The Stakes of Uncertainty: Developing and Integrating Machine Learning in Clinical Care

2018 EPIC Proceedings

17 Pages Posted: 1 Feb 2019

See all articles by Madeleine Clare Elish

Madeleine Clare Elish

Google Inc.; University of Oxford - Oxford Internet Institute

Date Written: October 11, 2018


The wide-spread deployment of machine learning tools within healthcare is on the horizon. However, the hype around “AI” tends to divert attention toward the spectacular, and away from the more mundane and ground- level aspects of new technologies that shape technological adoption and integration. This paper examines the development of a machine learning-driven sepsis risk detection tool in a hospital Emergency Department in order to interrogate the contingent and deeply contextual ways in which AI technologies are likely be adopted in healthcare. In particular, the paper bring into focus the epistemological implications of introducing a machine learning-driven tool into a clinical setting by analyzing shifting categories of trust, evidence, and authority. The paper further explores the conditions of certainty in the disciplinary contexts of data science and ethnography, and offers a potential reframing of the work of doing data science and machine learning as “computational ethnography” in order to surface potential pathways for developing effective, human-centered AI.

Keywords: AI, machine learning, deep learning, healthcare, sepsis, medicine, anthropology

Suggested Citation

Elish, Madeleine Clare, The Stakes of Uncertainty: Developing and Integrating Machine Learning in Clinical Care (October 11, 2018). 2018 EPIC Proceedings, Available at SSRN:

Madeleine Clare Elish (Contact Author)

Google Inc. ( email )

1600 Amphitheatre Parkway
Second Floor
Mountain View, CA 94043
United States

University of Oxford - Oxford Internet Institute ( email )

1 St. Giles
University of Oxford
Oxford OX1 3PG Oxfordshire, Oxfordshire OX1 3JS
United Kingdom

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