Predictive modeling with electronic health record (EHR) data is anticipated to drive personalized medicine and improve healthcare quality. Constructing predictive statistical models typically requires extraction of curated predictor variables from normalized EHR data, a labor-intensive process that discards the vast majority of information in each patient’s record. We propose a representation of patients’ entire raw EHR records based on the Fast Healthcare Interoperability Resources (FHIR) format. We demonstrate that deep learning methods using this representation are capable of accurately predicting multiple medical events from multiple centers without site-specific data harmonization. We validated our approach using de-identified EHR data from two US academic medical centers with 216,221 adult patients hospitalized for at least 24 h. In the sequential format we propose, this volume of EHR data unrolled into a total of 46,864,534,945 data points, including clinical notes. Deep learning models achieved high accuracy for tasks such as predicting: in-hospital mortality (area under the receiver operator curve [AUROC] across sites 0.93–0.94), 30-day unplanned readmission (AUROC 0.75–0.76), prolonged length of stay (AUROC 0.85–0.86), and all of a patient’s final discharge diagnoses (frequency-weighted AUROC 0.90). These models outperformed traditional, clinically-used predictive models in all cases. We believe that this approach can be used to create accurate and scalable predictions for a variety of clinical scenarios. In a case study of a particular prediction, we demonstrate that neural networks can be used to identify relevant information from the patient’s chart.

A key challenge in developing and deploying Machine Learning (ML) systems is understanding their performance across a wide range of inputs. To address this challenge, we created the What-If Tool, an open-source application that allows practitioners to probe, visualize, and analyze ML systems, with minimal coding. The What-If Tool lets practitioners test performance in hypothetical situations, analyze the importance of different data features, and visualize model behavior across multiple models and subsets of input data. It also lets practitioners measure systems according to multiple ML fairness metrics. We describe the design of the tool, and report on real-life usage at different organizations. Index Terms-Interactive Machine Learning, Model Debugging, Model Comparison

We present a design study of the TensorFlow Graph Visualizer, part of the TensorFlow machine intelligence platform. This tool helps users understand complex machine learning architectures by visualizing their underlying dataflow graphs. The tool works by applying a series of graph transformations that enable standard layout techniques to produce a legible interactive diagram. To declutter the graph, we decouple non-critical nodes from the layout. To provide an overview, we build a clustered graph using the hierarchical structure annotated in the source code. To support exploration of nested structure on demand, we perform edge bundling to enable stable and responsive cluster expansion. Finally, we detect and highlight repeated structures to emphasize a model's modular composition. To demonstrate the utility of the visualizer, we describe example usage scenarios and report user feedback. Overall, users find the visualizer useful for understanding, debugging, and sharing the structures of their models.

The interpretation of deep learning models is a challenge due to their size, complexity, and often opaque internal state. In addition, many systems, such as image classifiers, operate on low-level features rather than high-level concepts. To address these challenges, we introduce Concept Activation Vectors (CAVs), which provide an interpretation of a neural net's internal state in terms of human-friendly concepts. The key idea is to view the high-dimensional internal state of a neural net as an aid, not an obstacle. We show how to use CAVs as part of a technique, Testing with CAVs (TCAV), that uses directional derivatives to quantify the degree to which a user-defined concept is important to a classification result-for example, how sensitive a prediction of zebra is to the presence of stripes. Using the domain of image classification as a testing ground, we describe how CAVs may be used to explore hypotheses and generate insights for a standard image classification network as well as a medical application.

We present the Language Interpretability Tool (LIT), an open-source platform for visualization and understanding of NLP models. We focus on core questions about model behavior: Why did my model make this prediction? When does it perform poorly? What happens under a controlled change in the input? LIT integrates local explanations, aggregate analysis, and counterfactual generation into a streamlined, browser-based interface to enable rapid exploration and error analysis. We include case studies for a diverse set of workflows, including exploring counterfactuals for sentiment analysis, measuring gender bias in coreference systems, and exploring local behavior in text generation. LIT supports a wide range of models-including classification, seq2seq, and structured predictionand is highly extensible through a declarative, framework-agnostic API. LIT is under active development, with code and full documentation available at https://github.com/ pair-code/lit. 1 * Equal contribution. 1 A video walkthrough is available at https://youtu. be/j0OfBWFUqIE.