Cognitive Biases contribute significantly to diagnostic and treatment errors. Physicians are constantly concerned with gathering and interpreting evidence, taking action and evaluating decisions. One of the most critical aspects for Radiation Oncology doctors is delineation. This process involves accurately outlining the target tumors and identifying the organs at risk (OARs) to create effective radiation therapy plans. This work is fundamental in achieving the delicate balance between effectively treating the cancer and preserving the patient's quality of life by protecting vital organs and minimizing side effects. To make such a decision in the UCSD radiation oncology department, the doctors rely on two key factors: 1) the imaging data with AI detection around the tumor and organs, and 2) their own personal knowledge and experience. Drawing from previous cases they have handled, how different tumors behave, and how they appear on imaging scans. Steenbakker et al. showed that there were significant differences in the delineation styles among radiation oncologists, indicating variability in how they defined the Gross Tumor Volume (GTV) for lung cancer patients [1]. This reliance on initial data and personal expertise can make them susceptible to anchoring bias. Anchoring bias occurs when decision-makers fixate on an initial piece of information, limiting the exploration of alternative hypotheses and potentially impacting the accuracy and effectiveness of the treatment plan.
To mitigate this bias, Lighthall et al. suggested emphasizing how (inputs) findings could also support alternative hypotheses [2]. In our design, we aim to use this approach to present multiple perspectives. This could be done by showing input attributions for multiple outcomes. By observing how these attributions differ across different hypotheses, doctors may be able to identify alternative diagnoses. Additionally, Lighthall et al. also suggested employing Klein's premortem prospective hindsight exercise, in which decision-makers assume their primary hypothesis turns out to be incorrect and must identify the reasons why [3]. This process can be aided by creating counterfactual explanations using rule-based methods through explainable AI models like Anchor LIME or LORE to determine which input features, if slightly altered, could result in different outcomes. This approach encourages doctors to consider a wider range of possibilities and reduces the likelihood of anchoring bias, ultimately enhancing the quality and precision of radiation therapy plans.
Key features:
Present input attributions.
Creating counterfactual explanations
Research Interest: AI safety and bias through mitigation and explainability
Mail: aalessa@ucsd.edu
Research Interest: Creating GenAI-integrated user-friendly interfaces for both the patient and professionals for Personalized Patient Care
Mail: arsharma@ucsd.edu