Shaping AI's Impact on Billions of Lives

Artificial Intelligence (AI), like any transformative technology, has the potential to be a double-edged sword, leading either toward significant advancements or detrimental outcomes for society as a whole. As is often the case when it comes to widely-used technologies in market economies (e.g., cars and semiconductor chips), commercial interest tends to be the predominant guiding factor. The AI community is at risk of becoming polarized to either take a laissez-faire attitude toward AI development, or to call for government overregulation. Between these two poles we argue for the community of AI practitioners to consciously and proactively work for the common good. This paper offers a blueprint for a new type of innovation infrastructure including 18 concrete milestones to guide AI research in that direction. Our view is that we are still in the early days of practical AI, and focused efforts by practitioners, policymakers, and other stakeholders can still maximize the upsides of AI and minimize its downsides. We talked to luminaries such as recent Nobelist John Jumper on science, President Barack Obama on governance, former UN Ambassador and former National Security Advisor Susan Rice on security, philanthropist Eric Schmidt on several topics, and science fiction novelist Neal Stephenson on entertainment. This ongoing dialogue and collaborative effort has produced a comprehensive, realistic view of what the actual impact of AI could be, from a diverse assembly of thinkers with deep understanding of this technology and these domains. From these exchanges, five recurring guidelines emerged, which form the cornerstone of a framework for beginning to harness AI in service of the public good. They not only guide our efforts in discovery but also shape our approach to deploying this transformative technology responsibly and ethically.

Pruning the Path to Optimal Care: Identifying Systematically Suboptimal Medical Decision-Making with Inverse Reinforcement Learning

In aims to uncover insights into medical decision-making embedded within observational data from clinical settings, we present a novel application of Inverse Reinforcement Learning (IRL) that identifies suboptimal clinician actions based on the actions of their peers. This approach centers two stages of IRL with an intermediate step to prune trajectories displaying behavior that deviates significantly from the consensus. This enables us to effectively identify clinical priorities and values from ICU data containing both optimal and suboptimal clinician decisions. We observe that the benefits of removing suboptimal actions vary by disease and differentially impact certain demographic groups.

Inverse Transition Learning: Learning Dynamics from Demonstrations

We consider the problem of estimating the transition dynamics $T^*$ from near-optimal expert trajectories in the context of offline model-based reinforcement learning. We develop a novel constraint-based method, Inverse Transition Learning, that treats the limited coverage of the expert trajectories as a \emph{feature}: we use the fact that the expert is near-optimal to inform our estimate of $T^*$. We integrate our constraints into a Bayesian approach. Across both synthetic environments and real healthcare scenarios like Intensive Care Unit (ICU) patient management in hypotension, we demonstrate not only significant improvements in decision-making, but that our posterior can inform when transfer will be successful.

Directly Optimizing Explanations for Desired Properties

When explaining black-box machine learning models, it's often important for explanations to have certain desirable properties. Most existing methods `encourage' desirable properties in their construction of explanations. In this work, we demonstrate that these forms of encouragement do not consistently create explanations with the properties that are supposedly being targeted. Moreover, they do not allow for any control over which properties are prioritized when different properties are at odds with each other. We propose to directly optimize explanations for desired properties. Our direct approach not only produces explanations with optimal properties more consistently but also empowers users to control trade-offs between different properties, allowing them to create explanations with exactly what is needed for a particular task.

Decision-Point Guided Safe Policy Improvement

Within batch reinforcement learning, safe policy improvement (SPI) seeks to ensure that the learnt policy performs at least as well as the behavior policy that generated the dataset. The core challenge in SPI is seeking improvements while balancing risk when many state-action pairs may be infrequently visited. In this work, we introduce Decision Points RL (DPRL), an algorithm that restricts the set of state-action pairs (or regions for continuous states) considered for improvement. DPRL ensures high-confidence improvement in densely visited states (i.e. decision points) while still utilizing data from sparsely visited states. By appropriately limiting where and how we may deviate from the behavior policy, we achieve tighter bounds than prior work; specifically, our data-dependent bounds do not scale with the size of the state and action spaces. In addition to the analysis, we demonstrate that DPRL is both safe and performant on synthetic and real datasets.

Contrastive Explanations That Anticipate Human Misconceptions Can Improve Human Decision-Making Skills

People's decision-making abilities often fail to improve or may even erode when they rely on AI for decision-support, even when the AI provides informative explanations. We argue this is partly because people intuitively seek contrastive explanations, which clarify the difference between the AI's decision and their own reasoning, while most AI systems offer "unilateral" explanations that justify the AI's decision but do not account for users' thinking. To align human-AI knowledge on decision tasks, we introduce a framework for generating human-centered contrastive explanations that explain the difference between AI's choice and a predicted, likely human choice about the same task. Results from a large-scale experiment (N = 628) demonstrate that contrastive explanations significantly enhance users' independent decision-making skills compared to unilateral explanations, without sacrificing decision accuracy. Amid rising deskilling concerns, our research demonstrates that incorporating human reasoning into AI design can foster human skill development.

A Deployed Online Reinforcement Learning Algorithm In An Oral Health Clinical Trial

Dental disease is a prevalent chronic condition associated with substantial financial burden, personal suffering, and increased risk of systemic diseases. Despite widespread recommendations for twice-daily tooth brushing, adherence to recommended oral self-care behaviors remains sub-optimal due to factors such as forgetfulness and disengagement. To address this, we developed Oralytics, a mHealth intervention system designed to complement clinician-delivered preventative care for marginalized individuals at risk for dental disease. Oralytics incorporates an online reinforcement learning algorithm to determine optimal times to deliver intervention prompts that encourage oral self-care behaviors. We have deployed Oralytics in a registered clinical trial. The deployment required careful design to manage challenges specific to the clinical trials setting in the U.S. In this paper, we (1) highlight key design decisions of the RL algorithm that address these challenges and (2) conduct a re-sampling analysis to evaluate algorithm design decisions. A second phase (randomized control trial) of Oralytics is planned to start in spring 2025.

Understanding the Relationship between Prompts and Response Uncertainty in Large Language Models

Large language models (LLMs) are widely used in decision-making, but their reliability, especially in critical tasks like healthcare, is not well-established. Therefore, understanding how LLMs reason and make decisions is crucial for their safe deployment. This paper investigates how the uncertainty of responses generated by LLMs relates to the information provided in the input prompt. Leveraging the insight that LLMs learn to infer latent concepts during pretraining, we propose a prompt-response concept model that explains how LLMs generate responses and helps understand the relationship between prompts and response uncertainty. We show that the uncertainty decreases as the prompt's informativeness increases, similar to epistemic uncertainty. Our detailed experimental results on real datasets validate our proposed model.

Towards Integrating Personal Knowledge into Test-Time Predictions

Machine learning (ML) models can make decisions based on large amounts of data, but they can be missing personal knowledge available to human users about whom predictions are made. For example, a model trained to predict psychiatric outcomes may know nothing about a patient's social support system, and social support may look different for different patients. In this work, we introduce the problem of human feature integration, which provides a way to incorporate important personal-knowledge from users without domain expertise into ML predictions. We characterize this problem through illustrative user stories and comparisons to existing approaches; we formally describe this problem in a way that paves the ground for future technical solutions; and we provide a proof-of-concept study of a simple version of a solution to this problem in a semi-realistic setting.

A Sim2Real Approach for Identifying Task-Relevant Properties in Interpretable Machine Learning

Existing user studies suggest that different tasks may require explanations with different properties. However, user studies are expensive. In this paper, we introduce a generalizable, cost-effective method for identifying task-relevant explanation properties in silico, which can guide the design of more expensive user studies. We use our approach to identify relevant proxies for three example tasks and validate our simulation with real user studies.