What is Interpretable? Using Machine Learning to Design Interpretable Decision-Support Systems

Recent efforts in Machine Learning (ML) interpretability have focused on creating methods for explaining black-box ML models. However, these methods rely on the assumption that simple approximations, such as linear models or decision-trees, are inherently human-interpretable, which has not been empirically tested. Additionally, past efforts have focused exclusively on comprehension, neglecting to explore the trust component necessary to convince non-technical experts, such as clinicians, to utilize ML models in practice. In this paper, we posit that reinforcement learning (RL) can be used to learn what is interpretable to different users and, consequently, build their trust in ML models. To validate this idea, we first train a neural network to provide risk assessments for heart failure patients. We then design a RL-based clinical decision-support system (DSS) around the neural network model, which can learn from its interactions with users. We conduct an experiment involving a diverse set of clinicians from multiple institutions in three different countries. Our results demonstrate that ML experts cannot accurately predict which system outputs will maximize clinicians' confidence in the underlying neural network model, and suggest additional findings that have broad implications to the future of research into ML interpretability and the use of ML in medicine.