The third ML4H symposium was held in person on December 10, 2023, in New Orleans, Louisiana, USA. The symposium included research roundtable sessions to foster discussions between participants and senior researchers on timely and relevant topics for the \ac{ML4H} community. Encouraged by the successful virtual roundtables in the previous year, we organized eleven in-person roundtables and four virtual roundtables at ML4H 2022. The organization of the research roundtables at the conference involved 17 Senior Chairs and 19 Junior Chairs across 11 tables. Each roundtable session included invited senior chairs (with substantial experience in the field), junior chairs (responsible for facilitating the discussion), and attendees from diverse backgrounds with interest in the session's topic. Herein we detail the organization process and compile takeaways from these roundtable discussions, including recent advances, applications, and open challenges for each topic. We conclude with a summary and lessons learned across all roundtables. This document serves as a comprehensive review paper, summarizing the recent advancements in machine learning for healthcare as contributed by foremost researchers in the field.

Machine/deep learning (ML) has earned significant attention in the medical field, offering state-of-the-art solutions in enhancing disease diagnosis and treatment management and broadening healthcare accessibility. As AI systems gain traction in medical imaging diagnosis, there is a growing awareness about the imperative need for fairness guarantee in the systems' prediction and the investigation of latent biases which may emerge in intricate real-world scenarios [1, 7]. Unfortunately, AI models often inadvertently encode sensitive attributes (such as race and gender) when processing medical images, thereby influencing their discriminatory behaviour [6, 13, 2]. This issue becomes particularly noticeable when models are trained on data sourced from external repositories but are evaluated on data from internal ones. Therefore, while the diagnosis remains consistent across datasets, differences in protected attributes can lead to suboptimal model performance on the internal datasets [3].

Machine Learning Health Operations (MLHOps) is the combination of processes for reliable, efficient, usable, and ethical deployment and maintenance of machine learning models in healthcare settings. This paper provides both a survey of work in this area and guidelines for developers and clinicians to deploy and maintain their own models in clinical practice. We cover the foundational concepts of general machine learning operations, describe the initial setup of MLHOps pipelines (including data sources, preparation, engineering, and tools). We then describe long-term monitoring and updating (including data distribution shifts and model updating) and ethical considerations (including bias, fairness, interpretability, and privacy). This work therefore provides guidance across the full pipeline of MLHOps from conception to initial and ongoing deployment.

Clinical notes are becoming an increasingly important data source for machine learning (ML) applications in healthcare. Prior research has shown that deploying ML models can perpetuate existing biases against racial minorities, as bias can be implicitly embedded in data. In this study, we investigate the level of implicit race information available to ML models and human experts and the implications of model-detectable differences in clinical notes. Our work makes three key contributions. First, we find that models can identify patient self-reported race from clinical notes even when the notes are stripped of explicit indicators of race. Second, we determine that human experts are not able to accurately predict patient race from the same redacted clinical notes. Finally, we demonstrate the potential harm of this implicit information in a simulation study, and show that models trained on these race-redacted clinical notes can still perpetuate existing biases in clinical treatment decisions.

Robust machine learning relies on access to data that can be used with standardized frameworks in important tasks and the ability to develop models whose performance can be reasonably reproduced. In machine learning for healthcare, the community faces reproducibility challenges due to a lack of publicly accessible data and a lack of standardized data processing frameworks. We present MIMIC-Extract, an open-source pipeline for transforming raw electronic health record (EHR) data for critical care patients contained in the publicly-available MIMIC-III database into dataframes that are directly usable in common machine learning pipelines. MIMIC-Extract addresses three primary challenges in making complex health records data accessible to the broader machine learning community. First, it provides standardized data processing functions, including unit conversion, outlier detection, and aggregating semantically equivalent features, thus accounting for duplication and reducing missingness. Second, it preserves the time series nature of clinical data and can be easily integrated into clinically actionable prediction tasks in machine learning for health. Finally, it is highly extensible so that other researchers with related questions can easily use the same pipeline. We demonstrate the utility of this pipeline by showcasing several benchmark tasks and baseline results. These authors has an equal contribution, and should be considered co-first authors.