Equally impressive to their algorithm's performance is their effort to validate their technique with images from multiple institutions, addressing the challenge of generalizability that many machine learning–based diagnostics face.2 However, their work raises a fundamental question that should be considered as algorithms begin to perform tasks that could previously be performed only by clinicians. Is the algorithm being asked to perform exactly the same task as its human counterpart? This question has important implications for evaluating the relative performance of the algorithm as well as for assessing the clinical significance of its findings. Initially, it appears that the algorithm and the radiologists are given the same task: to identify ENE in lymph nodes from CT scans.