From Data-Driven to Purpose-Driven Artificial Intelligence: Systems Thinking for Data-Analytic Automation of Patient Care

In this work, we reflect on the data-driven modeling paradigm that is gaining ground in AI-driven automation of patient care. We argue that the repurposing of existing real-world patient datasets for machine learning may not always represent an optimal approach to model development as it could lead to undesirable outcomes in patient care. We reflect on the history of data analysis to explain how the data-driven paradigm rose to popularity, and we envision ways in which systems thinking and clinical domain theory could complement the existing model development approaches in reaching human-centric outcomes. We call for a purpose-driven machine learning paradigm that is grounded in clinical theory and the sociotechnical realities of real-world operational contexts. We argue that understanding the utility of existing patient datasets requires looking in two directions: upstream towards the data generation, and downstream towards the automation objectives. This purpose-driven perspective to AI system development opens up new methodological opportunities and holds promise for AI automation of patient care.

AI Alignment through Reinforcement Learning from Human Feedback? Contradictions and Limitations

This paper critically evaluates the attempts to align Artificial Intelligence (AI) systems, especially Large Language Models (LLMs), with human values and intentions through Reinforcement Learning from Feedback (RLxF) methods, involving either human feedback (RLHF) or AI feedback (RLAIF). Specifically, we show the shortcomings of the broadly pursued alignment goals of honesty, harmlessness, and helpfulness. Through a multidisciplinary sociotechnical critique, we examine both the theoretical underpinnings and practical implementations of RLxF techniques, revealing significant limitations in their approach to capturing the complexities of human ethics and contributing to AI safety. We highlight tensions and contradictions inherent in the goals of RLxF. In addition, we discuss ethically-relevant issues that tend to be neglected in discussions about alignment and RLxF, among which the trade-offs between user-friendliness and deception, flexibility and interpretability, and system safety. We conclude by urging researchers and practitioners alike to critically assess the sociotechnical ramifications of RLxF, advocating for a more nuanced and reflective approach to its application in AI development.