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Designing with Machine Learning in Digital Pathology: Augmenting Medical Specialists through Interaction Design
Linköping University, Department of Science and Technology, Media and Information Technology. Linköping University, Faculty of Science & Engineering. Linköping University, Center for Medical Image Science and Visualization (CMIV).ORCID iD: 0000-0002-7014-8874
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Recent advancements in machine learning (ML) have led to a dramatic increase in AI capabilities for medical diagnostic tasks. Despite technical advances, developers of predictive AI models struggle to integrate their work into routine clinical workflows. Inefficient human-AI interactions, poor sociotechnical fit and a lack of interactive strategies for dealing with the imperfect nature of predictions are known factors contributing to this lack of adoption.

User-centred design methods are typically aimed at discovering and realising desirable qualities in use, pragmatically oriented around finding solutions despite the limitations of material- and human resources. However, existing methods often rely on designers possessing knowledge of suitable interactive metaphors and idioms, as well as skills in evaluating ideas through low-fidelity prototyping and rapid iteration methods—all of which are challenged by the data-driven nature of machine learning and the unpredictable outputs from AI models.

Using a constructive design research approach, my work explores how we might design systems with AI components that aid clinical decision-making in a human-centred and iterative fashion. Findings are derived from experiments and experiences from four exploratory projects conducted in collaboration with professional physicians, all aiming to probe this design space by producing novel interactive systems for or with ML components.

Contributions include identifying practical and theoretical design challenges, suggesting novel interaction strategies for human-AI collaboration, framing ML competence for designers and presenting empirical descriptions of conducted design processes. Specifically, this compilation thesis contains three works that address effective human-machine teaching and two works that address the challenge of designing interactions that afford successful decision-making despite the uncertainty and imperfections inherent in machine predictions.

Finally, two works directly address design-researchers working with ML, arguing for a systematic approach to increase the repertoire available for theoretical annotation and understanding of the properties of ML as a designerly material.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2021.
Series
Linköping Studies in Science and Technology. Dissertations, ISSN 0345-7524 ; 2157
National Category
Design Human Computer Interaction
Identifiers
URN: urn:nbn:se:liu:diva-176117DOI: 10.3384/diss.diva-176117ISBN: 978-91-7929-604-9 (print)OAI: oai:DiVA.org:liu-176117DiVA, id: diva2:1561336
Public defence
2021-09-23, K3, Kåkenhus, Campus Norrköping, Norrköping, 09:00 (English)
Opponent
Supervisors
Available from: 2021-08-30 Created: 2021-06-07 Last updated: 2025-02-25Bibliographically approved
List of papers
1. Machine learning as a design material: a curated collection of exemplars for visual interaction
Open this publication in new window or tab >>Machine learning as a design material: a curated collection of exemplars for visual interaction
2018 (English)In: DS 91: Proceedings of NordDesign 2018, Linköping, Sweden, 14th - 17th August 2018 / [ed] Philip Ekströmer, Simon Schütte and Johan Ölvander, Brandes & Apsel Verlag, 2018, p. 1-10Conference paper, Published paper (Refereed)
Abstract [en]

Although machine learning is not a new phenomenon, it has truly entered the spotlight in recent years. With growing expectations, we see a shift in focus from performance tuning to awareness of meaningful interaction and purpose. Interaction design and UX research is currently in a position to provide important and necessary knowledge contributions to the development of machine learning systems. Machine learning can be viewed as a design material that is arguably more unpredictable, emergent, and “alive” than traditional ones. These characteristics suggest practice-based work along the lines of research-through-design as a promising approach for machine learning system development research. Design researchers using a research-through-design approach agree that a created artefact carries knowledge, but there is no consensus on how such knowledge is best articulated and transferred within academic discourse. Knowledge contributions need to be abstracted from the particular to a higher level. We suggest curated collections, a variation of annotated portfolios, as a way to abstract and communicate intermediate-level knowledge that is suitable and useful for the research-through-design community. A curated collection presents thoughtfully selected and inter-related exemplars, articulating their salient traits. The insights collected in a curated collection can be used to inform future design in related design situations. This paper provides a curated collection addressing the fine-grained details of interaction with machine learning systems. The examples are drawn from highly visual interaction, predominantly in the domain of digital pathology. The collection of interaction examples is used to elicit a set of salient traits, including the preservation of visual context, rapid real-time refinement, leaving traces, and applying judicious automation. Finally, we show how this curated collection could inform the design of a future system in a different domain. The insights are applied to a case of interaction design to support air traffic controllers in their collaboration with future agentive systems

Place, publisher, year, edition, pages
Brandes & Apsel Verlag, 2018
Series
NordDESIGN ; 2018
Keywords
digital design, interaction design, machine learning, curated collection
National Category
Design Human Computer Interaction Other Engineering and Technologies Information Systems, Social aspects Computer and Information Sciences
Identifiers
urn:nbn:se:liu:diva-160675 (URN)9789176851852 (ISBN)
Conference
The NordDesign 2018, Linköping, Sweden, 14th - 17th August 2018
Available from: 2019-10-01 Created: 2019-10-01 Last updated: 2025-02-25Bibliographically approved
2. TissueWand, a rapid histopathology annotation tool
Open this publication in new window or tab >>TissueWand, a rapid histopathology annotation tool
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2020 (English)In: Journal of Pathology Informatics, ISSN 2229-5089, E-ISSN 2153-3539, Vol. 11, no 27Article in journal (Refereed) Published
Abstract [en]

Background: Recent advancements in machine learning (ML) bring great possibilities for the development of tools to assist with diagnostic tasks within histopathology. However, these approaches typically require a large amount of ground truth training data in the form of image annotations made by human experts. As such annotation work is a very time-consuming task, there is a great need for tools that can assist in this process, saving time while not sacrificing annotation quality. Methods: In an iterative design process, we developed TissueWand – an interactive tool designed for efficient annotation of gigapixel-sized histopathological images, not being constrained to a predefined annotation task. Results: Several findings regarding appropriate interaction concepts were made, where a key design component was semi-automation based on rapid interaction feedback in a local region. In a user study, the resulting tool was shown to cause substantial speed-up compared to manual work while maintaining quality. Conclusions: The TissueWand tool shows promise to replace manual methods for early stages of dataset curation where no task-specific ML model yet exists to aid the effort.

Place, publisher, year, edition, pages
Medknow Publications, 2020
Keywords
Annotation, digital pathology, usability, user interface design, machine learning
National Category
Design Human Computer Interaction
Identifiers
urn:nbn:se:liu:diva-168487 (URN)10.4103/jpi.jpi_5_20 (DOI)
Funder
Wallenberg AI, Autonomous Systems and Software Program (WASP)
Available from: 2020-08-25 Created: 2020-08-25 Last updated: 2025-02-25Bibliographically approved
3. From machine learning to machine teaching: the importance of UX
Open this publication in new window or tab >>From machine learning to machine teaching: the importance of UX
2018 (English)In: interactions, ISSN 1072-5520, E-ISSN 1558-3449, Vol. 25, no 6, p. 52-57Article in journal (Refereed) Published
Place, publisher, year, edition, pages
New York: ACM Press, 2018
Keywords
digital design, interaction design, machine learning
National Category
Design Human Computer Interaction
Identifiers
urn:nbn:se:liu:diva-163529 (URN)10.1145/3282860 (DOI)2-s2.0-85056462250 (Scopus ID)
Available from: 2020-02-07 Created: 2020-02-07 Last updated: 2025-02-25Bibliographically approved
4. Verification Staircase: a Design Strategy for Actionable Explanations
Open this publication in new window or tab >>Verification Staircase: a Design Strategy for Actionable Explanations
2020 (English)In: Proceedings of the Workshop on Explainable Smart Systems for Algorithmic Transparency in Emerging Technologies co-located with 25th International Conference on Intelligent User Interfaces (IUI 2020), Cagliari, Italy, March 17, 2020 / [ed] Alison Smith-Renner and Styliani Kleanthous and Brian Lim and Tsvi Kuflik and Simone Stumpf and Jahna Otterbacher and Advait Sarkar and Casey Dugan and Avital Shulner Tal, Aachen: CEUR-WS.org , 2020, Vol. 2582Conference paper, Published paper (Refereed)
Abstract [en]

What if the trust in the output of a predictive model could be acted upon in richer ways than a simple binary decision of accept or reject? Designing assistive AI tools for medical specialists entails supporting a complex but safety-critical decision process. It is common that decisions in this domain can be decomposed to a combination of many smaller decisions. In this paper, we present Verification Staircase – a design strategy that can be used for such scenarios. The verification staircase is when multiple interactive assistive tools are combined to allow for a nuanced amount of automation to aid the user. This can support a wide range of prediction quality scenarios, spanning from unproblematic minor mistakes to misleading major failures. By presenting the information in a hierarchical way, the user is able to learn how underlying predictions are connected to overall case predictions, and over time, calibrate their trust so that they can choose the appropriate level of automatic support.

Place, publisher, year, edition, pages
Aachen: CEUR-WS.org, 2020
Series
CEUR Workshop Proceedings, ISSN 1613-0073
Keywords
digital design, interaction design, machine learning, artificial intelligence, explainable artificial intelligence
National Category
Design Human Computer Interaction Computer Sciences
Identifiers
urn:nbn:se:liu:diva-165763 (URN)
Conference
Workshop on Explainable Smart Systems for Algorithmic Transparency in Emerging Technologies co-located with 25th International Conference on Intelligent User Interfaces (IUI 2020), Cagliari, Italy, March 17–20, 2020
Funder
Wallenberg AI, Autonomous Systems and Software Program (WASP)
Note

Accepted for oral presentation at Workshop on Explainable Smart Systems for Algorithmic Transparency in Emerging Technologies co-located with 25th International Conference on Intelligent User Interfaces (IUI 2020), Cagliari, Italy, March 17, 2020

Available from: 2020-05-20 Created: 2020-05-20 Last updated: 2025-02-25Bibliographically approved
5. Designing for the Long Tail of Machine Learning
Open this publication in new window or tab >>Designing for the Long Tail of Machine Learning
2020 (English)Manuscript (preprint) (Other academic)
Abstract [en]

Recent technical advances has made machine learning (ML) a promising component to include in end user facing systems. However, user experience (UX) practitioners face challenges in relating ML to existing user-centered design processes and how to navigate the possibilities and constraints of this design space. Drawing on our own experience, we characterize designing within this space as navigating trade-offs between data gathering, model development and designing valuable interactions for a given model performance. We suggest that the theoretical description of how machine learning performance scales with training data can guide designers in these trade-offs as well as having implications for prototyping. We exemplify the learning curve's usage by arguing that a useful pattern is to design an initial system in a bootstrap phase that aims to exploit the training effect of data collected at increasing orders of magnitude.

Keywords
digital design, interaction design, machine learning
National Category
Design Human Computer Interaction
Identifiers
urn:nbn:se:liu:diva-163530 (URN)
Note

Accepted for presentation in poster format for the ACM CHI'19 Workshop <Emerging Perspectives in Human-Centered Machine Learning>

Available from: 2020-02-07 Created: 2020-02-07 Last updated: 2025-02-25Bibliographically approved
6. Rapid Assisted Visual Search: Supporting Digital Pathologists with Imperfect AI
Open this publication in new window or tab >>Rapid Assisted Visual Search: Supporting Digital Pathologists with Imperfect AI
2021 (English)In: IUI '21: 26th International Conference on Intelligent User Interfaces, NEW YORK, NY, UNITED STATES: Association for Computing Machinery (ACM), 2021, p. 504-513Conference paper, Published paper (Refereed)
Abstract [en]

Designing useful human-AI interaction for clinical workflows remains challenging despite the impressive performance of recent AI models. One specific difficulty is a lack of successful examples demonstrating how to achieve safe and efficient workflows while mitigating AI imperfections. In this paper, we present an interactive AI-powered visual search tool that supports pathologists in cancer assessments. Our evaluation with six pathologists demonstrates that it can 1) reduce time needed with maintained quality, 2) build user trust progressively, and 3) learn and improve from use. We describe our iterative design process, model development, and key features. Through interviews, design choices are related to the overall user experience. Implications for future human-AI interaction design are discussed with respect to trust, explanations, learning from use, and collaboration strategies.  

 

Place, publisher, year, edition, pages
NEW YORK, NY, UNITED STATES: Association for Computing Machinery (ACM), 2021
National Category
Human Computer Interaction
Identifiers
urn:nbn:se:liu:diva-176116 (URN)10.1145/3397481.3450681 (DOI)000747690200059 ()2-s2.0-85104502977 (Scopus ID)9781450380171 (ISBN)
Conference
IUI '21: 26th International Conference on Intelligent User Interfaces, College Station TX USA, April 14 - 17, 2021
Note

Funding: Autonomous Systems and Software Program (WASP)

Available from: 2021-06-07 Created: 2021-06-07 Last updated: 2024-08-30
7. Proactive Construction of an Annotated Imaging Database for Artificial Intelligence Training
Open this publication in new window or tab >>Proactive Construction of an Annotated Imaging Database for Artificial Intelligence Training
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2021 (English)In: Journal of digital imaging, ISSN 0897-1889, E-ISSN 1618-727X, Vol. 34, p. 105-115Article in journal (Refereed) Published
Abstract [en]

Artificial intelligence (AI) holds much promise for enabling highly desired imaging diagnostics improvements. One of the most limiting bottlenecks for the development of useful clinical-grade AI models is the lack of training data. One aspect is the large amount of cases needed and another is the necessity of high-quality ground truth annotation. The aim of the project was to establish and describe the construction of a database with substantial amounts of detail-annotated oncology imaging data from pathology and radiology. A specific objective was to be proactive, that is, to support undefined subsequent AI training across a wide range of tasks, such as detection, quantification, segmentation, and classification, which puts particular focus on the quality and generality of the annotations. The main outcome of this project was the database as such, with a collection of labeled image data from breast, ovary, skin, colon, skeleton, and liver. In addition, this effort also served as an exploration of best practices for further scalability of high-quality image collections, and a main contribution of the study was generic lessons learned regarding how to successfully organize efforts to construct medical imaging databases for AI training, summarized as eight guiding principles covering team, process, and execution aspects.

Place, publisher, year, edition, pages
Springer-Verlag New York, 2021
Keywords
Artificial intelligence; Annotation; Case collection; Radiology; Pathology
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:liu:diva-171711 (URN)10.1007/s10278-020-00384-4 (DOI)000587960300001 ()33169211 (PubMedID)2-s2.0-85095841989 (Scopus ID)
Note

Funding Agencies|Linkoping University; Visual Sweden [VS1702]

Available from: 2020-11-30 Created: 2020-11-30 Last updated: 2025-09-05Bibliographically approved

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