Abstract
The use of Artificial Intelligence (AI), Machine Learning (ML) and advanced analytics can yield important contributions to our understanding of how current systems and practices contribute to health disparities. They can also inform the development of equitable interventions, policies and decision-making in clinical care. This can only happen if we understand and address the biases in our healthcare system today, and how they are reflected in the data we use to develop and train AI systems. In this chapter, we will provide an overview of healthcare data sources and describe the ways in which the different types of data can be biased. We will discuss the impact of biased data, citing specific examples of how biased data has led to erroneous results or decisions, with particular focus on health equity and disparities. We will then describe strategies and techniques to both improve data prospectively, and to mitigate biases in how we use and interpret existing data to inform decision-making in healthcare.
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References
Schulman KA, Berlin JA, Harless W, Kerner JF, Sistrunk S, Gersh BJ, et al. The effect of race and sex on physicians’ recommendations for cardiac catheterization. N Engl J Med. 1999;340(8):618–26.
Institute of Medicine Committee on U, Eliminating R, Ethnic Disparities in Health C, Smedley BD, Stith AY, Nelson AR. Unequal treatment: confronting racial and ethnic disparities in health care. Washington, DC: National Academies Press; 2003.
Marcelin JR, Siraj DS, Victor R, Kotadia S, Maldonado YA. The impact of unconscious bias in healthcare: how to recognize and mitigate it. J Infect Dis. 2019;220(220 Suppl 2):S62–73.
Freedman LS, Simon R, Foulkes MA, Friedman L, Geller NL, Gordon DJ, et al. Inclusion of women and minorities in clinical trials and the NIH Revitalization Act of 1993--the perspective of NIH clinical trialists. Control Clin Trials. 1995;16(5):277–85; discussion 86–9, 93–309.
Devlin A, Gonzalez E, Ramsey F, Esnaola N, Fisher S. The effect of discrimination on likelihood of participation in a clinical trial. J Racial Ethn Health Disparities. 2020;7(6):1124–9.
Obermeyer Z, Powers B, Vogeli C, Mullainathan S. Dissecting racial bias in an algorithm used to manage the health of populations. Science. 2019;366(6464):447–53.
Mahmood SS, Levy D, Vasan RS, Wang TJ. The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective. Lancet. 2014;383(9921):999–1008.
Splansky GL, Corey D, Yang Q, Atwood LD, Cupples LA, Benjamin EJ, et al. The Third Generation Cohort of the National Heart, Lung, and Blood Institute’s Framingham Heart Study: design, recruitment, and initial examination. Am J Epidemiol. 2007;165(11):1328–35.
Gijsberts CM, Groenewegen KA, Hoefer IE, Eijkemans MJ, Asselbergs FW, Anderson TJ, et al. Race/ethnic differences in the associations of the Framingham risk factors with carotid IMT and cardiovascular events. PLoS One. 2015;10(7):e0132321.
Vyas DA, Eisenstein LG, Jones DS. Hidden in plain sight - reconsidering the use of race correction in clinical algorithms. N Engl J Med. 2020;383(9):874–82.
Ntoutsi E, Fafalios P, Gadiraju U, Iosifidis V, Nejdl W, Vidal ME, et al. Bias in data‐driven artificial intelligence systems—an introductory survey. Wiley Interdiscipl Rev Data Min Knowl Discov. 2020;10(3):e1356.
FitzGerald C, Hurst S. Implicit bias in healthcare professionals: a systematic review. BMC Med Ethics. 2017;18(1):19.
Leavy S, O’Sullivan B, Siapera E. Data, power and bias in artificial intelligence. arXiv. 2020:200807341.
Challen R, Denny J, Pitt M, Gompels L, Edwards T, Tsaneva-Atanasova K. Artificial intelligence, bias and clinical safety. BMJ Qual Saf. 2019;28(3):231–7.
Parikh RB, Teeple S, Navathe AS. Addressing bias in artificial intelligence in health care. JAMA. 2019;322:2377.
Lee CS, Lee AY. Clinical applications of continual learning machine learning. Lancet Digit Health. 2020;2(6):e279–e81.
Amodei D, Olah C, Steinhardt J, Christiano P, Schulman J, Mané D. Concrete problems in AI safety. arXiv. 2016:160606565.
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Koski, E., Saiz, F.S., Park, Y., South, B.R., Scheufele, E.L., Dankwa-Mullan, I. (2022). Addressing Health Equity: Sources, Impact and Mitigation of Biased Data. In: Kiel, J.M., Kim, G.R., Ball, M.J. (eds) Healthcare Information Management Systems. Health Informatics. Springer, Cham. https://doi.org/10.1007/978-3-031-07912-2_26
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