Big data and machine learning can usher in a new era of policymaking – Harvard Kennedy School

Q: What are the challenges to undertaking data analytical research? And where have these modes of analysis been successful?

The challenges are many, especially when you want to make a meaningful impact in one of the most complex sectorsthe health care sector. The health care sector involves a variety of stakeholders, especially in the United States, where health care is extremely decentralized yet highly regulated, for example in the areas of data collections and data use. Analytics-based solutions that can help one part of this sector might harm other parts, making finding globally optimal solutions in this sector extremely difficult. Therefore, finding data-driven approaches that can have public impact is not a walk in the park.

Then there are various challenges in implementation. In my lab, we can design advanced machine learning and AI algorithms that have outstanding performance. But if they are not implemented in practice, or if the recommendations they provide are not followed, they wont have any tangible impact.

In some of our recent experiments, for example, we found that the algorithms we had designed outperformed expert physicians in one of the leading U.S. hospitals. Interestingly, when we provided physicians with our algorithmic-based recommendations, they did not put much weight on the advice they got from the algorithms, and ignored it when treating patients, although they knew the algorithm most likely outperforms them.

We then studied ways of removing this obstacle. We found that combining human expertise with the recommendations provided by algorithms not only made it more likely for the physicians to put more weight on the algorithms advice, but also synthesized recommendations that are superior to both the best algorithms and the human experts.

We have also observed similar challenges at the policy level. For example, we have developed advanced algorithms trained on large-scale data that could help the Centers for Disease Control and Prevention improve its opioid-related policies. The opioid epidemic caused more than 556,000 deaths in the United States between 2000 and 2020, and yet the authorities still do not have a complete understanding of what can be done to effectively control this deadly epidemic. Our algorithms have produced recommendations we believe are superior to the CDCs. But, again, a significant challenge is to make sure CDC and other authorities listen to these superior recommendations.

I do not want to imply that policymakers or other authorities are always against these algorithm-driven solutionssome are more eager than othersbut I believe the helpfulness of algorithms is consistently underrated and often ignored in the practice.

Q: How do you think about the role of oversight and regulation in this field of new technologies and data analytical models?

Imposing appropriate regulations is important. There is, however, a fine line: while new tools and advancements should be guarded against misuses, the regulations should not block these tools from reaching their full potential.

As an example, in a paper that we published in the National Academy of Medicine in 2021, we discussed that the use of mobile health (mHealth) interventions (mainly enabled through advanced algorithms and smart devices) have been rapidly increasing worldwide as health care providers, industry, and governments seek more efficient ways of delivering health care. Despite the technological advances, increasingly widespread adoption, and endorsements from leading voices from the medical, government, financial, and technology sectors, these technologies have not reached their full potential.

Part of the reason is that there are scientific challenges that need to be addressed. For example, as we discuss in our paper, mHealth technologies need to make use of more advanced algorithms and statistical experimental designs in deciding how best to adapt the content and delivery timing of a treatment to the users current context.

However, various regulatory challenges remainsuch as how best to protect user data. The Food and Drug Administration in a 2019 statement encouraged the development of mobile medical apps (MMAs) that improve health care but also emphasized its public health responsibility to oversee the safety and effectiveness of medical devicesincluding mobile medical apps. Balancing between encouraging new developments and ensuring that such developments abide by the well-known principle of do no harm is not an easy regulatory task.

At the end, what is needed are two-fold: (a) advancements in the underlying science, and (b) appropriately balanced regulations. If these are met, the possibilities for using advanced analytics science methods in solving our lingering societal problems are endless.

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Big data and machine learning can usher in a new era of policymaking - Harvard Kennedy School

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