Open source software is the best path to clinical translation

Slides from a debate at ICCR 2024 on whether open source or not is the way to go for the radiology community (and to a greater extent clinical decision making).

This slide deck makes plea for open source in research to share idea, and in technological innovation, to build the commons that we need for a shared and balanced future.

Transcript

1. Open source software is the best path to clinical translation Ga¨ el Varoquaux Sharing is caring
2. For academic research As a research enabler - Sharing code for reproducibility - To enable sharing of ideas Not a business plan Most of it will die, that’s fine better open source that dies than closed source that dies G Varoquaux 1
3. Open Innovation Disassembling to understand Reusing parts in surprising ways Enabling education G Varoquaux 2
4. Openness for trust & control Health = Private, sensitive data Own the technological stack Health = High-stake decisions Inspecting the decision-making G Varoquaux 3
5. The lure of software profits Software seldom makes money by itself Network effects Platform business Scale economies Most software never makes it G Varoquaux 4
6. Software = capture economy Once you become dependent on software the vendor milks you The old game of vendor lock in G Varoquaux 5
7. The unsustainability insurance Research seldom creates products so let’s be open source Not disenfranchise the stakeholders We are researchers, closed source kills us long term G Varoquaux 6
8. The long haul Long term strategy for open source A strategy of commons Sharing the common cost - Much software is infrastructure - It needs to be a common Sustainable software business dilute costs via open source G Varoquaux 7
9. Communities Two kind of open source Open as disclosure & transparency Community-driven shared objects Commons Complementary benefits to the field G Varoquaux 8
10. Open source is the game that gives us a shared benefit as opposed to a bet on an individual win G Varoquaux 9
11. Messy, imperfect But can be beautiful Organic But requires process open source should not mean amateur Many failures, granted True also of closed-source (winners curse) G Varoquaux 10
12. Simple is beautiful But the demands of the real world... - Feature creep - Product vision Not a strength of “design by comittee” Software is about managing complexity G Varoquaux 11
13. Closed does not make safe “Many eyes make bugs shallow” Better a known bug than an unknown one Battle of narrative More scrutiny on open = more criticism log4j failure: a testimonial to open source adoption G Varoquaux 12
14. Maintenance To fix bug To adapt to a changing reality touch screens, GPUs, AI, data integration Back to process and the need for scrutiny Due diligence Easier with open liability & competition are drivers G Varoquaux 13
15. Supply chain Software does not sit in vaccum But builds on shoulder of giants linux, python, pytorch G Varoquaux 14
16. Open standards Phasing out obsolete systems Avoiding lock in The battle against standards is ugly Counter narrative: Go fast alone G Varoquaux 15
17. Data is the new oil The era of AI A trained model is tied legally to the data it was trained on The capture game is moving to a new field Privacy at tension with openess G Varoquaux 16
18. People technology is a social endeavor Data, software the endgame is sharing effort and distributing control Challenge: aligning individuals IT manufactory No scarcity economy G Varoquaux 17
19. Open source is the long run imperfect, but enables anyone to improve G Varoquaux 18