Defining the undefinable: the black box problem in healthcare artificial intelligence.

The 'black box problem' is a long-standing talking point in debates about artificial intelligence (AI). This is a significant point of tension between ethicists, programmers, clinicians and anyone else working on developing AI for healthcare applications. However, the precise definition of these systems are often left undefined, vague, unclear or are assumed to be standardised within AI circles. This leads to situations where individuals working on AI talk over each other and has been invoked in numerous debates between opaque and explainable systems. This paper proposes a coherent and clear definition for the black box problem to assist in future discussions about AI in healthcare. This is accomplished by synthesising various definitions in the literature and examining several criteria that can be extrapolated from these definitions. © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.