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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>The Challenge of Imputation in Explainable Artificial Intelligence Models</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Muhammad Aurangzeb Ahmad</string-name>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Carly Eckert M.D</string-name>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Ankur Teredesai</string-name>
          <email>ankurg@kensci.com</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Department of Computer Science, University of Washington Tacoma</institution>
          ,
          <country country="US">USA</country>
        </aff>
      </contrib-group>
      <abstract>
        <p>Explainable models in Artificial Intelligence are often employed to ensure transparency and accountability of AI systems. The fidelity of the explanations are dependent upon the algorithms used as well as on the fidelity of the data. Many real world datasets have missing values that can greatly influence explanation fidelity. The standard way to deal with such scenarios is imputation. This can, however, lead to situations where the imputed values may correspond to a setting which refer to counterfactuals. Acting on explanations from AI models with imputed values may lead to unsafe outcomes. In this paper, we explore different settings where AI models with imputation can be problematic and describe ways to address such scenarios. Contact Author</p>
      </abstract>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>-</title>
      <p>Even though the field of Artificial Intelligence is more than
sixty years old, it is only in the last decade or so that AI
systems are being increasingly interwoven into the fabric of the
socio-technical apparatus of the society and are thus having
a massive impact on society. This increasing incorporation
of AI has led to increased calls for accountability and
regulation of AI systems [Gunning, 2017]. Model explanations
are considered to be one of the most important ways to
provide accountability of AI systems. The model explanations,
however, can only be as good as the data on which the
algorithms are based. This is where the issue of missing and
imputed data becomes pivotal for model explanations. In some
domains like healthcare, almost all datasets have missing
values [Cismondi et al., 2013]. As many applications of AI in
healthcare are patient-oriented, decisions that are informed
by AI and ML models can potentially have significant clinical
consequences. Additionally, the requirements for a
responsible and robust AI solution in critical domains like healthcare,
criminal justice system etc. require additional considerations
that affect safety and compliance with regulations [Ahmad et
al., 2018b].</p>
      <p>One of the main reasons why imputation is used in AI and
machine learning models is that it allows the use of all
available data for model building instead of restricting oneself to a
subset of completed records, likely achieve via deletion. The
net effect is that models built using imputed data often result
in better predictive performance. Consequently, imputation
may be necessary if performance is more important than
explainability. Even outside of data missingness, researchers
acknowledge that there is a trade-off between explainable AI
models and their predictive performance [Weller, 2017] i.e.,
in general the more explainable a model is the less
predictive power it will have and vice versa. Thus, Deep Learning
models, which are epitome of black box models, are
relatively opaque but models like linear regression models are
more straightforward to interpret. The choice of the
underlying algorithm for model explanation is often dependent upon
the risk involved [Ahmad et al., 2018b]. For example, in
a problem predicting the likely need for palliative care, the
physician must know why the prediction is being made since
the prediction may changes the plan of care for a patient. In
this scenario predictive performance could be sacrificed for
intelligibility of the prediction. On the other hand, if the
application is to predict the upcoming patient census in an
emergency department the ED charge nurse may be less concerned
with model explainability.</p>
      <p>Concerns regarding the safety of AI systems become
paramount when we consider that incorrect imputation can
lead to explanations that may not have fidelity with the
underlying phenomenon and thus may lead to potentially
harmful actions, especially in decision support systems.
Consequently, questions regarding imputation are of paramount
importance from a safety and even regulatory perspective in high
risk fields like healthcare, criminal justice system, and
elsewhere. In this paper we will explore multiple scenarios that
can arise when dealing with imputation in model
explanations in AI. To illustrate the problems with imputation, we
consider use cases in the healthcare domain using data from a
hospital system in the mid-Western United States consisting
of data from 76 thousand patients, similar but not identical to
the dataset used in [Ahmad et al., 2018a].
2</p>
    </sec>
    <sec id="sec-2">
      <title>Imputation with Unsafe Outcomes</title>
      <p>It is important to note that explainability is just one
mechanism to ensure safety of AI systems and to mitigate against
unwarranted and unforeseen outcomes. Optimizing for
explinability via post-hoc models while simultaneously
optimizing for performance via imputation may lead to unsafe
outcomes as we demonstrate with examples from healthcare
and the criminal justice system.
One of the main dangers for using imputed values for model
explanations is that the explanations that are produced may
in fact have factors which are absurd or do not make domain
sense. To illustrate, consider the following example based
off of the problem of predicting the length of stay of a
patient at a hospital at the time of admission. Suppose that a
black box model is used (e.g., Extreme Gradient Boosting) as
the underlying predictive model. One way to extract
explanations from this models is to use post-hoc models like LIME
[Ribeiro et al., 2016] or Shapley Values [Shapley, 1953]. To
illustrate such a case, consider the output for model
explanation in Table 1 for predicting length of stay in a hospital using
the LIME model. The Table gives the factor and its
associated value, as well as the relative importance of the factor for
the explanation and whether it was imputed or not. The third
most important factor, the albumin level which refers to a lab
test, is an imputed value.</p>
      <p>Suppose the end user for this system is a clinician who is
trying to understand why the predictions are being made. To
get the full context she looks at her patient’s lab results (e.g.,
a list of the most recent lab tests and results for the patient.)
She will observe a missing value for Albumin but when she
looks at the explanation for the predictions and sees the lab
value for a lab which was not actually performed. The
problem with this scenario is that it could cast doubt on the
entire machine learning solution in the mind of the user since
the explanation for the prediction is at odds with the patient
history. Consider the alternative ways in which this scenario
can play out e.g., if the explanation for the prediction is that
the patient has a low readmission risk due to a low Troponin.
Troponin refers to a group of proteins found in skeletal and
heart muscle fibers that are responsible for regulating
muscular contraction [Ebashi et al., 1971]. However if Troponin has
not been evaluated, the physician may overlook that fact and
assume that an acute coronary event has already been ruled
out. However if the acute coronary event is indeed the real
reason for the patient is at risk then it is may lead to a
catastrophic outcome.</p>
      <p>Additionally imputing from a biased population
(hospitalized patients, for example) does not give one a true
representation of the value in a patient without pathology e.g.,
Troponin is only measured in people with an expected heart
attack or other acute cardiac issue. Therefore, the distribution
of values for Troponin does not represent that of the
nondiseased population. If a 20 year old is in the Emergency
Department for abdominal pain from appendicitis, one should
not impute a Troponin. What this example illustrates is that
in some contexts there is additional context which may not
be captured by data and imputing without domain knowledge
can be potentially hazardous.</p>
      <sec id="sec-2-1">
        <title>Feature</title>
        <p>Readmits last year
Creatinine Level
Albumin Level
Avg. Cigarettes/week
Systolic BP</p>
      </sec>
      <sec id="sec-2-2">
        <title>2.2 Use Case: Imputation in Criminal Justice</title>
      </sec>
      <sec id="sec-2-3">
        <title>System</title>
        <p>Another use case where imputation can lead to adverse
consequences is in the criminal justice system. If the prediction
task is to predict if the person is likely to re-offend or not,
then imputing values may lead to scenarios where the person
is deemed low risk because variables related to the person’s
risk profile are imputed based on people who are similar to
him in the larger population. The problem with this approach
using imputation is that if the sample is biased against
minority populations then imputation may always leads to
imputing negative tendencies and thus higher risk scores for the
minority population. This may happen even if demographic
features are not used in model building [Berk et al., 2018]
and because such factors are not used they will also not show
up as explanation factors. The end user will only see that the
person is a high risk because of certain, possibly violent,
tendencies or past history. If the imputed nature of such
explanations is not highlighted then this is likely to lead to faulty
recommendations and even wrongfully long sentences.
3</p>
      </sec>
    </sec>
    <sec id="sec-3">
      <title>Alternates to Imputation in Model</title>
    </sec>
    <sec id="sec-4">
      <title>Explanations</title>
      <p>Since model performance is a requirement in most machine
learning applications and explanation fidelity is needed, it is
important to consider alternatives to imputation. One way to
address the problem of missing values in some domains is
to use indicator variables because the presence and absence
of certain variable is still useful information. In Electronic
Health Records (EHR) datasets majority of the labs and
vitals are missing for most patients because testing for all labs
is unnecessary and thus the labs were never ordered. Most
machine learning predictive models infer the missing values
via imputation. If a result exists for a lab then that implies
that the ordering clinician deemed it necessary. Therefore, the
fact that the lab was ordered is itself useful information. We
propose that this information can be incorporated in machine
learning models in at least two ways. In the first scheme,
indicator variables for features like labs and vitals can be used.
Instead of the original values for the variables we record their
presence and absence as follows:
f (x) =
0; if x = null
1; otherwise
(1)
The alternate method is to use central values i.e., average,
median, truncated average etc. or central values by cohort for
variables like labs and vitals as follows:</p>
      <p>norm(x); if x = null
f (x) = (2)
x; otherwise</p>
      <sec id="sec-4-1">
        <title>Model</title>
        <p>Model with no Missing Variables
Model with MICE Imputation
Model with Indicator Variables
Model with Averages Imputed</p>
        <p>It should be noted that even though one can use imputed
variables instead of the corresponding variable with the actual
and missing values, in most cases the expected performance
of a model based on the indicator variables would be less as
compared to a model with imputed values. Consider Decision
Trees where the split of the decision tree branch needs to be
decided for a variable in integer space e.g., age. A popular
scheme to do this is to consider the midpoints between actual
data points and determine which splits give the best
information gain or other information theoretic criteria.</p>
        <p>Assuming that most variable spaces will be non-binary
spaces, the split that one gets from the indicator variables
will be different since the loss of entropy given by the
equation would be different. In other words the models which
are created from the imputed variables vs. the indicator
variables would be different. To illustrate this, we build multiple
prediction models on the mid-Western EHR data described
above. The results of prediction for the models are given in
Table 2. The model with no missing values refers to a model
that was built with only using variables with no missing
values. We note that even for the model which used variables
with missing values, we did not use a variable where more
than fifty percent of the values were missing. Since the space
of such variables is much smaller as compared to the space
considered for all the variables, the performance of the
models is quite mediocre i.e., an MAE of 4.09 days. The results
for the model with a sophisticated imputation technique like
MICE are quite good with an MAE of 2.08 days and that for
the model with indicator variables is 2.46 days.</p>
        <p>Lastly, we also tried model building with average values
and the results are better than what we get for indicator
variables model but with the caveat that these values do not
correspond to anything that was measured but rather the values are
inferred for normalcy. While the indicator variables models
is not as good as the imputation model, it may still be
sufficiently good to be used in a production setting. The added
advantage of using such a model would be that the model
explanations would actually correspond to how the data is i.e.,
indicate the presence or absence of a variable.
4</p>
      </sec>
    </sec>
    <sec id="sec-5">
      <title>Explanability vs. Types of Data Missingness</title>
      <p>All imputation methods add bias to the data which in turn
affects the fidelity of the model built based on the imputed
data. This implies that model fidelity is dependent upon the
nature of the missing data and the imputation technique. Data
can be, Missing at random, not missing at random and
completely missing at random [Little and Rubin, 2019]. Consider
how each of these missingness types affect model
explanations: If the data is missing completing at random (MCAR)
then even though imputation adds bias to the data, the
introduced bias would be local i.e., at the instance level and
not global since the data is not systematically missing. On
the other hand, if the data is missing at random (MAR) then
it means that the missing data is at least partially dependent
upon other variables in the data e.g., in a survey people who
are in the service sector may be less likely to report their
income, clinicians may not order certain labs to be tested if they
think that the patient is less likely to have certain conditions.
Imputing in such cases, add bias to the data at the global level.</p>
      <p>Imputation for data that is missing at random can be done
by employing domain knowledge or some other known
aspect of data e.g., expected values for populations with normal
characteristics may be imputed for some laboratory tests if
the patients do not have certain conditions. Lastly, if the data
is not missing at random (NAMR) then sophisticated
statistical methods like MICE, 3D-MICE are often used used for
imputation. MICE or multiple imputation by chained
equations [Azur et al., 2011] is a method where each missing
variable is imputed by a separate model but it maintains
consistency between imputations by means of passive imputation. It
should be noted that however, all imputation methods
introduce biases and studies have shown that imputed values can
be wildly off from real values [Luo et al., 2017]. If the values
are off then the explanations will be incorrect. Thus,
explanations for AI models are less likely to be off in case of the data
missingness is because of MAR or MCAR but imputation for
NMAR data could occasionally lead to explanations that may
not correspond to how the model actually works. We address
these and other concerns in the section on operationalization
of explanations.</p>
      <p>Implementations of tree based models like XGBoost
handle missing values by having a default direction for nodes
with missing values in the current instance set [Chen and
Guestrin, 2016]. The direction of the missing data is thus
used as a proxy of data missingness. Such implementations
of tree based algorithms minimize error loss in the training
phase. However this also means that if the distribution of
missing values in the test set is different from that of the
training set then the performance of the predictive models will
suffer and consequently the quality of explanations generated by
the models would also degrade.
5</p>
    </sec>
    <sec id="sec-6">
      <title>Operationalizing Explanations with</title>
    </sec>
    <sec id="sec-7">
      <title>Imputation</title>
      <p>An important axis of accountability of Artificial Intelligence
systems is Fairness. There are multiple notions of what
constitutes fairness in machine learning [Srivastava et al., 2019],
to illustrate the effect of imputation on fairness and
explainability we focus on group level notions of fairness. A system
that is fair need not be explainable if the underlying algorithm
can ensure that the various groups of interest are being scored
in a fair manner even when the model is blackbox.
Requiring the model to be explainable and interpretable may require
it impute values about groups which could render the model
unfair since imputed values can add bias against certain
protected groups e.g., ethnicity, race, gender etc. The choice of
the trade-off should be made with respect to the use case and
the application domain.</p>
      <p>It has been noted that generating and operationalizing
explanations is not strictly a machine learning problem [Weller,
2017]. The same machine learning model may be used to
generate disparate explanations if the use case or the end users
are different [Ahmad et al., 2018b]. The risk profile of the end
user determines how explanations should be operationalized.
If the use of explainable models is an absolute requirement
in a setting where there are a large number of missing values
then appropriate disclaims regarding data missing and
imputation should be given to the end user. Even with such
messaging it is still possible that automation bias can creep in and
lead to unsafe recommendations and outcomes [Mullainathan
and Obermeyer, 2017]. Additionally, imputation of missing
values can lead to models which are unfair and thus require
special attention [Mart´ınez-Plumed et al., 2019].
6</p>
    </sec>
    <sec id="sec-8">
      <title>Conclusion</title>
      <p>In this paper we have highlighted a number of issues related to
extracting explanations from AI and machine learning
models that use imputation of missing data. If such issues are not
surfaced to the end user then acting upon explanations from
such models can lead to dire consequence in terms of human
safety and well being. The case of incorrect explanations in
the healthcare domain is especially acute. At the minimum
use of explanations at the local instance level should be
accompanied by appropriate disclaimers and end users should
be properly educated about the potential hazards of incorrect
explanations. The other alternative is to take an
engineering approach to explanations and assume that assurance of
AI systems takes precedence over explainability. Just as one’s
choice of algorithm for prediction problems needs to take into
account the risk profile of the prediction, the same should also
apply for imputation.</p>
    </sec>
  </body>
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