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Leveraging imperfection with MEDLEY: a multi-model approach harnessing bias in medical AI
KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Biomedical Engineering and Health Systems, Ergonomics. Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden; KTH Royal Inst Technol, Sch Engn Sci Chem Biotechnol & Hlth, Dept Biomed Engn & Hlth Syst, Huddinge, Sweden; Karolinska Univ Hosp, Dept Clin Physiol, Stockholm, Sweden.ORCID iD: 0000-0001-7807-8682
Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.
Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden; Karolinska Univ Hosp, Dept Clin Physiol, Stockholm, Sweden; Univ Borås, Fac Text, Engn & Business Swedish Sch Text, Dept Text Technol, Borås, Sweden; Karolinska Univ Hosp, Dept Med Technol, Huddinge, Sweden.
2026 (English)In: Frontiers in Artificial Intelligence, E-ISSN 2624-8212, Vol. 9, article id 1701665Article in journal (Refereed) Published
Abstract [en]

Bias in medical artificial intelligence is conventionally viewed as a defect that requires elimination. However, human reasoning inherently incorporates biases shaped by education, culture, and experience, suggesting their presence may be inevitable and potentially valuable. We propose MEDLEY (Medical Ensemble Diagnostic system with Leveraged diversitY), a conceptual framework that orchestrates multiple AI models while preserving their diverse outputs rather than collapsing them into a consensus. Unlike traditional approaches that suppress disagreement, MEDLEY documents model-specific biases as potential strengths and treats hallucinations as provisional hypotheses for clinician verification. A proof-of-concept demonstrator for differential diagnosis was developed using over 30 large language models, preserving both consensus and minority views, rendering diagnostic uncertainty and latent biases transparent to support clinical oversight. While not yet a validated clinical tool, the demonstration illustrates how structured diversity can enhance medical reasoning under the supervision of clinicians. By reframing AI imperfection as a resource, MEDLEY offers a paradigm shift that opens new regulatory, ethical, and innovation pathways for developing trustworthy medical AI systems.

Place, publisher, year, edition, pages
Frontiers Media SA , 2026. Vol. 9, article id 1701665
Keywords [en]
AI regulation and governance, bias and fairness in AI, clinical decision support systems, diagnostic uncertainty, hallucination in large language models, human-in-the-loop AI, medical artificial intelligence, multi-model and ensemble learning
National Category
Computer Sciences
Identifiers
URN: urn:nbn:se:kth:diva-381874DOI: 10.3389/frai.2026.1701665ISI: 001717350300001PubMedID: 41858846Scopus ID: 2-s2.0-105033261448OAI: oai:DiVA.org:kth-381874DiVA, id: diva2:2062324
Note

QC 20260525

Available from: 2026-05-25 Created: 2026-05-25 Last updated: 2026-05-25Bibliographically approved

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Abtahi, Farhad

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