Chirag Nagpal

Chirag Nagpal

I am a Research Scientist with the Context in AI Research (CAIR) Team within Google Responsible AI. My interests are in building machine learning algorithms, tools, pipelines and software that augment decision making by being robust, fair and having broad practical utility across all domains of interest to Alphabet.

I received my PhD from the School of Computer Science at Carnegie Mellon, where I gained extensive experience in probabilistic inference and numerical optimization for semi-parametric graphical models with applications in patient risk stratification and treatment benefit assessment.

My graduate research has seen application in numerous patient risk prediction problems across multiple areas of healthcare [1] [2], has spun open source software [3] [4], and has been taught at graduate courses in MIT and Harvard [5].
Authored Publications
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    Preview abstract Large language models (LLMs) hold promise to serve complex health information needs but also have the potential to introduce harm and exacerbate health disparities. Reliably evaluating equity-related model failures is a critical step toward developing systems that promote health equity. We present resources and methodologies for surfacing biases with potential to precipitate equity-related harms in long-form, LLM-generated answers to medical questions and conduct a large-scale empirical case study with the Med-PaLM 2 LLM. Our contributions include a multifactorial framework for human assessment of LLM-generated answers for biases and EquityMedQA, a collection of seven datasets enriched for adversarial queries. Both our human assessment framework and our dataset design process are grounded in an iterative participatory approach and review of Med-PaLM 2 answers. Through our empirical study, we find that our approach surfaces biases that may be missed by narrower evaluation approaches. Our experience underscores the importance of using diverse assessment methodologies and involving raters of varying backgrounds and expertise. While our approach is not sufficient to holistically assess whether the deployment of an artificial intelligence (AI) system promotes equitable health outcomes, we hope that it can be leveraged and built upon toward a shared goal of LLMs that promote accessible and equitable healthcare. View details
    Preview abstract With growing machine learning (ML) and large language model applications in healthcare, there have been calls for fairness in ML to understand and mitigate ethical concerns these systems may pose. Fairness has implications for health in Africa, which already has inequitable power imbalances between the Global North and South. This paper seeks to explore fairness for global health, with Africa as a case study. We conduct a scoping review to propose fairness attributes for consideration in the African context and delineate where they may come into play in different ML-enabled medical modalities. We then conduct qualitative research studies with 625 general population study participants in 5 countries in Africa and 28 experts in ML, Health, and/or policy focussed on Africa to obtain feedback on the proposed attributes. We delve specifically into understanding the interplay between AI, health and colonialism. Our findings demonstrate that among experts there is a general mistrust that technologies that are solely developed by former colonizers can benefit Africans, and that associated resource constraints due to pre-existing economic and infrastructure inequities can be linked to colonialism. General population survey responses found about an average of 40% of people associate an undercurrent of colonialism to AI and this was most dominant amongst participants from South Africa. However the majority of the general population participants surveyed did not think there was a direct link between AI and colonialism.Colonial history, country of origin, National income level were specific axes of disparities that participants felt would cause an AI tool to be biased This work serves as a basis for policy development around Artificial Intelligence for health in Africa and can be expanded to other regions. View details
    Preview abstract With growing machine learning (ML) and large language model applications in healthcare, there have been calls for fairness in ML to understand and mitigate ethical concerns these systems may pose. Fairness has implications for health in Africa, which already has inequitable power imbalances between the Global North and South. This paper seeks to explore fairness for global health, with Africa as a case study. We conduct a scoping review to propose fairness attributes for consideration in the African context and delineate where they may come into play in different ML-enabled medical modalities. We then conduct qualitative research studies with 625 general population study participants in 5 countries in Africa and 28 experts in ML, Health, and/or policy focussed on Africa to obtain feedback on the proposed attributes. We delve specifically into understanding the interplay between AI, health and colonialism. Our findings demonstrate that among experts there is a general mistrust that technologies that are solely developed by former colonizers can benefit Africans, and that associated resource constraints due to pre-existing economic and infrastructure inequities can be linked to colonialism. General population survey responses found about an average of 40% of people associate an undercurrent of colonialism to AI and this was most dominant amongst participants from South Africa. However the majority of the general population participants surveyed did not think there was a direct link between AI and colonialism.Colonial history, country of origin, National income level were specific axes of disparities that participants felt would cause an AI tool to be biased This work serves as a basis for policy development around Artificial Intelligence for health in Africa and can be expanded to other regions. View details
    Deep Cox Mixtures for Survival Regression
    Steve Yadlowsky
    Proceedings of the 6th Machine Learning for Healthcare Conference, PMLR (2021), pp. 674-708
    Preview abstract Survival analysis is a challenging variation of regression modeling because of the presence of censoring, where the outcome measurement is only partially known, due to, for example, loss to follow up. Such problems come up frequently in medical applications, making survival analysis a key endeavor in biostatistics and machine learning for healthcare, with Cox regression models being amongst the most commonly employed models. We describe a new approach for survival analysis regression models, based on learning mixtures of Cox regressions to model individual survival distributions. We propose an approximation to the Expectation Maximization algorithm for this model that does hard assignments to mixture groups to make optimization efficient. In each group assignment, we fit the hazard ratios within each group using deep neural networks, and the baseline hazard for each mixture component non-parametrically. We perform experiments on multiple real world datasets, and look at the mortality rates of patients across ethnicity and gender. We emphasize the importance of calibration in healthcare settings and demonstrate that our approach outperforms classical and modern survival analysis baselines, both in terms of discriminative performance and calibration, with large gains in performance on the minority demographics. View details