between the platform and human oncologists have been quite low. Other studies supported by IBM claim concordance rates as high as 96%. We use the Watson for Oncology case to examine the practice of using concordance levels between tumor boards and a machine learning decision-support system as a form of evidence. We address a challenge related to the epistemic authority between oncologists on tumor boards and the Watson Oncology platform by arguing that the use of concordance levels as a form of evidence of quality or trustworthiness is problematic. Although the platform provides links to the literature from which it draws its conclusion, it obfuscates the scoring criteria that it uses to value some studies over others. In other words, the platform “black boxes” the values that are coded into its scoring system.
Highlights
During the past several years, IBM has been developing, among others, the Watson for Oncology platform (WFO), which is an artificial intelligence cognitive computing system
We critically examine the practice of using concordance levels between tumor boards and the WFO decision-support system as a form of evidence, we recognize the potential of the WFO platform to aid oncologists in their everyday work
We address a challenge related to the epistemic authority between oncologists on tumor boards and the Watson Oncology platform by arguing that the use of concordance levels as a form of evidence is problematic since it does not address the fundamental metric of outcome of specific treatment options for different patients
Summary
During the past several years, IBM has been developing, among others, the Watson for Oncology platform (WFO), which is an artificial intelligence cognitive computing system (see IBM 2018). We address a challenge related to the epistemic authority between oncologists on tumor boards and the Watson Oncology platform by arguing that the use of concordance levels as a form of evidence is problematic since it does not address the fundamental metric of outcome of specific treatment options for different patients. McDougall suggests that in the medical field, for example, patient perspectives are rarely considered in developing treatment option recommendations, which suggests a reintroduction of medical paternalism to patient treatment practices Platforms such as Watson may provide exciting new opportunities to help oncologists make decisions about possible treatment options at a global level, there is a risk that such platforms introduce values and practices, which are not locally shared by physicians and patients alike. The use of concordance as a form of evidence represents a type of “algorithmic culture” (Striphas 2015), which we consider problematic since it lacks reliable and comparable reference or metric through which patient outcomes can be evaluated
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