Do no harm: a roadmap for responsible machine learning for health care

Progress in ML for health care to date has been limited by the lack of well-defined questions and a dearth of annotated datasets. Many ML researchers remain focused on questions for which annotations are readily available, without necessarily questioning the clinical relevance of the problems and their solutions. For example, a popular benchmark challenge in the community focuses on predicting in-hospital mortality on the basis of data collected during the first 48 hours after admission to the intensive care unit4. Clearly annotated data are publicly available, and in recent years, performance on this task has approached an area under the curve (Box 1) of 0.9 (ref. However, assessing clinical utility requires careful evaluation against the scenario in which the model will be used.