This report describes an accountability framework for artificial intelligence (AI). The framework is organized around four complementary principles and describes key practices for federal agencies and other entities that are considering and implementing AI systems. Each practice includes a set of questions for entities, auditors, and third-party assessors to consider, along with audit procedures and types of evidence for auditors and third-party assessors to collect.

Report discussing currently available machine learning (ML) medical diagnostic technologies for five selected diseases, emerging ML medical diagnostic technologies, challenges affecting the development and adoption of ML technologies for medical diagnosis, and policy options to help address challenges in the use of artificial intelligence (AI) technologies in health care (Part One). Part Two presents a framework for evaluating and promoting provider adoption of new AI-assisted diagnostic decision support tools (AI-DDS), centered on four integrated domains: 1) Reason to Use, 2) Means to Use, 3) Methods to Use, and 4) Desire to Use.

Report representing the results of a Comptroller General forum on recent developments in the area of artificial intelligence (AI) - and key implications regarding potential benefits, challenges to realizing these benefits, and resulting policy implications and research priorities.

Statement discussing the evolution of artificial intelligence (AI) over time, the potential future opportunities and risks of AI, and the future implications of AI on policies and research priorities.

Artificial intelligence and machine learning (AI/ML) is a set of technologies that includes automated systems able to perform tasks that normally require human intelligence, such as visual perception, speech recognition, and decision-making. AI/ML has promising applications in health care, including drug development. For example, it may have the potential to help identify new treatments, reduce failure rates in clinical trials, and generally result in a more efficient and effective drug development process. However, applying AI/ML technologies within the health care system also raises ethical, legal, economic, and social questions. GAO was asked to conduct a technology assessment on the use of AI technologies in drug development with an emphasis on foresight and policy implications. This report discusses (1) current and emerging AI technologies available for drug development and their potential benefits; (2) challenges to the development and adoption of these technologies; and (3) policy options to address challenges to the use of machine learning in drug development. -- from Foreword

Document summarizing deepfake technology and highlighting opportunities, challenges, and policy questions related to the development of this technology.

Border fencing is intended to benefit border security operations in various ways, according to officials from the U.S. Border Patrol (Border Patrol), which is within the Department of Homeland Security's (DHS) U.S. Customs and Border Protection (CBP). For example, according to officials, border fencing supports Border Patrol agents' ability to execute essential tasks, such as identifying illicit-cross border activities. CBP collects data that could help provide insight into how border fencing contributes to border security operations, including the location of illegal entries. However, CBP has not developed metrics that systematically use these, among other data it collects, to assess the contributions of border fencing to its mission. For example, CBP could potentially use these data to determine the extent to which border fencing diverts illegal entrants into more rural and remote environments, and border fencing's impact, if any, on apprehension rates over time. Developing metrics to assess the contributions of fencing to border security operations could better position CBP to make resource allocation decisions with the best information available to inform competing mission priorities and investments. CBP is taking a number of steps to sustain tactical infrastructure (TI) along the southwest border; however, it continues to face certain challenges in …

A letter report issued by the Government Accountability Office with an abstract that begins "Changes in patient demographics present unique challenges for VA in providing safe environments for all veterans treated in Department of Veterans Affairs (VA) facilities. GAO was asked to examine whether or not sexual assault incidents are fully reported and what factors may contribute to any observed underreporting, how facility staff determine sexual assault-related risks veterans may pose in residential and inpatient mental health settings, and precautions facilities take to prevent sexual assaults and other safety incidents. GAO reviewed relevant laws, VA policies, and sexual assault incident documentation from January 2007 through July 2010 provided by VA officials and the VA Office of the Inspector General (OIG). In addition, GAO visited and reviewed portions of selected veterans' medical records at five judgmentally selected VA medical facilities chosen to ensure the residential and inpatient mental health units at the facilities varied in size and complexity. Finally, GAO spoke with the four Veterans Integrated Service Networks (VISN) that oversee these VA medical facilities."

A letter report issued by the Government Accountability Office with an abstract that begins "The August 1, 2007, collapse of a Minnesota bridge raised nationwide questions about bridge safety and the U.S. Department of Transportation's (DOT) ability to prioritize resources for bridges. The Highway Bridge Program (HBP), the primary source of federal funding for bridges, provided over $4 billion to states in fiscal year 2007. This requested study examines (1) how the HBP addresses bridge conditions, (2) how states use HBP funds and select bridge projects for funding, (3) what data indicate about bridge conditions and the HBP's impact, and (4) the extent to which the HBP aligns with principles GAO developed, based on prior work and federal laws and regulations, for re-examining surface transportation programs. GAO reviewed program documents; analyzed bridge data; and met with transportation officials in states that have high levels of HBP funding and large bridge inventories, including California, Missouri, New York, Pennsylvania, Texas, and Washington."

A letter report issued by the Government Accountability Office with an abstract that begins "Members of Congress and state agencies have raised questions about complaints that some Medicare Advantage (MA) organizations and their agents inappropriately marketed their health plans to Medicare beneficiaries. Inappropriate marketing may include activities such as providing inaccurate information about covered benefits and conducting prohibited marketing practices. The Centers for Medicare & Medicaid Services (CMS) is responsible for oversight of MA organizations and their plans. The Government Accountability Office (GAO) was asked to examine (1) the extent to which CMS has taken compliance and enforcement actions, (2) how CMS has helped beneficiaries affected by inappropriate marketing and the problems beneficiaries have encountered, and (3) information CMS has about the extent of inappropriate marketing. To do this work, GAO reviewed relevant laws and policies; analyzed Medicare data on beneficiary complaints, compliance actions and enforcement actions; and interviewed officials from CMS and selected state departments of insurance, state health insurance assistance programs, and MA organizations."

A letter report issued by the Government Accountability Office with an abstract that begins "Institutions of higher education, including for-profit, nonprofit, and public schools, receive billions of dollars each year from the Department of Education (Education) to help students pay for school. In the 2009-2010 school year, Education provided $132 billion in grants and loans to students under federal student aid programs, up from $49 billion in the 2001-2002 school year. However, relatively little information is available about the quality of education being provided by these schools. Student characteristics are also important to consider when comparing educational outcomes at schools in different sectors (for-profit, nonprofit, and public). Measuring the quality of educational programs (i.e., how much knowledge or skill students gain) is difficult. Because few direct measures are available, indirect outcome measures, such as graduation and student loan default rates, are often used. Although no single outcome can be used to fully measure something as complex as educational quality, looking at multiple outcome measures (e.g., graduation rates, pass rates on licensing exams, employment outcomes, and student loan default rates) can shed light on the quality of education provided by schools. Available data indicate that for-profit schools enroll a higher proportion …

A letter report issued by the Government Accountability Office with an abstract that begins "From the passage of the homosexual conduct policy statute, in fiscal year 1994, through fiscal year 2003 the military services separated about 9,500 servicemembers for homosexual conduct. This represents about 0.40 percent of the 2.37 million members separated for all reasons during this period. Questions have been raised about the costs of separating servicemembers for homosexual conduct. Also, in the post-September 11th environment, there has been concern about the separation of servicemembers with critical occupations or important foreign language skills in, for example, Arabic. GAO was asked to determine (1) the military services' annual financial costs from fiscal year 1994 through fiscal year 2003 for certain activities associated with administering the Department of Defense's (DOD) policy on homosexual conduct--e.g., the recruitment and training of servicemembers to replace those separated under the homosexual conduct statute--and (2) the extent to which the policy has resulted in the separation of servicemembers with critical occupations and important foreign language skills. GAO provided DOD with a draft of this report for comment, and DOD provided additional information on separations for homosexual conduct compared with other unprogrammed separations."

A letter report issued by the Government Accountability Office with an abstract that begins "To provide safe and secure workplaces for overseas posts, the Department of State (State) has built 64 new embassy compounds (NEC) and other facilities since 1999, has 31 ongoing projects, and plans to build at least 90 more. In 2007, State reported the U.S. contractor pool for building NECs had reached its limit and proposed legislation to amend the criteria to qualify for NEC awards. GAO was asked to examine (1) how contractor participation in the NEC program changed in recent years, (2) the degree to which State assessed the need for and potential outcomes of its proposed amendment, (3) factors contractors consider when deciding to participate in the program, and (4) actions State has taken to address reported declines in contractor participation. GAO examined two indicators of contractor participation; reviewed State documents and proposed legislation; and interviewed State officials and U.S. firms that won NEC awards from 2001-2007."

A letter report issued by the Government Accountability Office with an abstract that begins "In recent years, nearly half of all annual apprehensions of illegal aliens along the entire Southwest border with Mexico have occurred along the Arizona border. Keeping illegal flows of people and drugs under control remains a top priority for the Department of Homeland Security's (DHS) U.S. Customs and Border Protection (CBP). In 2005, the Secure Border Initiative Network (SBInet) was conceived as a surveillance technology to create a "virtual fence" along the border. After spending nearly $1 billion, DHS deployed SBInet systems along 53 miles of Arizona's border that represent the highest risk for illegal entry. In January 2011, in response to concerns regarding SBInet's performance, cost, and schedule, DHS cancelled future procurements. CBP developed the Arizona Border Surveillance Technology Plan (Plan) for the remainder of the Arizona border. Funding for this Plan for fiscal year 2012 is $242 million. GAO was requested to assess the extent to which CBP (1) has the information needed to support and implement the Plan and (2) estimated life-cycle costs for future investments in accordance with best practices. GAO analyzed Plan documents and cost estimates, compared those estimates with best …

A letter report issued by the Government Accountability Office with an abstract that begins "The United States Marine Corps is facing a critical shortage of heavy-lift aircraft. In addition, current weapon systems are heavier than their predecessors, further challenging the Marine Corps's current CH-53E heavy-lift helicopters. To address the emerging heavy-lift requirements, the Marine Corps initiated the CH-53K Heavy Lift Replacement program, which has experienced significant cost increase and schedule delays since entering development in 2005. This report (1) determines how the CH-53K's estimates of cost, schedule, and quantity have changed since the program began development and the impact of these changes and (2) determines how the CH-53K's current acquisition strategy will meet current program targets as well as the warfighter's needs. To address these objectives, GAO analyzed the program's budget, schedules, acquisition reports, and other documents and interviewed officials from the program office, the prime contractor's office, the Marine Corps, the Defense Contract Management Agency, and the Office of the Secretary of Defense."

A letter report issued by the Government Accountability Office with an abstract that begins "The Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank Act) required GAO to report on the relative independence, effectiveness, and expertise of the inspectors general (IG) established by the IG Act of 1978, as amended (IG Act), including IGs appointed by the President with Senate confirmation and those appointed by their agency heads in designated federal entities (DFE). GAO was also required to report on the effect that provisions in the Dodd-Frank Act have on IG independence. The objectives of this report are to provide information as reported by the IGs on (1) the implementation of provisions intended to enhance their independence in the IG Reform Act of 2008 (Reform Act), the IG Act, and the Dodd-Frank Act; (2) their measures of effectiveness, including oversight of American Recovery and Reinvestment Act of 2009 (Recovery Act) funds; and (3) their expertise and qualifications in areas specified by the IG Act. GAO relied primarily on responses to its survey received from 62 IGs established by the IG Act. GAO also obtained information from the President's fiscal year 2011 budget, the IGs' annual report to the President for …

A letter report issued by the Government Accountability Office with an abstract that begins "The Army Materiel Command (AMC) is using the Logistics Modernization Program (LMP) Increment 1 to support its industrial operations, but additional development is necessary, according to the Army, because the current system does not support certain critical requirements, including enabling the Army to generate auditable financial statements by fiscal year 2017. Officials at the 14 AMC sites GAO visited stated that LMP provided the core functionality they needed to support their operations and that they are improving in their ability to use the system. Additionally, some sites have locally developed tools to augment LMP capabilities. Army officials stated that although LMP is functional, it currently does not support certain critical requirements that have emerged since its initial development, such as automatically tracking repair and manufacturing operations on the shop floor of depots and arsenals. In addition, according to Army officials, the current system will not enable the Army to generate auditable financial statements by 2017, the statutory deadline for this goal. Increment 2, which is estimated to cost $730 million through fiscal year 2026, is expected to address these shortcomings. The Army is in the process …

A letter report issued by the Government Accountability Office with an abstract that begins "This is the Spanish language highlights associated with GAO-10-91. Executive Order 13166 (August 11, 2000) directs each federal agency to improve access to federal programs and services for persons with limited English proficiency (LEP). Using guidance issued by DOJ, agencies are generally required to develop recipient guidance and/or an LEP plan outlining steps for ensuring that LEP persons can access federal services and programs. As requested, GAO (1) determined which agencies have completed their recipient guidance and LEP plan, (2) assessed the extent to which the selected agencies have implemented the Executive Order consistent with DOJ's guidance, and (3) examined DOJ's and the three selected agencies' efforts to enhance collaboration. GAO analyzed the Executive Order and agencies' recipient guidance and plans posted on LEP.gov; selected the IRS, FEMA, and SBA for this review because of the amount and significance of their interaction with LEP persons; and reviewed documentation of agencies' collaborative efforts to provide access to federal services. (Spanish Language Summary)"

A letter report issued by the Government Accountability Office with an abstract that begins "In early 2001, U.S. stock and option markets began quoting prices in decimal increments rather than fractions of a dollar. At the same time, the minimum price increment, or tick size, was reduced to a penny on the stock markets and to 10 cents and 5 cents on the option markets. Although many believe that decimal pricing has benefited small individual (retail) investors, concerns have been raised that the smaller tick sizes have made trading more challenging and costly for large institutional investors, including mutual funds and pension plans. In addition, there is concern that the financial livelihood of market intermediaries, such as the broker-dealers that trade on floor-based and electronic markets, has been negatively affected by the lower ticks, potentially altering the roles these firms play in the U.S. capital market. GAO assessed the effect of decimal pricing on retail and institutional investors and on market intermediaries."

A letter report issued by the Government Accountability Office with an abstract that begins "Today, and in the foreseeable future, military operations require U.S. personnel, in particular Army and Marine Corps ground forces, to communicate and interact with multinational partners and local populations. The committee report accompanying a proposed bill for the National Defense Authorization Act for Fiscal Year 2011 directed GAO to review several issues related to language and culture training for Army and Marine Corps general purpose forces. For this report, GAO evaluated (1) the extent to which the Army and Marine Corps had developed strategies with elements such as goals, funding priorities, and metrics to guide training approaches and investments that were aligned with Department of Defense (DOD) planning efforts and (2) DOD's approach for identifying training requirements for Army and Marine Corps forces that will deploy to the U.S. Central Command area of responsibility. To do so, GAO analyzed Army and Marine Corps strategies and training requirements and interviewed cognizant officials."

A letter report issued by the Government Accountability Office with an abstract that begins "The House Committee on Armed Services report that accompanies the National Defense Authorization Act of fiscal year 2006 directs GAO to review results of the military disability evaluation system. In response to this mandate, GAO determined: (1) how current DOD policies and guidance for disability determinations compare for the Army, Navy, and Air Force, and what policies are specific to reserve component members of the military; (2) what oversight and quality control mechanisms are in place at DOD and these three services of the military to ensure consistent and timely disability decisions for active and reserve component members; and (3) how disability decisions, ratings, and processing times compare for active and reserve component members of the Army, the largest branch of the service, and what factors might explain any differences."

A letter report issued by the Government Accountability Office with an abstract that begins "GAO has identified the Department of Defense's (DOD) management of its inventory as a high-risk area since 1990 due to ineffective and inefficient inventory systems and practices. Management of inventory acquisition lead times is important in maintaining cost-effective inventories, budgeting, and having material available when needed, as lead times are DOD's best estimate of when an item will be received. Under the Comptroller General's authority to conduct evaluations on his own initiative, GAO analyzed the extent to which (1) DOD's estimated lead times varied from actual lead times, and (2) current management actions and initiatives have reduced lead times as compared to past years. To address these objectives, GAO computed the difference between the components' actual and estimated lead times, and compared component initiatives to reduce lead times for 1994-2002 to 2002-2005."

A letter report issued by the Government Accountability Office with an abstract that begins "The biomedical research organizations of the Department of Defense (DOD) use a coordinated approach to plan combat casualty care research and development, but not all of DOD's nonmedical research organizations share information early in the research process. GAO has previously reported that federal agencies can enhance and sustain collaboration of efforts by using key practices, such as agreeing on roles and responsibilities and establishing the means to operate across organizational boundaries. In 2010, DOD established a planning committee to coordinate the efforts of organizations conducting combat casualty care research. The committee developed a draft charter in 2010 identifying members respective roles and responsibilities. DOD issued the final charter in early January 2013, while GAO was conducting its review. DOD also facilitated operation across organizational boundaries by colocating most of the organizations conducting combat casualty care research. However, DOD organizations that typically do not conduct biomedical research, such as the Army Research Laboratory, are not involved in DOD's efforts to coordinate this research. When these organizations conduct research relevant to combat casualty care they do not always share information with appropriate officials early in the research process, …

A letter report issued by the Government Accountability Office with an abstract that begins "The Centers for Medicare & Medicaid Services (CMS)--an agency within the Department of Health and Human Services (HHS)--and the Congress, through the Deficit Reduction Act of 2005 (DRA), recently acted to constrain spending on imaging services, one of the fastest growing set of services under Medicare Part B, which covers physician and other outpatient services. GAO was asked to provide information to help the Congress evaluate imaging services in Medicare. In this report, GAO provides information on (1) trends in Medicare spending on imaging services from 2000 through 2006, (2) the relationship between spending growth and the provision of imaging services in physicians' offices, and (3) imaging management practices used by private payers that may have lessons for Medicare. To do this work, GAO analyzed Medicare claims data from 2000 through 2006, interviewed private health care plans, and reviewed health services literature."