Accuracy is an important concern for suppliers of artificial intelligence (AI) services, but considerations beyond accuracy, such as safety (which includes fairness and explainability), security, and provenance, are also critical elements to engender consumers' trust in a service. Many industries use transparent, standardized, but often not legally required documents called supplier's declarations of conformity (SDoCs) to describe the lineage of a product along with the safety and performance testing it has undergone. SDoCs may be considered multi-dimensional fact sheets that capture and quantify various aspects of the product and its development to make it worthy of consumers' trust. Inspired by this practice, we propose FactSheets to help increase trust in AI services. We envision such documents to contain purpose, performance, safety, security, and provenance information to be completed by AI service providers for examination by consumers. We suggest a comprehensive set of declaration items tailored to AI and provide examples for two fictitious AI services in the appendix of the paper. * A. Olteanu's work was done while at IBM Research. Author is currently affiliated with Microsoft Research.
Background
Polygenic risk scores (PRSs) can stratify populations into cardiovascular disease (CVD) risk groups. We aimed to quantify the potential advantage of adding information on PRSs to conventional risk factors in the primary prevention of CVD.
Methods and findings
Using data from UK Biobank on 306,654 individuals without a history of CVD and not on lipid-lowering treatments (mean age [SD]: 56.0 [8.0] years; females: 57%; median follow-up: 8.1 years), we calculated measures of risk discrimination and reclassification upon addition of PRSs to risk factors in a conventional risk prediction model (i.e., age, sex, systolic blood pressure, smoking status, history of diabetes, and total and high-density lipoprotein cholesterol). We then modelled the implications of initiating guideline-recommended statin therapy in a primary care setting using incidence rates from 2.1 million individuals from the Clinical Practice Research Datalink. The C-index, a measure of risk discrimination, was 0.710 (95% CI 0.703–0.717) for a CVD prediction model containing conventional risk predictors alone. Addition of information on PRSs increased the C-index by 0.012 (95% CI 0.009–0.015), and resulted in continuous net reclassification improvements of about 10% and 12% in cases and non-cases, respectively. If a PRS were assessed in the entire UK primary care population aged 40–75 years, assuming that statin therapy would be initiated in accordance with the UK National Institute for Health and Care Excellence guidelines (i.e., for persons with a predicted risk of ≥10% and for those with certain other risk factors, such as diabetes, irrespective of their 10-year predicted risk), then it could help prevent 1 additional CVD event for approximately every 5,750 individuals screened. By contrast, targeted assessment only among people at intermediate (i.e., 5% to <10%) 10-year CVD risk could help prevent 1 additional CVD event for approximately every 340 individuals screened. Such a targeted strategy could help prevent 7% more CVD events than conventional risk prediction alone. Potential gains afforded by assessment of PRSs on top of conventional risk factors would be about 1.5-fold greater than those provided by assessment of C-reactive protein, a plasma biomarker included in some risk prediction guidelines. Potential limitations of this study include its restriction to European ancestry participants and a lack of health economic evaluation.
Conclusions
Our results suggest that addition of PRSs to conventional risk factors can modestly enhance prediction of first-onset CVD and could translate into population health benefits if used at scale.
Background Population-based studies of ultrasound measures of carotid atherosclerosis are informative about future risks of cardiovascular disease. Design Cross-sectional studies of carotid artery atherosclerosis in 24,822 Chinese adults from the China Kadoorie Biobank and 2579 Europeans from the UK Biobank. Methods Mean intima-media thickness of the common carotid arteries and presence of carotid artery plaque were examined in the China Kadoorie Biobank study. The carotid intima-media thickness (cIMT) findings in Chinese (mean age 59 years) were compared with a European population (mean age 62 years). Results Overall, the mean cIMT in Chinese was 0.70 mm (SD 0.16) and increased with age by 0.08 mm (SE 0.008) per 10-years older age. About 31% of the Chinese had carotid plaques and the prevalence varied 10-fold with age (6% at 40-49 to 63% at 70-89 years) and four-fold by region (range, 14%-57%). After adjustment for age, sex and region, plaque prevalence was higher in smokers than in non-smokers (36% vs. 28%) and two-fold higher in individuals with systolic blood pressure ≥160 mmHg than those with systolic blood pressure <120 mmHg (44% vs. 22%) in the China Kadoorie Biobank study. Mean cIMT was similar in the younger Chinese and European adults, but increased more steeply with age in the Chinese ( p = 0.002). Conclusions About one-third of Chinese adults had carotid plaques. The rate of progression of carotid atherosclerosis with age was more extreme in the Chinese compared with the European population, highlighting the need for more intensive strategies for cardiovascular disease prevention in China.
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