  The rising popularity of artificial intelligence in healthcare is
highlighting the problem that a computational model achieving super-human
clinical performance at its training sites may perform substantially worse at
new sites. In this perspective, we present common sources for this failure to
transport, which we divide into sources under the control of the experimenter
and sources inherent to the clinical data-generating process. Of the inherent
sources we look a little deeper into site-specific clinical practices that can
affect the data distribution, and propose a potential solution intended to
isolate the imprint of those practices on the data from the patterns of disease
cause and effect that are the usual target of probabilistic clinical models.
